What is GSM?
Resources · Understanding your body
What is GSM?
If sex has started to feel different, drier, more uncomfortable, or simply not like it used to, there's a real, medical explanation, and a name for it.
Genitourinary syndrome of menopause
The tissues
- Vagina
- Vulva
- Urethra
- Bladder
declines
Become
- Thinner
- Drier
- Less elastic
- More fragile
GSM is a collection of vaginal, vulvar, sexual and urinary symptoms that occur when estrogen levels decline during and after menopause. This drop in estrogen causes the tissues of the vagina, vulva, urethra and bladder to become thinner, drier, less elastic and more fragile, leading to a range of uncomfortable or disruptive symptoms.1
The Menopause Society suggests that the genitourinary syndrome of menopause (GSM) includes bothersome vaginal, vulvar (lips of the vagina), and urinary symptoms that can affect quality of life, sexual satisfaction, and even your relationship with your partner.2
How common is this, really?
Multiple medical institutions report that more than half, and some as many as 87%, of postmenopausal women experience GSM symptoms.
Estimates vary by study. And yet the same research consistently finds that most women never bring it up with a doctor.
What it can feel like4
Vaginal
- Dryness
- Burning
- Itching
- Irritation
- Thinning of tissues
- Discharge
Sexual
- Pain with intercourse
- Decreased lubrication
- Reduced arousal
- Difficulty achieving orgasm
Urinary
- Urgency
- Frequency
- Burning with urination
- Incontinence
- Recurrent urinary tract infections
What are the treatments?5
There are many effective treatment options for GSM, including over-the-counter and prescription therapies.
Prescription therapies include
- Low-dose vaginal estrogens
- Vaginal dehydroepiandrosterone (DHEA) inserts
- Oral ospemifene
Nonhormone remedies6
Vaginal lubricants
Used with sexual activity, lubricants reduce discomfort and increase pleasure by decreasing friction. These include water-, silicone-, and oil-based products. Oil-based lubricants may damage condoms and may increase the risk of vaginal infections.
Lubricants should not contain flavors (sugar), warming properties, or solvents and preservatives such as propylene glycol and parabens that may cause irritation in some women.
Vaginal moisturizers
Used regularly, often several times weekly, to maintain vaginal moisture, with a goal of reducing the daily symptoms of GSM.
Regular sexual stimulation
Promotes vaginal blood flow and secretions. Sexual stimulation with a partner, alone, or with a device (such as a vibrator) may improve vaginal health.
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Why does sex hurt now?
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