Do You Know What Genitourinary Syndrome of Menopause (GSM) Is? - Ellen Dolgen
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Do You Know What Genitourinary Syndrome of Menopause (GSM) Is?

According to the Journal of Menopausal Medicine, Genitourinary Syndrome of Menopause describes various menopausal symptoms and signs associated with physical changes of the vulva, vagina, and lower urinary tract. Most women don’t even know what this condition is, nor understand that it is a chronic problem that requires ongoing treatment and IS treatable.

You can thank the Board of Directors of the International Society for the Study of Women’s Sexual Health (ISSWSH) and the Board of the North American Menopause Society (NAMS) for this new term. Genitourinary Syndrome of Menopause is quite the mouthful, so let’s refer to it as GSM.  In the meantime, I am going to reach out to the OPI Labeling Committee and have them rename this condition.

What causes GSM?

Estrogen decline seems to be the culprit. We have estrogen receptors in our vagina, vulva, pelvic floor musculature, urethra, and bladder.

Most of us have an annual Gyn check-up. However, the research found that vaginal health is not frequently discussed during doctor visits.  Women are not aware of the condition, nor do they understand the treatment options.

If our gynecologists are not asking questions to find out if we are experiencing symptoms of GSM, then we need to educate ourselves about GSM so that we can come prepared with questions.

To help you become your own best health advocate, here is a GSM 101:

What are the symptoms of GSM?

Common symptoms of GSM include not only genital symptoms (dryness, burning, and irritation) and sexual symptoms (lack of lubrication, discomfort or painful sex, and impaired function, but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections). If you are experiencing any of the symptoms of GSM, please do not think that you are alone.   According to the recent study posted in the Journal of the North Menopause Society,  it is pretty common.

The US National Library of Medicine National Institutes of Health reported that an observational study by Moral et al. found that vaginal dryness affects up to 93% of women; the study also noted that this symptom is moderate to severe in intensity in 68% of the cases. Irritation and burning/itching of the vulva/vagina are other signs that women with GSM frequently complain about, and they are reported in 63.3% of the affected women. The most predominant complaints of sexually active women are reduced lubrication and dyspareunia, the prevalence of which has been reported to be 90% and 80%, respectively. Loss of libido, arousal, vaginal bleeding/spotting during or after intercourse is also frequently reported. Urinary symptoms are considered less frequent, with dysuria (painful urination) 29%, urgency and urge incontinence 28%, recurrent urinary tract infections, stress incontinence, and voiding issues being some of the most common manifestations.

If you are experiencing any of the above symptoms of GSM, make an appointment with your Menopause Specialist. 

What are the treatment options of GSM?

A trained Menopause Specialist will be able to create an individual program to meet your GSM needs.   Your specialist will review the severity of your symptoms and the impact on your quality of life (QOL). There is no one-size-fits-all answer.  Many women find they need a combination of different protocols for the greatest success.  Here are some of the treatment options to discuss with your specialist:

Non-Hormonal therapy:

Vaginal Lubricants

Vaginal moisturizers

Ablative laser – CO2 laser or Yag Laser

Oral Ospemifene (Serm)

Hormonal Therapy:

Oral Estrogen

Transdermal Estrogen (Patch or Gel)

Local Estrogen Therapy (creams, tablets, or a ring)

DHEA Tablet


I know what you are thinking, the vagina can be quite the pain in the ass.  If you are experiencing any of the symptoms of GSM, don’t hide your vagina under a bush.  Make an appointment with a Menopause Specialist ASAP!  Come prepared with your questions.

Be sure to get the help you need and deserve!

Remember:  Suffering in silence is OUT!  Reaching out is IN.

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* does not recommend, endorse, or make any representation about any tests, studies, practices, procedures, treatments, services, opinions, healthcare providers, physicians, or medical institutions that may be mentioned or referenced.


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