What is genitourinary syndrome of menopause?

According to the North American Menopause Society, genitourinary syndrome of menopause (GSM) is a condition describing the symptoms and signs of decreased estrogen on the female genitourinary tract, including the vagina, labia, urethra, and bladder.

 

What are the symptoms of genitourinary syndrome of menopause?

There are many symptoms of GSM, many of which mimic those of urinary tract infections.  The most common symptoms include:

• Vaginal dryness

• Vaginal burning and irritation

• Burning with urination

• Urinary frequency and urgency

• Recurrent urinary tract infections (UTIs)

• Pain and dryness with sexual activity

 

How is genitourinary syndrome of menopause diagnosed?

Your doctor can generally diagnose genitourinary syndrome of menopause with a history and pelvic examination. The patient history can help your doctor identify symptoms while the pelvic examination may identify findings consistent with GSM and eliminate other pathologic conditions that may cause similar symptoms.

 

How is genitourinary syndrome of menopause treated?

There are number of treatment options for genitourinary syndrome of menopause.

 

Non-hormonal treatments include vaginal lubricants or moisturizers.  Many of these are over-the-counter. Your doctor can make specific recommendations to you.

 

Hormonal treatments include vaginal estrogen, administered as either a cream or tablet with an applicator or a vaginal ring.  Once prescribed, vaginal estrogen should be used as lifelong therapy.  Vaginal estrogen, which is different than oral estrogen, acts locally in the vagina with only a small amount absorbed into the bloodstream.  If used regularly, estrogen bloodstream levels are similar to those of postmenopausal patients not using vaginal estrogen.  There are a multitude of high-quality studies demonstrating that vaginal estrogen does not increase your risk of blood clots, breast cancer, or uterine cancer.  However, many studies have shown that vaginal estrogen is very effective at reducing symptoms of GSM and recurrent UTIs.