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PubMed This is a summary of 73 peer-reviewed journal articles Updated
Gynecology · Genitourinary Syndrome of Menopause

Genitourinary Syndrome of Menopause (GSM) Comprehensive Guide

At a Glance

Genitourinary Syndrome of Menopause (GSM), formerly known as atrophic vaginitis, is a common condition caused by low estrogen after menopause. It causes vaginal dryness, painful intimacy, and frequent UTIs. Highly effective treatments include moisturizers and low-dose vaginal estrogen.

Welcome to the Comprehensive Guide to Genitourinary Syndrome of Menopause (GSM). If you are experiencing vaginal dryness, frequent urinary tract infections, or pain with intimacy, you are not alone. GSM is a common, progressive condition linked to estrogen deficiency after menopause.

This resource will help you understand the biological causes, interpret your symptoms, prepare for diagnostic evaluations, and choose the most effective, evidence-based treatments.

Guide Contents

01

Understanding Genitourinary Syndrome of Menopause (GSM)

Learn about Genitourinary Syndrome of Menopause (GSM), formerly atrophic vaginitis. Understand the causes of vaginal dryness and postmenopause urinary changes.

02

Mapping Your Symptoms and Finding Clarity

Discover the symptoms of Genitourinary Syndrome of Menopause (GSM). Learn why it is often mistaken for chronic UTIs and how to get an accurate diagnosis.

03

Your Evaluation and Diagnostic Tests

Learn how doctors diagnose Genitourinary Syndrome of Menopause (GSM). Understand what vaginal pH, VMI tests, and pelvic exams reveal about your vaginal health.

04

Standard of Care and Treatment Options

Explore standard treatments for postmenopausal atrophic vaginitis (GSM). Learn about non-hormonal options, low-dose vaginal estrogen, DHEA, and ospemifene.

05

Special Considerations and Alternative Therapies

Learn about alternative therapies for GSM and atrophic vaginitis, including laser treatments, FDA warnings, and safe options for breast cancer survivors.

06

Long-Term Management and Building Your Care Team

Learn how to effectively manage Genitourinary Syndrome of Menopause (GSM) long-term. Find out why consistent treatment matters and how to build a care team.

Common questions in this guide

What is Genitourinary Syndrome of Menopause (GSM)?
GSM is a chronic, progressive condition caused by a lack of estrogen after menopause. It can cause a variety of uncomfortable symptoms, including vaginal dryness, pain during intimacy, urinary urgency, and frequent urinary tract infections.
Is GSM the same thing as atrophic vaginitis?
Yes, GSM is the updated medical term for what was previously called postmenopausal atrophic vaginitis. The name was changed because the new term better describes how estrogen deficiency affects both the vaginal and urinary systems, rather than just the vagina.
How do doctors diagnose Genitourinary Syndrome of Menopause?
Doctors typically diagnose GSM through a discussion of your symptoms and a physical exam. They may also use objective tests, such as checking your vaginal pH level or looking at a sample of cells to calculate the Vaginal Maturation Index.
What are the most effective treatments for GSM?
Treatments often start with non-hormonal vaginal moisturizers. If those aren't enough, doctors frequently prescribe low-dose vaginal estrogen, which is considered the gold standard. Other FDA-approved options include vaginal DHEA and oral medications like Ospemifene.
Can GSM cause frequent UTIs?
Yes, frequent UTIs are a very common symptom of GSM. Because estrogen helps maintain a healthy urinary tract, a drop in estrogen levels after menopause can make you much more susceptible to urinary infections.

Questions to Ask Your Doctor

Curated prompts to bring to your next appointment.

  1. 1.Based on my medical history, what is the safest and most effective first step for managing my urogenital health?
  2. 2.How often should I follow up with you to ensure my GSM treatment is working and my tissues remain healthy?
  3. 3.If my symptoms include frequent urinary urgency, should I also see a urologist or a pelvic floor specialist?

Questions For You

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This guide provides educational information about Genitourinary Syndrome of Menopause (GSM). It is not a substitute for professional medical advice, diagnosis, or treatment from your gynecologist or primary care provider.

Get notified when new evidence is published on postmenopausal atrophic vaginitis.

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