Genitourinary syndrome (now most commonly called genitourinary syndrome of menopause, or GSM) refers to a group of symptoms affecting the vagina, vulva, and urinary tract, primarily caused by a lack of estrogen.

Cause

The main trigger is a decline in estrogen levels, typically occurring:

• during menopause
• after surgery involving the ovaries
• during certain cancer treatments or hormone therapies
• temporarily during breastfeeding

A lack of estrogen causes the mucous membranes to become thinner, drier, and less elastic.

Typical Symptoms

In the genital area

• Vaginal dryness
• Burning or itching
• Pain during sexual intercourse (dyspareunia)
• Bleeding after sex

In the urinary tract

• Frequent urge to urinate
• Burning during urination
• Recurrent urinary tract infections
• Stress or urge incontinence

Why the Term Is Important

In the past, people often spoke only of “vaginal atrophy.”
GSM is more precise because it describes both genital and urinary tract symptoms together.

Treatment Options

• Non-hormonal: vaginal moisturizers, lubricants
• Local hormonal therapy: estrogen-containing vaginal creams, tablets, or rings
• Other options: pelvic floor training and, if necessary, physician-recommended therapies

Important: GSM is common, treatable, and not an unavoidable consequence of aging.