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You need to use the bathroom…again.

And you need to use it now!

If you’ve gone through menopause and are noticing increased urgency, frequency, or discomfort in urination, you may have what’s known as GSM, or genitourinary syndrome of menopause.

What is genitourinary syndrome of menopause (GSM)?

GSM is a relatively new term that describes the combination of vaginal, sexual, and urinary symptoms caused by the decrease in estrogen to these areas as you age. 

Previously known as vaginal atrophy, the name was changed to better encompass the broad range of symptoms beyond the genital area and to help women feel more comfortable discussing their symptoms with medical professionals.

However, many women still don’t recognize their urinary symptoms as being menopause-related and may think they have a urinary tract infection or some other issue. 

What are the symptoms of GSM? 

Genital symptoms

• Vaginal dryness 
• Vaginal and vulvar itching or irritation 

Sexual symptoms 

• Lack of lubrication 
• Pain or discomfort during sexual activity 
• Bleeding after sexual activity
• Decreased arousal
• Difficulty achieving orgasm

Urinary symptoms

• Increased need to urinate
• Increased urge to urinate
• Urinary incontinence
• Recurrent urinary tract infections

How does menopause affect your bladder and urinary areas?

Just like in the genital areas, estrogen plays an important role in the function of the urinary tract, bladder, and urethra areas. During its decline in menopause, these areas can become affected and not function normally. 

GSM symptoms vs. UTI

Many women don’t realize that their urinary symptoms are related to menopause. However, it’s important to understand the difference between menopause-related urinary symptoms and urinary tract infections (UTI), so you can get the proper care and the right treatment, as well as avoid taking unnecessary antibiotics.

As mentioned, with urinary symptoms related to menopause, you’ll typically notice an increase in the frequency and urgency of urination–in other words, using the bathroom more often and with a greater need to relieve yourself quickly. However, with a UTI, you’ll also notice pain and perhaps a fever, which indicates an infection. 

How common is GSM?

Of the 64 million women of menopause age, about half will experience symptoms of GSM. And roughly one-third of this group report symptoms that are moderate to severe.

How does GSM affect the quality of life?

GSM isn’t directly life-threatening. However, due to its progressive, chronic nature, it can significantly impair your quality of life if left untreated. Further, it tends to worsen with age due to declining levels of estrogen. 

In addition to the physical symptoms, GSM can affect you psychologically as well. The lack of lubrication during sexual activity can cause anxiety around intimacy with your partner, which may lead to overall lower self-esteem. Further, studies indicate that women with GSM have increased sleeping problems and a general decline in overall life satisfaction.

How is GSM treated? 

If you’re concerned about GSM, It’s important to talk to your healthcare provider about the proper treatment, as it may vary based on each person’s unique situation. However, here are some general treatment recommendations for GSM symptoms: 

• For external, vulvar discomfort and dryness, a vaginal moisturizer such as Intimate Skin Moisturizer by FemmePharma

• For internal vaginal discomfort during sexual activity, as well as general vaginal dryness, a non-hormonal lubricant and moisturizer such as Personal Lubricant & Vaginal Moisturizer by FemmePharma

• Hormone therapy, in some cases
• Alternative (not medically proven) therapies such as black cohosh or laser treatment[i]
• Lifestyle adjustments such as increased sexual activity to improve vaginal elasticity, quitting smoking for better circulation, and pelvic floor exercises for strength[ii]

*** 

We hope this article provides you with a good general overview of GSM. For more information, check out the resources listed below or speak to your healthcare provider. And for a list of providers who specialize in menopause, see the North American Menopause Society’s searchable practitioner database.

[i] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561742/

[ii]  https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288

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