Genitourinary Syndrome Menopause (GSM)
Menopause is a transitional period in a woman’s life characterized by hormonal changes which can lead to a host of symptoms, such as changes in weight, fluctuations in mood, and more.
Genitourinary Syndrome of Menopause (GSM), previously referred to as vulvovaginal atrophy or atrophic vaginitis, is a chronic condition that affects the vagina, vulva, pelvic floor tissues and urinary tract. Women may experience vaginal dryness, vaginal burning or painful intercourse, and are at an increased risk for urinary tract infections.
What is GSM?
In the years leading up to and including a woman’s menopause, the ovaries reduce their production of estrogen. Estrogen is a sex hormone that plays a role in:
- Puberty
- Menstruation
- Glucose metabolism
- Insulin sensitivity
- Bone health
After menopause, or in cases of imbalanced hormones, the production of estrogen from the ovaries is extremely low and can cause the symptoms of GSM. The tissues of the body are affected and can include a reduction in skin thickness, elasticity, muscle function and even blood flow.
Those more at risk
Women are more at risk of GSM if they:
- Are going through or have gone through menopause
- Have had surgery to remove the ovaries
- Have smoked or have a history of alcohol abuse
- Are undergoing certain cancer treatments, such as anti-estrogen medications for patients undergoing breast cancer treatment
Treatment options
Vaginal estrogen therapy
A decline in estrogen levels after menopause leads to changes in the skin of the vagina, urethra and vulva. Estrogen plays an important role in keeping the vaginal and vulvar tissue moist and healthy. With the normal decline in estrogen after menopause, the tissues and skin in the vaginal area may thin and become dry. Younger women undergoing breast cancer treatment with anti-estrogen medications may also experience these changes.
Following a pelvic examination, treatment may be recommended. Some simple changes can help reduce vaginal and vulvar irritation. Use chemical-free detergents. If you wear pads due to urinary leakage, stay away from menstrual pads – use pads designed to hold urine or consider trying 100% cotton pads. Some women find using a vaginal moisturizer or lubricant helpful. Coconut oil is often the best vaginal lubricant and is widely available. Avoid petroleum-based lubricants.