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Because the condition causes both vaginal and urinary symptoms, doctors use the term "genitourinary syndrome of menopause GSM " to describe vaginal atrophy and its accompanying of vaginal soreness causes. Viral infections: Certain viruses can cause vaginal infection and pain. GSM signs and symptoms may begin to bother you during the years leading up to menopause, or they may not become a problem until several years into menopause.