Genitourinary Syndrome of Menopause: What You Should Know

Menopause is an inevitable phase in a woman’s life, which marks the transition from being fertile to becoming infertile. During this phase, many women experience physical and mental changes, which include low sex drive, mood changes, weight gain, and sleeping problems. However, some women experience more severe symptoms like vaginal dryness, painful sex and incontinence.

The genitourinary syndrome is an umbrella term for dryness in the vagina, painful sex, increased urge to urinate, and, or incontinence. As a woman in menopause or approaching this phase, you should be aware of the common signs to expect so that you can take the right actions when the signs become extreme.

This guide focuses on the genitourinary syndrome of menopause, its symptoms, and treatment options. Read on to learn how to manage this condition effectively and live a normal life.

What Is Genitourinary Syndrome In Menopause (GSM)?

Genitourinary Syndrome of Menopause: What You Should Know

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GSM is a relatively new term for vulvovaginal atrophy or vaginal atrophy. It is a chronic condition caused by low levels of estrogen in the body as a result of menopause, although there could be other possible causes.

GSM is prevalent and affects 40 to 54% of postmenopausal women globally.  This condition can significantly affect one quality of life, and some women may never realize the problem until the symptoms become severe.

However, you can still enjoy quality sex when diagnosed with genitourinary syndrome of menopause by managing the condition. You should openly talk to your partner about the problem, seek treatment for the vaginal irritation and maintain a healthy lifestyle for positive results.

Common Signs of GSM

In line with this review, most women experience GSM symptoms in the premenopausal stage (40 to 44 years) or the early postmenopausal phase (45 to 50 years). However, the condition can appear at any age, and its common symptom is vaginal dryness. 

Usually, the estrogen hormone maintains the vaginal elasticity and lubrication. When a woman hits the menopause stage, the level of estrogen starts to drop, meaning the vagina becomes less lubricated, hence the dryness. Here are other common signs and symptoms of GSM.

  • Less vaginal lubrication
  • Pain when urinating
  • Pain during sexual intercourse
  • Increased vaginal itching and irritation
  • Increased urge to urinate
  • Urinating more regularly
  • Urinary tract infections

When you notice one or more of the above signs, visit a doctor immediately.

How to Diagnose GSM

A doctor will first ask a few questions about your experience and when you started noticing the signs. After that, multiple tests may be done to determine if GSM is the problem.

The first is a pelvic test, in which the doctor examines your pelvic organs, including the vagina, vulva, and cervix, for any signs of GSM. In addition, the health professional may take a sample of your urine if you experience urinal infections or changes in your urination.

How to Treat GSM

GSM is a chronic condition that is easy to manage with a few treatment options. Here are some of them:

1. Topical Treatment

Genitourinary Syndrome of Menopause: What You Should Know

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Topical treatment is the most common option that your doctor may recommend for mild GSM. It includes the use of lubricants and moisturizers.

Lubricants – a water-based lubricant is applied to the genital area before sexual intercourse. Its primary purpose is to reduce friction during intercourse, thus reducing Pain.

Moisturizers -a moisturizer aims to increase moisture in the vaginal area and reduce the dryness. You should apply a moisturizer after a bath every day or a few days.

Most topical treatments don’t need a recommendation, but you should buy high-quality products from reputable manufacturers.

2. Estrogen Hormone Therapy

Hormone therapy is an effective treatment option for people with severe effects of GSM. The treatment works by increasing the level of estrogen in the vaginal area, allowing the genital part to lubricate itself naturally. 

The doctor may offer this treatment in multiple ways, so you can choose what suits you perfectly. For instance, it may come in the form of a cream that you will apply to the vagina daily before going to bed.

Also, it may be in the form of a tablet or a soft ring inserted into the vagina. The ring releases a daily dose of estrogen, allowing the vagina to remain elastic and more lubricated. 

When you choose hormonal therapy, the doctor will give you a disposable applicator, which you will be using to insert the medication.

3. Pelvic Floor Physical Therapy

Genitourinary Syndrome of Menopause: What You Should Know

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Pelvic floor physical therapy is a highly effective treatment plan for people experiencing urinal problems, such as incontinence. The exercise strengthens the pelvic floor muscles, making it easier to manage urination. However, this training needs patience as the results may not be instant.

4. Vaginal Dilators

Vaginal dilators are a non-hormonal treatment which you can use alongside creams. The dilator stretches the vaginal walls gradually, allowing you to enjoy a smoother and less painful penetration. This treatment plan may be an excellent solution for you if you experience Pain during sex.

5. Self-Care Treatment

Self-care is important when suffering from GSM, as it manages the pain, irritation, and discomfort and allows the other treatment options to work quickly. Here are some self-care plans a doctor may recommend according to the severity of the condition.

  • Keep the vaginal area clean by bathing once or twice per day
  • Avoid harsh hygiene products, like soaps, sprays, or fabric, which may irritate the genital area
  • Avoid smoking
  • Embrace foreplay to prepare the body before sex fully
  • Maintain a healthy lifestyle by eating healthy meals and getting quality sleep.


Genitourinary syndrome is a common condition that affects women in the menopause phase. Its leading cause is low estrogen levels, although it can also happen because of some cancer treatments or surgeries. Common signs include vaginal dryness, painful sex, and urinary incontinence.

It’s recommended that you seek the help of a doctor immediately when you notice any of its signs. The doctor may suggest many human and non-hormonal therapies to manage it.

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