Genitourinary Syndrome of Menopause (GSM): A Common Yet Overlooked Condition
Genitourinary Syndrome of Menopause (GSM) is a prevalent but often underdiagnosed condition affecting up to 84% of postmenopausal women. Characterized by vulvovaginal and urinary symptoms due to declining estrogen levels, GSM can significantly impact sexual health, self-esteem, and overall well-being. Unlike other menopause symptoms, GSM does not resolve on its own and tends to worsen without treatment.
Symptoms and Impact
GSM presents with vaginal dryness, irritation, burning, painful intercourse (dyspareunia), post-coital bleeding, reduced arousal, urinary urgency, frequent urinary tract infections (UTIs), and tissue fragility. Women using progestogen-only contraception, breastfeeding mothers, and those undergoing cancer treatments may also experience GSM symptoms. However, many women do not seek help due to embarrassment, and healthcare providers rarely initiate discussions about GSM.
Diagnosis and Screening
Routine screening for genitourinary symptoms should be part of perimenopausal and postmenopausal care. Women experiencing recurrent urinary infections, discomfort during sex, exercise, or daily activities should be evaluated for GSM. Additionally, conditions such as diabetes, multiple sclerosis, and certain medications can aggravate GSM symptoms.
Examination and Treatment Options
Although a pelvic examination is ideal, treatment should not be delayed if GSM symptoms are present. Effective treatment options include:
- Local estrogen therapy to restore vaginal health
- Vaginal moisturizers and lubricants for hydration and comfort
- Pelvic floor therapy to improve symptoms of urinary urgency and discomfort
Healthcare providers should proactively discuss GSM during menopause consultations and cervical screenings, ensuring early diagnosis and intervention.
GSM is a progressive but treatable condition. Raising awareness, encouraging open conversations about menopause and vaginal health, and offering personalized treatment can significantly improve a woman’s quality of life. Proactive management of GSM is essential to prevent unnecessary discomfort and long-term complications.
