GSM

What is the Genitourinary Syndrome of Menopause (GSM)?

Genitourinary Syndrome of Menopause (GSM) refers to the highly prevalent, chronic, progressive collection of symptoms affecting the genital, sexual, and urinary systems in women. Once these symptoms start, they usually do not get better without treatment, and they can often get worse.

What are the common symptoms of GSM?

Urinary leaking and incontinence; increased UTIs; vaginal dryness, itching, and burning; painful intercourse; low libido.

What causes GSM?

With lower estrogen levels after menopause, the vaginal and vulvar tissue thins and loses its elasticity and lubrication, which leads to burning, itchiness and dryness. There is an increase in vaginal PH and microflora, leading to more UTIs.

How many women does GSM affect?

Recent studies report that up to 84% of postmenopausal women experience one or more symptoms of GSM. When physically examined, GSM is clinically evident in 90% of women.

When do GSM symptoms typically start?

The majority of women experience GSM symptoms during menopause although, for some women, symptoms can start earlier. It can begin years after menopause, and often, women may not relate it to menopause.

Why is GSM a long-term health risk?

Not only does GSM impact the quality of life for many women but there are long-term health implications—chronic UTIs—that are costly to the US healthcare system and can be deadly for women.

What can I do to prevent and/or alleviate the symptoms of GSM?

The good news is that there are safe and effective treatments as well as preventative measures for GSM. See here for the Menopause Society's position statement on treatment and prevention options for GSM.

One effective but under-utilized preventative and treatment option is local vaginal estrogen.