I started getting symptoms of VA when i was 48, it was pretty severe at that stage so it obviously started before then, at that stage i was still getting periods, my last one was just before my 52nd birthday. I struggled to get treatment for two years as i was told VA was not possible until at least 2 years post meno, one who told me that included a female GP who is a few years older than me.
I then saw another GP who offered to prescribe Ovestin when i asked to try it and of course my symptoms improved, i later changed to Vagifem as i prefer that one. At a later date i was referred to a meno specialist ( ha ha, what a joke he was) because i wanted to try systemic HRT as although Vagifem was great i felt it wasn't quite enough as time went one. When i saw him he tried to tell me that i didn't have VA, well maybe that was the Vagifem working i told him, but he was insistent i couldn't have it as he said not possible if peri, he then said he wanted me to have a vulval biopsy, i refused and left.
I then went private, got systemic HRT and Vagifem prescribed daily and haven't looked back since.