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Women's Health

Genitourinary Syndrome of Menopause

GSM is the medical term for both vaginal and bladder symptoms associated with decreasing estrogen levels in perimenopause and menopause. The vagina, labia, urethra, and lower bladder all originate from the same cells and all respond to estrogen — so when estrogen decreases, we can have vaginal symptoms and bladder symptoms. Unlike hot flashes and night sweats, these symptoms do not tend to get better with time.

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Most women don't talk to their doctors about these symptoms and never get treatment. You don't have to — reach out today so that you can feel like yourself again.

What it can look like

Symptoms of GSM

Vaginal Dryness

Vaginal Dryness

Decreased estrogen in the vaginal tissues can cause thin and dry vaginal skin. This can lead to itching, irritation, and discomfort.

Pain with Sex

Pain with Sex

Thin and dry vaginal skin can cause severe pain with intercourse. This can lead to bleeding with sex and even avoidance — and sometimes strain on relationships.

Overactive Bladder

Overactive Bladder

Because the bladder is also sensitive to estrogen, low estrogen can cause urinary frequency, overactive bladder, and urge incontinence.

Frequent UTIs

Frequent Urinary Tract Infections

UTIs can become more frequent in perimenopause and menopause due to the decrease in estrogen. Studies show that vaginal estrogen can decrease the incidence of urinary tract infections.

Treatment of GSM

Topical vaginal estrogen is the first-line treatment for GSM. Almost anyone can use this, because it doesn't increase blood levels of estrogen and there are few side effects. It comes in many different forms — cream, tablet, and ring. If this is not effective, there are other options such as a pill (Osphena) and vaginal DHEA (Intrarosa).

According to internet surveys in women over 40 years old:

85%
report vaginal dryness
59%
report pain with sex
(up to)
77%
report itching or irritation
(up to)

You don't have to live with it.

GSM is common, treatable, and worth talking about. Let's find the option that's right for you.

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This information is for educational purposes and is not a substitute for individualized medical advice. Please consult Dr. Stone about your specific situation.