According to Jaime Sepulveda, M.D., two out of three women going through menopause will develop a condition known as genitourinary syndrome of menopause, or GSM. Although the term sounds foreboding, the condition and its symptoms are both common and easily treated.
“The symptoms of genitourinary syndrome of menopause are experienced by two-thirds of menopausal women,” explained Dr. Sepulveda. “Some women have a burning sensation while others may experience more prominent symptoms. Any occurrence of GSM is due to a lack of the hormone estrogen in a woman’s body. The good news is that such a deficiency is part of the normal aging process and the treatment for the condition is as simple as visiting a gynecologist.”
Generally, the symptoms of GSM include genital dryness and a marked decrease in natural lubrication, which can cause irritation and even pain during sexual activity. In more severe cases, patients also can experience an overactive bladder, painful urination and recurrent urinary tract infections.
In addition to the physical symptoms of GSM, the condition can affect a woman’s quality of life. According to a 2015 report published in the Journal of Menopausal Medicine, 40 percent of women with these symptoms reported overall sexual dysfunction, 34 percent arousal difficulties, 24 percent lack of desire and 19 percent orgasm difficulties. The report concluded that most women suffering symptoms associated with genitourinary syndrome of menopause are reluctant to speak with their gynecologist about their condition, assuming the condition was due to a normal process of aging.
The most common treatments for GSM include both non-hormonal and hormonal therapies approved by the U.S. Food and Drug Administration and prescribed by a doctor. While some women with symptoms find relief using over-the-counter remedies such as water-based vaginal lubricants or coconut oil, hormone therapy is significantly more effective.
“There is strong evidence that women with symptoms such as urinary incontinence, dryness and burning will improve with a short course, low-dose of locally applied estrogen,” Dr. Sepulveda said. “There is also less risk involved than with orally administered estrogen, which results in higher absorption by the body.”
For women concerned about potential side effects of hormone treatment, another treatment option is the use of selective estrogen receptor dodulators (SERM) that can produce estrogen-like effects without the risks and side effects of hormones. SERM medications also can be used in conjunction with estrogen.
“There has also been some promise shown using hyaluronic acid suppositories and energy-based treatments such as laser and radiofrequency, but these approaches require further study and evidence before they can be recommended as first-line treatments for GSM,” Dr. Sepulveda said. “In most cases, I recommend local estrogen in low doses over a short period for my patients with symptoms of genitourinary syndrome of menopause.”