What is GSM?

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.

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?

Very. Estimates vary by study, but multiple medical institutions report that more than half, and some report as many as 87% [3], of postmenopausal women experience GSM symptoms. And yet the same research consistently finds that most women never bring it up with a doctor.

What It Can Feel Like [4]

• Vaginal symptoms: dryness, burning, itching, irritation, thinning of tissues or discharge
• Sexual symptoms: pain with intercourse, decreased lubrication, reduced arousal or difficulty achieving orgasm
  
• Urinary symptoms: urgency, frequency, burning with urination, incontinence or 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 inserts, and oral ospemifene.

Nonhormone remedies [6]

• Vaginal lubricants are used with sexual activity and 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 are 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.