What Is Genitourinary Syndrome of Menopause and Why Should We Care?

Abstract

Genitourinary syndrome of menopause (GSM; previously known as vulvovaginal atrophy or atrophic vaginitis) involves symptoms of vaginal dryness, burning, and itching as well as dyspareunia, dysuria, urinary urgency, and recurrent urinary tract infections. It is estimated that nearly 60% of women in menopause experience GSM but the majority of these women do not bring up this concern with their health care provider. Studies also show that only 7% of health care providers ask women about this condition. This may be due to embarrassment or thinking this is a normal part of aging, both by patients and health care providers. This condition is progressive and may affect many aspects of a woman's physical, emotional, and sexual health. This article is intended to address the signs, symptoms, and significant impact this condition can have for women and help health care providers be more comfortable knowing how to ask about GSM, diagnosis it, and review the various treatment options that are available.

Figure 1.

Loss of pigmentation to bilateral labia majora, minora, and perineum. Thinned texture and characteristic “cigarette paper” wrinkling. Small erosions at left perineum.

Figure 2.

Note the smooth, pale inner labia minora, the prominent erythematous urethral caruncle, and narrowed introitus.

Figure 3.

Labia minora atrophied and no longer existent. Fusion of superior labia obscuring clitoris.