Genitourinary syndrome of menopause
Also called GSM, vaginal atrophy, vulvovaginal atrophy, atrophic vaginitis
Genitourinary syndrome of menopause (GSM) is the set of genital, urinary and sexual symptoms caused by the loss of estrogen around and after menopause. It affects the vulva, vagina, urethra and bladder. Typical symptoms include vaginal dryness, burning and irritation; pain with sex and reduced lubrication; and urinary urgency, painful urination, waking at night to urinate and repeated urinary tract infections.
The name is relatively new. It was introduced in 2014 by a consensus of the International Society for the Study of Women's Sexual Health and the North American Menopause Society (now The Menopause Society) to replace older terms such as vulvovaginal atrophy, atrophic vaginitis and urogenital atrophy, which described only the vaginal changes and not the urinary ones.
Why it matters after 45
At least half of women who reach menopause show signs of GSM, and vaginal dryness is often the first. GSM is described as chronic and progressive. It is also widely underdiagnosed, partly because many women are reluctant to raise it or assume it is simply a normal part of aging.
Where it comes up
Related terms
References
- Cleveland Clinic. Vaginal Atrophy (Genitourinary Syndrome of Menopause). https://my.clevelandclinic.org/health/diseases/15500-vaginal-atrophy
- Angelou K, Grigoriadis T, Diakosavvas M, et al. The Genitourinary Syndrome of Menopause: An Overview of the Recent Data. Cureus, 2020. https://pmc.ncbi.nlm.nih.gov/articles/PMC7212735/
- Valadares ALR, Kulak Junior J, et al. Genitourinary Syndrome of Menopause (FEBRASGO position statement). RBGO Gynecology and Obstetrics, 2022. https://pmc.ncbi.nlm.nih.gov/articles/PMC9948134/
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