Go through these in order and stop at the first one that applies. If you are reading this for someone else, answer for them.
1
Is any of this happening now?
Call 911
Go to urgent or emergency care for:
Heavy vaginal bleeding, especially with weakness, fainting, or dizziness
Sudden severe pelvic or abdominal pain
Severe pain with fever, vomiting, confusion, or feeling very unwell
Other emergency signs, for anyone
Someone who is struggling to breathe, gasping, choking, or cannot get words out
Someone who has chest pain, tightness or pressure lasting more than a few minutes
Someone who has sudden weakness or drooping on one side of the face or body, slurred speech, or sudden confusion
Someone who is unconscious, or cannot be woken
Someone who is bleeding heavily and it will not stop with firm pressure
Someone who has had a seizure that will not stop, or does not wake up afterwards
Someone who has lips or skin that look pale, blue, grey or blotchy
Someone who you believe has taken an overdose or swallowed something poisonous
2
Is any of this happening?
Be seen today
Any vaginal bleeding after menopause should be checked promptly, even if it happens only once or seems light.
Most causes are not an emergency, but the reason needs to be identified.
Seek same-day medical advice if dryness or pain occurs with fever, worsening lower abdominal or pelvic pain, foul-smelling discharge, or bleeding during pregnancy.
3
Does any of this apply?
Book an appointment
Book a routine appointment if the dryness persists, keeps returning, affects sex or daily life, or does not improve with simple self-care.
Arrange an assessment if you also have unusual discharge, sores, ongoing itching, repeated urinary symptoms, or bleeding after sex.
Every sign above is quoted from the sofidex article on Vaginal dryness. If you are not sure, err upward — it is always reasonable to be checked.