For women who began hormone therapy near the menopause transition and have persistent symptoms, there is no general rule for stopping hormone therapy at age 65. When cessation of hormone therapy is needed or desired, it can be challenging, as symptoms may recur and other health considerations (such as osteoporosis prevention) arise. The first part of this episode discusses hormone therapy cessation. The second part focuses on the Genitourinary Syndrome of Menopause (GSM), a new term for the symptoms of vaginal dryness, dyspareunia, dysuria, and recurrent UTI which are associated with estrogen loss. GSM tends to worsen as time passes after the menopause transition, but there are several safe and effective treatments.