Genitourinary Syndrome of Menopause (GSM)

Genitourinary syndrome of menopause (GSM) is a medical condition that affects women during and after menopause. It is characterized by a combination of symptoms related to the genitourinary system, including the vagina, vulva, and urinary tract.

Causes and Risk Factors

GSM is caused by the decline in estrogen levels that occurs during menopause. Estrogen plays a crucial role in maintaining the health and function of the genitourinary system. With decreased estrogen levels, the vaginal tissue becomes thinner, drier, and less elastic, leading to symptoms such as vaginal dryness, itching, and burning.

Other risk factors for GSM include:

• Age: Women over 50 years old are more likely to experience GSM
• Hysterectomy: Women who have had a hysterectomy may be at increased risk for GSM
• Cancer treatments: Certain cancer treatments, such as chemotherapy and radiation therapy, can increase the risk of GSM
• Smoking: Smoking can decrease estrogen levels and worsen GSM symptoms

Symptoms

The symptoms of GSM can vary from woman to woman but may include:

• Vaginal dryness, itching, or burning
• Painful sex (dyspareunia)
• Urinary frequency or urgency
• Urinary incontinence
• Recurrent urinary tract infections (UTIs)
• Vaginal discharge or odor

Diagnosis

GSM is typically diagnosed based on a combination of medical history, physical examination, and laboratory tests. A healthcare provider may perform:

• Pelvic exam to assess vaginal tissue and check for any abnormalities
• Vaginal swab or urine test to rule out infections
• Hormone level tests to evaluate estrogen levels

Treatment Options

Treatment for GSM depends on the severity of symptoms and may include:

• Hormone replacement therapy (HRT) to restore estrogen levels
• Local estrogen therapy, such as vaginal creams or rings, to deliver estrogen directly to the vagina
• Non-hormonal treatments, such as vaginal moisturizers and lubricants, to alleviate symptoms
• Lifestyle modifications, such as avoiding irritants and practicing pelvic floor exercises

Management and Prevention

To manage and prevent GSM, women can take the following steps:

• Practice good genital hygiene
• Avoid harsh soaps and douching
• Use gentle, fragrance-free products
• Stay hydrated to help maintain vaginal moisture
• Engage in regular physical activity to promote overall health

It is essential for women to discuss their symptoms and concerns with a healthcare provider to develop an individualized treatment plan and prevent long-term complications.