Menopause Specialist

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05/08/23

Vaginal and bladder symptoms – Genitourinary syndrome of menopause (GSM)

Vaginal and bladder symptoms – Genitourinary syndrome of menopause (GSM)

Genitourinary syndrome of menopause (GSM) is the term that is now used for vulvovaginal atrophy. 

This comprehensive term encompasses conditions of the vagina, vulva, pelvic floor and urinary tract. GSM, like many other symptoms of menopause, is related to low oestrogen levels. 

 

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While some women may find discussing the symptoms of GSM uncomfortable, it is important to seek help from a medical professional. GSM often goes undiagnosed, and it is a syndrome that can have a big impact on your quality of life

Vaginal/vulva symptoms of GSM include:

  • Vaginal dryness
  • Decreased lubrication during sexual activity
  • Dysparenuia (painful intercourse) 
  • Vaginal wall prolapse
  • Vaginal bleeding and discharge
  • Burning, dryness, irritation or itching of the vulva
  • Bleeding or spotting after intercourse
  • Loss of libido

 Urinary symptoms of GSM include:

  • Recurrent UTIs
  • Urinary incontinence
  • Stress incontinence (from sneezing, laughing, lifting a heavy object)
  • Urgency urinary incontinence
  • Dysurian (painful urination)

Unlike some symptoms of menopause which can eventually subside, GSM symptoms can worsen over time. It is important to speak to your doctor or menopause specialist about these symptoms if you are experiencing them. They will be able to assist you in the management of the condition and help relieve symptoms. Treatment options for GSM include:

  • Vaginal moisturisers – for mild symptoms, can be used alongside hormone treatment
  • Vaginal lubricants – for short-term relief for vaginal dryness
  • Vaginal oestrogen – in the form of a pessary, cream or gel. This is the best way to restore vaginal pH and decrease incidence og UTIs.
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