What Is Genitourinary Syndrome of Menopause?
Genitourinary Syndrome of Menopause is used to describe a range of aggravating symptoms that affect the genitals, urinary tract and sexual function due to a clinical state of hypoestrogenism, which concurs during menopause. The term was previously known as atrophic vaginitis (AV) or vulvovaginal atrophy (VVA). The International Society for the Study of Women’s Sexual Health (ISSWSH) and the North American Menopause Society (NAMS) endorsed the new term “Genitourinary Syndrome of Menopause” (GSM) in 2014, because it is medically more accurate, all encompassing, and publicly more acceptable than “vulvovaginal atrophy.”
Why Does Genitourinary Syndrome Occur?
The female genitals and lower urinary tracts share a common embryological origin and oestrogen receptor function. Due to this, both are sensitive to the effects of female sex steroid hormones. Oestrogen, which is essential in keeping the vitality of the genitourinary system, declines following menopause. The vagina shortens and loses its elasticity, and its epithelium becomes thin, dry, and fragile. The vaginal acidity is also changed, making it prone to infections. As the vulva becomes atrophic, the labia majora and minora shrink and contract, exposing the underlying sensitive areas and making them more prone to chafing. The introitus is also retracted, and the urethral meatus becomes more prominent. Pelvic floor muscles become weaker, giving rise to urinary symptoms.
How Common Is Genitourinary Syndrome?
Genitourinary Syndrome is a common condition, affecting more than 40% of women at midlife and beyond. Despite being a treatable medical condition, it is often under-diagnosed and under-treated. According to the Pan-Asian REVIVE study on GSM in five Asian countries, only 21% had been clinically diagnosed with GSM and only 24% had ever used treatment for their symptoms.

What Are Signs and Symptoms of GSM?
Generally, the manifestations of GSM are divided into genital, urological and sexual symptoms. A summary of the manifestations of GSM is below:
- Vaginal dryness
- Vaginal burning
- Vaginal discharge
- Genital itching
- Burning with urination
- Urgency with urination
- Frequent urination
- Recurrent urinary tract infections
- Urinary incontinence
- Light bleeding after intercourse
- Discomfort with intercourse
- Decreased vaginal lubrication during sexual activity
- Shortening and tightening of the vaginal canal
Genitourinary Syndrome Treatment in Southern California
At Women’s Center for Pelvic Wellness, expert urogynecologists, Dr. Alexis May Kimble and Dr. David Kimble can help determine a treatment plan for GSM. Call the office at (626) 535-0832 or book an appointment using the form below to feel more like yourself again.