What is genitourinary syndrome of menopause (GSM)?

When a woman goes through menopause, her estrogen levels decrease along with the levels of other sex-steroid hormones. These decreases can lead to changes in certain areas of her body, like the vagina, vulva, and bladder.

For example, estrogen helps keep the vaginal tissues moist and flexible. But when estrogen levels decline, the vagina can become dry, pale, and inelastic, and it may feel tight.

These hormonal drops can lead to a group of genital and urinary symptoms that are called genitourinary syndrome of menopause (GSM).

GSM is thought to affect about half of postmenopausal women. Symptoms may include:

  • Vaginal dryness, burning sensations, and pain/irritation in the genital area
  • Poor vaginal lubrication during sex, discomfort or pain with intercourse, and impaired sexual function
  • An urgent need to urinate, painful urination, or recurrent urinary tract infections (UTIs)

Women do not need to have all of the symptoms to be diagnosed with GSM, but if the symptoms are bothersome, they should be evaluated and treated.

GSM is a chronic and progressive medical condition. It does not get better over time. However, symptoms can be safely managed with a wide variety of treatments.

Genitourinary syndrome of menopause is a fairly new term. It was developed in 2014 by experts from the International Society for the Study of Women’s Sexual Health (ISSWSH) and the North American Menopause Society (NAMS). They felt that the term encompassed the genital, sexual, and urinary symptoms related to estrogen decline in ways that previous terms did not.


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