Do you offer remote check-ins or in-person only?
Do you offer remote check-ins or in-person only? We provide both. Many follow-ups for genitourinary syndrome of menopause (GSM) work well by phone or video, especially when reviewing moisturiser schedules, lubricant choices, or local vaginal oestrogen/DHEA technique. We’ll recommend in-person review for red flags, uncertain diagnoses, or when a pelvic/vulval exam, device-based session, or injectables are planned. Educational only. Results vary. Not a cure.
Detailed Medical Explanation
Do you offer remote check-ins or in-person only? Both options are available, and we’ll help you choose the format that fits your symptoms, safety, and goals. For many stages of genitourinary syndrome of menopause (GSM)—also called vaginal dryness/atrophy—remote reviews work well. That’s because early progress comes from foundations you can implement at home: a scheduled vaginal moisturiser (many prefer hyaluronic-acid gels), a generous, compatible personal lubricant (water-based for versatility and condom use; silicone-based for the longest glide on a tender vestibule; oil-based feels rich but may degrade latex condoms/toys), and accurate placement of creams at the vestibule/posterior fourchette if that’s where you sting. Technique coaching, dose adjustments for local vaginal oestrogen/DHEA, and habit tweaks (gentle cleansing, breathable underwear, chlorine rinse-off) can be taught and refined over video or phone.
When remote check-ins make sense. 1) You’re building or fine-tuning your moisturiser schedule and lubricant match. 2) You’re starting or adjusting local vaginal oestrogen or vaginal DHEA and need support with placement, dose spacing, or managing mild early effects such as transient stinging or light spotting. 3) You’re tracking outcomes (fewer “”paper-cut”” micro-tears, less urine sting, easier initial penetration) and want to review a symptom diary without travel. 4) You’re continuing a plan that’s already helping and only minor tweaks are needed. We also use remote follow-ups after straightforward device/injectable sessions when everything is settling normally and no examination is required.
When we recommend in-person assessment. Choose face-to-face if you have red flags—malodorous green/grey discharge (possible BV), intense itch with thick white discharge (possible thrush), fever, visible blood in urine, or new post-menopausal bleeding. Come in if you have persistent burning or ulcers, changing white plaques (possible dermatoses such as lichen sclerosus), or deep pelvic pain suggesting pelvic floor contributors or endometriosis/adenomyosis. We also recommend in-person review for pelvic/vulval examination, for energy-based treatments (radiofrequency/laser) or injectables (PRP/polynucleotides), and for hands-on pelvic health physiotherapy or dilator coaching.
How remote care fits into a stepwise pathway. We typically use remote appointments to guide you through the early, evidence-based steps, then invite you in if the diagnosis is unclear or if procedures are being considered. For a plain-English overview of the pathway and what happens at each stage, see how treatment steps are sequenced. If you’re planning budgets and timing, our treatment prices page explains what reviews include.
What to prepare for any format. Keep a short diary noting: where and when stinging occurs (entrance vs deeper), urine sting, micro-tears at the posterior fourchette, which lubricant lasts longest (many find silicone-based gives the most glide), and any irritant exposures (fragranced washes, tight/synthetic sports kit, chlorine not rinsed off). If you’re on anticoagulants or have severe allergies (e.g., fish allergy relevant to some polynucleotides), note this before any procedure planning. Bring product names and ingredients when you’ve had irritation—remote or in-person, that detail speeds up troubleshooting.
Safety first, regardless of format. If symptoms change suddenly, or you develop red flags, we’ll switch you to an in-person review for examination and tests before making treatment decisions. If procedures are planned, you’ll receive clear pre- and post-care instructions and we’ll schedule remote or in-person follow-ups to match how you’re feeling and what was done. Our aim is to blend convenience with clinical caution so you can progress confidently.
Clinical Context
Who is a good fit for remote check-ins? People whose main limiter is vestibular sting and dryness and who are trialling foundations: scheduled moisturiser 2–4 nights weekly; generous, compatible lubricant at every higher-friction moment; accurate placement of local oestrogen/DHEA when acceptable. Many reach comfort with coaching and small tweaks, without needing an immediate examination.
Who should prioritise in-person? Anyone with red flags (malodorous discharge, fever, visible haematuria, or new post-menopausal bleeding), persistent ulcers/changing plaques, or deep pelvic pain; those starting device-based or injectable adjuncts; and people recovering from pelvic/perineal surgery who need clearance and a tailored plan.
Alternatives and next steps. If hormones are unsuitable or declined, remote reviews can still optimise non-hormonal care: moisturiser routine, low-irritant products, lubricant base (water-based vs silicone-based), pelvic health physiotherapy referrals for muscle guarding, and dilator pacing. Educational only. Results vary. Not a cure.
Evidence-Based Approaches
NHS care formats: The NHS explains that GP and specialist consultations may run by phone/video or face to face; remote appointments are used for follow-up and medication reviews when safe and appropriate (NHS appointments overview).
Guideline framing for GSM: The NICE Menopause Guideline (NG23) recommends offering information on vaginal moisturisers and lubricants and considering low-dose local vaginal oestrogen when symptoms affect quality of life; these steps are well suited to remote coaching and review.
Prescribing and product detail: UK dosing/cautions for vaginal oestrogens and prasterone (DHEA) are set out in the British National Formulary (BNF), supporting technique optimisation and safety checks, often achievable via teleconsultation.
Effectiveness benchmarks: Systematic reviews in the Cochrane Library show that local vaginal oestrogens improve dryness, soreness, dyspareunia and vaginal pH versus placebo—useful context for remote goal-setting and timelines.
Pathophysiology & differential diagnosis: Peer-reviewed overviews on PubMed describe GSM biology (thinner epithelium, raised pH, fewer Lactobacillus) and help decide when an examination is required versus when remote optimisation is appropriate.