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HWN Suggests

The Magic of Hormones

This condition is called GSM... If we warned women that this was going to happen, we could stop the changes before they start. Hence why I said it’s the only essential oil and should be given early as prevention. Don’t start watering the garden after all the plants have wilted... Not only will vaginal estrogen decrease recurrent UTIs, but it will improve many lower urinary tract symptoms including frequency, urgency, and painful urination. It will also help improve arousal, lubrication and decrease painful penetration. The problem is that less than 7% of women with GSM are prescribed vaginal estrogen, and many who get the prescription don’t use it properly, can’t afford it, stop using it,…

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 Genitourinary syndrome of menopause (GSM) — a refresher

Women should be proactively educated on the changes in the genital tract after menopause at routine visits, rather than waiting for patients to bring up the subject. We suggest incorporating questions alongside bowel and bladder review of systems. While women have many different manifestations of GSM, the most common complaint is vaginal dryness, so “Do you have any vaginal dryness?”, would be a sensitive single question for practitioners not currently asking about genital health routinely. Unlike vasomotor symptoms, GSM often continues to worsen with time if untreated, and patients should be made aware that they cannot just “wait it out.”

 Hyaluronic Acid: A Valid Therapeutic Option for Early Management of Genitourinary Syndrome of Menopause in Cancer Survivors?

Despite the relative low number of patients included in the studies and missing information on the dosage used for some of them, the clinical testing has demonstrated that intravaginal treatment with HA-based products successfully reduces GSM symptoms in postmenopausal woman, and their efficacy is superimposable to that of topical estrogen preparations at least in the short term. The beneficial effect of HA treatment was also evidenced by the high degree of patients’ satisfaction. Furthermore, its favorable safety profile and excellent local tolerability were confirmed.

 If your menopause symptoms aren't going away, it could be this little-known syndrome

Anywhere from 27 to 84 percent of women experience genitourinary syndrome of menopause—an underdiagnosed condition with profound consequences on your everyday life.

 Treating the Incredible Shrinking Vagina

G.S.M. is primarily caused by dropping levels of estrogen during menopause. As a result, the skin of the vulva and the vagina become thinner with a loss of elasticity. The labia minora can also reduce in size. Common symptoms of G.S.M. include vaginal or vulvar dryness. Other symptoms can occur during sex, including loss of lubrication, an uncomfortable sandpaper-like sensation, pain, difficulties achieving orgasm and even tearing of the vagina or vulva. There is also an increased risk of urinary tract infections.

 ‘Millions of women are suffering who don’t have to’: why it’s time to end the misery of UTIs

Urinary tract infections have been a cause of chronic distress for generations of menopausal women. Campaigning journalist Kate Muir argues the problem could be halved if an alternative treatment to antibiotics is better understood. So why isn’t more being done? Although some GPs and urologists are getting the message and prescribing vaginal oestrogen, more work needs to be done.

Articles of Interest

Genitourinary Syndrome of Menopause

Genitourinary syndrome of menopause (GSM), formerly called vulvovaginal atrophy (VVA), is a syndrome defined as a set of signs and symptoms resulting from estrogen deficiency in the female genitourinary tract, including the vagina, lips, urethra, and bladder. This syndrome includes genital symptoms of dryness, burning and irritation, urinary symptoms and conditions of dysuria, nocturia, urgency and recurrent urinary tract infections (UTIs) and sexual symptoms of dyspareunia and lack of lubrication. Although it is more frequent in climacteric women, it can also occur in other situations of hypoestrogenism.

Genitourinary Syndrome of Menopause: Management Strategies for the Clinician

Genitourinary syndrome of menopause (GSM), previously known as atrophic vaginitis or vulvovaginal atrophy, affects more than half of postmenopausal women. Caused by low estrogen levels after menopause, it results in bothersome symptoms, including vaginal dryness, itching, dyspareunia, urinary urgency and increased frequency, and urinary tract infections. Even though women with GSM can have sexual dysfunction that interferes with partner relationships, women are often embarrassed to seek treatment, and health care professionals do not always actively screen for GSM. As a result, GSM remains underdiagnosed and undertreated.

My story: Living with GSM

Genitourinary syndrome of menopause (GSM), or ‘vaginal dryness’ sounds like a mild problem which might strike in your 60’s or 70’s (once the hot flushes have stopped), and causing a bit of bother in the bedroom. Wrong. GSM is a condition that affects up to 70% of women at some time, peri- or postmenopause, and this year, it was my turn.

Position Statement for Management of Genitourinary Syndrome of the Menopause (GSM)

One of the most consistently identified predictors of impaired sexual health in women is the presence of vaginal symptoms. Up to 84% of postmenopausal women have symptoms associated with Genitourinary Syndrome of the Menopause (GSM) yet only a minority receive any treatment. Unlike many other symptoms of the menopause, symptoms of GSM often worsen over time.

The Genitourinary Syndrome of Menopause: An Overview of the Recent Data

First-line treatment consists of non-hormonal therapies such as lifestyle changes, lubricants, and moisturizers, while hormonal therapy with locally administered intravaginal estrogen products is considered the “gold standard’’ in more persistent cases. Newer therapeutic approaches with SERMs or laser technologies can be employed as alternative options, but further research is required to analyze their implementation in day-to-day clinical practice.

The impact of genitourinary syndrome of menopause on well-being, functioning, and quality of life in postmenopausal women

It is important for gynecologists, nurse practitioners, and primary care doctors to be aware of the major impact of this syndrome on well-being and QoL of postmenopausal women. They should routinely assess perimenopausal and postmenopausal women for GSM and sexual activities.

The Recent Review of the Genitourinary Syndrome of Menopause

The genitourinary syndrome of menopause (GSM) is a new term that describes various menopausal symptoms and signs including not only genital symptoms (dryness, burning, and irritation), and sexual symptoms (lack of lubrication, discomfort or pain, and impaired function, but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections). The terms vulvovaginal atrophy and atrophic vaginitis, which were generally used until recently, had a limitation because they did not cover the full spectrum of symptoms and did not imply that the symptoms are related to a decreased estrogen level in menopause.

Urologists must start the conversation about genitourinary syndrome of menopause

Genitourinary syndrome of menopause (GSM), a spectrum of symptoms and signs caused by hypoestrogenic changes in urogenital tissues typically occurring during menopause, affects up to 87% of postmenopausal women. The discomfort, pain and irritation in symptomatic women can greatly impact their quality of life, including their sexual function and interpersonal relationships. Yet fewer than 6% of women with GSM signs and symptoms are being treated.

What happens during menopause? Science is finally piecing it together

GSM symptoms may be treated with a vaginal moisturizer or with estrogen administered vaginally, which seems to be safer than systemic hormones, Mayo’s Thielen says. Pelvic floor physical therapy and vaginal laser treatments (to stimulate blood flow) are also worthwhile, according to MyMenoPlan, a website aiming to personalize treatment advice that was developed by a network of menopause researchers and funded by the National Institutes of Health.