Section 1: What is Genitourinary Syndrome of Menopause?

Genitourinary Syndrome of Menopause (GSM) is a comprehensive term encompassing a range of symptoms affecting the vulva, vagina, and lower urinary tract due to menopausal changes.

GSM symptoms arise from changes in the genitourinary tract, including the vulva, vagina, and lower urinary system, primarily due to the decline in estrogen levels during menopause. You may have also heard GSM referred to as “vaginal atrophy” or “atrophic vaginitis”, however, these terms do not adequately cover all symptoms of GSM. GSM manifests in various ways, such as vaginal dryness and irritation, and pain during intercourse, and may include urinary discomforts like increased urgency and recurrent infections.

When it comes to urinary symptoms, you may experience:

• Burning with urination 
• Frequent urination or Urgency with urination 
• Recurring urinary tract infections 
• Urinary incontinence

You may experience pelvic floor issues like:

• Pelvic floor muscle weakness 
• Pelvic floor muscle increased tightness/tension 
• Decreased elasticity of pelvic floor muscles/tissues/fascia 

Vaginal symptoms include but may not be limited to:

• Vaginal dryness and decreased lubrication
• Vaginal irritation/burning/itching 
• Vaginal discharge
• Vaginal prolapse (a downward shift of pelvic organs into the vagina) 
• Genital itching

Sexual symptoms may include:

• Painful sexual intercourse (dyspareunia) 
• Decreased lubrication during intercourse
• Bleeding after sexual activity 
• Decreased arousal