Sexual Health,Discussed Openly.
Treated Seriously.
Discreet, evidence-based care for vaginal dryness, discomfort with intimacy, urinary symptoms, and changes in desire through midlife.
Genitourinary syndrome of menopause (GSM) affects most women after menopause, yet most never receive treatment — though dryness, painful intercourse, urinary symptoms, and low libido all respond to effective therapies.
Common. Treatable.
And Far Too Often
Suffered in Silence
These symptoms are among the most prevalent — and least discussed — consequences of hormonal change. Unlike hot flashes, GSM does not improve with time; without treatment, it typically progresses. Yet effective, well-studied therapies exist — and here, your symptoms will be believed, with nothing examined or prescribed without your full understanding and consent.
Care begins with a conversation that is unhurried, private, and free of judgment — considering every dimension:
- Vaginal dryness & irritation
- Pain or discomfort with intimacy
- Urinary urgency & recurrent UTIs
- Changes in desire & arousal
- Relationship & emotional context
- Pelvic floor function
Genitourinary Syndrome of Menopause
As estrogen declines, vaginal and urinary tissues become thinner, drier, and less elastic. The result — GSM — can include dryness, burning, irritation, discomfort with intercourse, urinary urgency, and more frequent urinary tract infections.
Because GSM is progressive rather than transient, early treatment matters. Evaluation at Mulberry includes a careful history and gentle examination to characterize your symptoms precisely and rule out other causes — so therapy targets the actual problem.
Painful Intercourse & Low Libido
Pain with intimacy is never something to simply accept — and it is rarely “just in your head.” Tissue changes, pelvic floor tension, hormonal shifts, and the anticipation of pain itself can each contribute, and each has a treatment path.
A lower level of desire is not automatically a disorder, and it warrants treatment only when it is distressing to you. When it is, the causes are multifactorial — hormones, sleep, mood, medications, relationship dynamics, and life stage all play roles. Dr. Nyein takes the time to understand your specific picture and builds a plan that addresses causes, including pelvic floor physical therapy referral and counseling partnerships when they help.
Evidence-Based Treatment Options
Effective options range from simple to prescription-strength: high-quality moisturizers and lubricants, low-dose vaginal estrogen in cream, tablet, or ring form, vaginal DHEA, and oral therapies where appropriate. Low-dose vaginal estrogen acts locally with minimal absorption and is among the best-studied treatments in menopausal medicine.
Treatment is matched to your symptoms, preferences, and medical history — and integrated with your broader hormonal care, so your whole plan works together rather than in fragments.
This Part of Your Health
Deserves Care Too
If dryness, discomfort, urinary symptoms, or changes in desire have affected your quality of life, effective treatment exists. Begin with a private, unhurried consultation with Dr. Nyein.