Understanding Genitourinary Syndrome of Menopause (GSM): A Common and Treatable Condition

At Dragonfly Menopause Care, one topic I frequently address with patients is the Genitourinary Syndrome of Menopause (GSM). GSM refers to a group of symptoms that often develop during perimenopause and menopause, including:

• Vaginal dryness

• Pain during sex

• Vaginal discharge

• Frequent urinary tract infections (UTIs) or UTI-like symptoms with no infection

• Pelvic pain

  
  

• 

  Genitourinary Syndrome of Menopause

  
  

What Causes GSM?

The primary cause of GSM is the decline in estrogen levels that occurs during the menopause transition. This hormonal shift leads to changes in the vaginal and urinary tissues, resulting in the symptoms mentioned above. Additionally, a loss of bioavailable free testosterone also plays a role. Testosterone, like estrogen, has receptors in these tissues, and its reduction can further impact their health and function.

How Is GSM Treated?

The good news is that GSM is highly treatable. Common treatments include:

• Vaginal Estrogen Therapy:Options include vaginal estrogen tablets, creams, or rings, which deliver estrogen directly to the affected tissues.

  
  

• Compounded Estradiol-Testosterone Cream:For more severe cases, a custom-compounded cream containing both estradiol and testosterone can be applied locally to provide relief.

  
  

It’s important to note that systemic estrogen therapies (like estradiol patches or sprays) are not as effective for GSM because they do not target the localized tissues directly.

The Role of Testosterone

The loss of bioavailable free testosterone can significantly impact vaginal and urinary tissue health. Supplementing with a topical testosterone cream may be necessary in some cases to fully address GSM symptoms.

Other Supportive Treatments

In addition to hormonal therapies, pelvic floor physical therapy can be incredibly beneficial for some patients, especially if pelvic floor muscle issues are contributing to pain or discomfort.

Why Talking About GSM Matters

These symptoms are common and can significantly impact quality of life, yet many women feel uncomfortable bringing them up. At Dragonfly Menopause Care, I make it a priority to ask about these issues so they can be addressed if desired.

Remember: GSM is treatable, and you don’t have to suffer in silence. Whether through hormonal therapy, pelvic floor physical therapy, or a combination of treatments, there are solutions to help you feel better.

If you’re experiencing any of these symptoms, I’m here to help. Let’s work together to find the best treatment plan for you.