Section 3: Treating GSM

There are effective management strategies and treatment options that can provide relief for your GSM symptoms and improve your quality of life.

Treatment for GSM includes hormonal and non-hormonal therapies. Local estrogen therapy is commonly used and can significantly alleviate symptoms by restoring the health of vaginal and urinary tissues. Non-hormonal moisturizers and lubricants also provide relief.

In addition to medical treatments, lifestyle adjustments can help manage symptoms. Staying sexually active helps maintain blood flow to the genital area, and pelvic floor exercises strengthen the muscles supporting the bladder and uterus, improving both urinary and genital symptoms.

For managing Genitourinary Syndrome of Menopause (GSM), there are several treatment strategies that combine hormonal, non-hormonal, and lifestyle modifications to enhance quality of life and alleviate symptoms.

Hormonal Therapies

Local Estrogen Therapy: This is often administered in the form of vaginal creams, tablets, or rings that release estrogen directly to the vaginal area. These treatments can help restore tissue health and alleviate symptoms such as dryness, itching, and discomfort during intercourse.

Examples include estradiol tablets, estradiol vaginal creams, or estrogen rings.

Non-hormonal Therapies

Vaginal Moisturizers: These are used several times a week to maintain vaginal moisture and elasticity. They are absorbed into the skin, enhancing the thickness and elasticity of vaginal cells, thereby improving moisture production.

Lubricants: Used at the time of sexual activity to reduce friction and pain, water-based lubricants like KY^TM Jelly or silicone-based options are popular choices.

It’s important to understand that vaginal moisturizers and lubricants serve distinct purposes and applications for alleviating discomfort associated with vaginal dryness.

Moisturizers are intended for regular use, applied daily or every few days, and even two hours before sexual activity to replenish moisture.

On the other hand, lubricants are specifically used during sexual activity to reduce friction and enhance comfort by creating a slippery barrier on the skin’s surface. Available in various types, such as water-based, which are condom and silicone toy safe but may become tacky, and oil-based, which are not suitable for use with condoms, each type caters to different needs and preferences.

Lifestyle Adjustments

Pelvic Floor Exercises: Often referred to as Kegel exercises, these involve contracting and relaxing the muscles that support the urinary tract and reproductive organs, improving urinary and genital symptoms.

Staying sexually active and maintaining sexual activity – whether through solo play or with a partner – can help preserve blood flow to the genital area, promoting tissue health and flexibility.

Pelvic Physical Therapy

This specialized therapy targets the pelvic floor muscles through exercises and manual techniques to strengthen and relax the muscles. Techniques used might include:

• Manual Therapy: Techniques such as massage and mobilization to relieve pelvic pain and improve muscle function.
• Biofeedback: Using sensors, biofeedback helps patients understand and improve their pelvic floor muscle control.
• Education on Proper Techniques for Pelvic Exercises: A pelvic physical therapist can provide detailed guidance on performing pelvic floor exercises correctly to avoid aggravating symptoms.

By integrating these treatments, women experiencing GSM can significantly improve their symptoms and quality of life.

If you believe you are experiencing one or more symptoms related to GSM, you can work with a Urogynecologist and/or a Pelvic Physical Therapist to develop a treatment plan that works for you.

A Urogynecologist is a medical specialist who focuses on the diagnosis and treatment of pelvic floor disorders in women. These disorders can include urinary incontinence, pelvic organ prolapse, and issues related to bladder, bowel, and sexual function that often arise from childbirth, menopause, or aging. Urogynecologists receive training in both gynecology and urology, providing them with a comprehensive understanding of the female pelvic anatomy and its complex interrelated systems. They are equipped to offer a range of treatments from conservative management, like pelvic floor exercises, to more advanced surgical interventions aimed at restoring pelvic health and improving quality of life.

A pelvic physical therapist is a specialized physical therapist who focuses on the evaluation and treatment of pelvic floor muscle dysfunction. These professionals treat a variety of conditions affecting the pelvic region, including incontinence, pelvic pain, and pelvic organ prolapse, which can arise from childbirth, surgery, aging, or injury. Pelvic floor therapists use a combination of manual therapies, exercises, and sometimes biofeedback to strengthen or relax pelvic muscles, improve bladder and bowel function, and alleviate pain. Their goal is to restore normal pelvic floor function and enhance the patient’s quality of life through personalized rehabilitation programs.

Knowledge Check – Genitourinary Syndrome of Menopause

In the first half of this module, we covered the symptoms that make up GSM and the various ways treatment options. In the second half, you’ll learn about specific strategies and practices for maintaining your pelvic floor health to prevent the devastating effects of GSM.

Let’s check-in to see how confident you are in your understanding of GSM and your pelvic floor health!