Because they don't ask for it! They don't come forward and why there is so much ignorance of the condition by medics across the board. I have read research papers from here and the USA saying that women will come up with excuses not to present when suffering symptoms, the main being too embarrassed, its private, my business etc.
Personally I don't know how they can live with symptoms of GSM, it can be crippling as it was in my case and when I presented I was given three courses of antibiotics over three months and all the nurses who I knew well, didn't have a clue what was going on with me. And all I needed was oestrogen!