What is the most likely diagnosis for a postmenopausal woman experiencing vaginal dryness and irritation?

The most likely diagnosis for a postmenopausal woman experiencing vaginal dryness and irritation is genitourinary syndrome of menopause (GSM). This condition is characterized by symptoms resulting from a decline in estrogen levels after menopause, leading to changes in the vaginal and urethral tissues. Women often experience vaginal dryness, irritation, discomfort during intercourse, and urinary symptoms, such as urgency.

As women go through menopause, the decreased estrogen can lead to thinning of the vaginal epithelium, reduced vaginal lubrication, and alterations in the vaginal flora, which can result in the symptoms noted. Identifying GSM is essential as it can significantly impact a woman's quality of life, and appropriate management options such as vaginal moisturizers, lubricants, or hormonal treatments are available.

Other conditions such as bacterial vaginosis and candidiasis could cause similar symptoms but are typically associated with vaginal infections, which may present differently and are less likely to occur in a postmenopausal woman without further risk factors. Additionally, vulvar cancer, while a possible diagnosis, is far less common and would typically present with other signs such as visible lesions or changes in the vulva. Therefore, in the context of a postmenopausal woman with these specific symptoms, genitourinary