The Overlooked Side of Menopause: Understanding GSM and How OHC Can Help 

As women transition through menopause, most people think of hot flashes, mood shifts, or sleep disturbances. But one condition that often flies under the radar is Genitourinary Syndrome of Menopause (GSM) — a constellation of symptoms affecting the genital and urinary systems. According to a recent Medscape article, GSM has a profound effect on quality of life yet remains frequently under-diagnosed and under-treated.

What Is Genitourinary Syndrome of Menopause (GSM) —and Why It’s Commonly Missed

GSM refers to symptoms that arise when estrogen levels decline, leading to thinning and drying of the vaginal and urethral tissues. Common symptoms include:

• Burning, irritation, or vulvovaginal dryness
• Pain during intercourse (dyspareunia) or reduced libido
• Urinary issues: urgency, frequency, dysuria, and recurrent urinary tract infections

Because these symptoms overlap with other conditions (e.g. urinary tract infections, vaginal infections, pelvic organ prolapse), GSM is often not recognized as a unified syndrome.

In part, the under-diagnosis stems from discomfort discussing these symptoms—many women feel embarrassed or unaware that they are treatable. In France, for instance, nearly half of women under 50 cited difficulty discussing menopause; and one-third of women aged 45–54 felt there was insufficient information on the subject.

Who Is at Risk?

While menopause itself is the primary driver, several factors increase the risk of GSM:

• Smoking, alcohol use
• Lack of sexual activity or long periods of sexual abstinence
• Oophorectomy (removal of ovaries)
• Premature ovarian failure
• Pelvic radiation, chemotherapy, or use of endocrine therapies

These factors contribute to diminished estrogen exposure in genital and urinary tissues, accelerating thinning, loss of elasticity, and microbial imbalance.

Treatment and Management: What Can Be Done

The goal of therapy is to restore comfort, maintain urinary health, and support sexual function. The recommended lifestyle and local measures below can provide symptomatic relief, especially in milder cases.

• Cease smoking, stay physically active
• Encourage regular sexual activity when possible
• Use non-hormonal lubricants or vaginal moisturizers (e.g. hyaluronic acid–based) as first-line therapy

When local measures are not enough:

• Vaginal estrogen therapies (creams, rings, suppositories) can help restore tissue integrity, acidity (pH), and microbial balance
• Dehydroepiandrosterone (DHEA) suppositories also have a role in improving vulvovaginal health
• Systemic hormonal therapy or selective estrogen receptor modulators (e.g. ospemifene) may be appropriate in certain cases, especially when other menopausal symptoms coexist.
• A CO₂ laser therapy is a non-hormonal alternative that has shown promise in improving vaginal and urinary symptoms by restoring mucosal health and vascularization.

Personalized care is key: the optimal approach depends on symptom severity, overall health, and patient preferences.

Why Early Recognition Matters

Because GSM symptoms tend to evolve slowly, many women dismiss them as part of “normal aging.” Yet untreated GSM can lead to chronic discomfort, sexual dysfunction, and recurrent urinary tract infections—negatively impacting quality of life.

Healthcare providers—especially in primary care—play a pivotal role in asking the right questions, recognizing patterns, and initiating early therapy.

At Orthohealing Center, we believe in a holistic approach to health—addressing conditions that may overlap with musculoskeletal or pelvic issues. If you or someone you know is experiencing symptoms such as vaginal dryness, burning, pain with intercourse, or recurrent UTIs after menopause, early intervention can make a meaningful difference in comfort and quality of life.

Visit Orthohealing Center Today!

If you’re navigating your way through perimenopause or post-menopausal life, and notice discomfort or irritating symptoms in your body, Dr. Danielle Aufiero offers personalized care that respects your biology and your lifestyle. Book a consultation to receive an accurate diagnosis and learn how Orthohealing Center can support your musculoskeletal health and healing journey!

(310) 453-5404

www.orthohealing.com