Do you routinely provide anticipatory guidance about the genitourinary syndrome of menopause?

I talk to all women about vaginal dryness and pain with penetrative intercourse during well-woman exams when I am doing a pelvic exam, starting around age 40. I think it is helpful for them to be prepared for the possibility of GSM as they go through menopause. I emphasize how common it is and how we have treatments that work well to encourage them to talk to me about their symptoms if they occur. We talk about the natural course of GSM vs vasomotor symptoms, for example. GSM tends to start more remote from menopause and gets worse, whereas vasomotor symptoms start a few years prior to menopause and will eventually get better. I give them information about vaginal moisturizers and effective lubricants to use with intercourse. I also talk ab...