Investigations

Genitourinary symptoms are common in the menopause and do not routinely require further investigation unless:

• There are other concerning signs or symptoms that may warrant urgent referral (red flags).
• There are other signs that might suggest an alternative diagnosis (such as lichen sclerosus, infection or STI).
• Symptoms are persistent despite hormone replacement.

For more information, see NICE CKS guidance for:

• Assessment of vulval itching.
• Assessment of UTI.
• Suspected vaginal candidosis.
• Suspected bacterial vaginosis.
• Suspected chlamydia, gonorrhoea or genital herpes.