As women transition into menopause, a natural phase of life often starting around age 50, many changes occur in the body. While some of these changes are well-known, others—like Genitourinary Syndrome of Menopause (GSM)—are less frequently discussed. Despite affecting up to 50% of postmenopausal women, GSM remains underdiagnosed and undertreated. This blog aims to shed light on GSM, its impact on urinary and sexual health, and the empowering steps women can take to address it.
What is GSM?
Genitourinary Syndrome of Menopause is a term used to describe a collection of symptoms caused by the decrease in estrogen and other hormones during menopause. This hormonal shift affects the vulva, vagina, urethra, and bladder, leading to changes in the genitourinary tract’s structure and function. Common symptoms include:
- Vaginal dryness
- Painful intercourse (dyspareunia)
- Vaginal itching or burning
- Recurrent urinary tract infections (UTIs)
- Urinary urgency and incontinence
These symptoms can significantly impact quality of life, sexual relationships, and self-esteem. However, GSM is treatable, and women don’t have to suffer in silence.
Why Does GSM Occur?
The root cause of GSM is the decline in estrogen levels. Estrogen plays a crucial role in maintaining the thickness, elasticity, and lubrication of the vaginal walls, as well as supporting the health of the urinary tract. When estrogen decreases:
- The vaginal walls thin and lose elasticity.
- Natural lubrication decreases, making the tissue more prone to irritation and tearing.
- The urinary tract becomes more susceptible to infections and irritation due to changes in pH and microbiome.
These changes are natural, but they can feel anything but normal when you’re experiencing them. Recognizing that these symptoms are part of a broader syndrome can help you take proactive steps toward relief.
Dispelling the Taboo Around GSM
Unfortunately, many women feel embarrassed to discuss these symptoms with their healthcare providers. Activated Health and Wellness aims to create a comfortable, judgment-free environment where patients feel safe discussing sensitive topics like GSM. A 2019 study found that less than 40% of women experiencing GSM symptoms sought medical help, often due to stigma or the misconception that these changes are an inevitable part of aging.
It’s time to break the silence around GSM. Open conversations with trusted healthcare professionals and partners can pave the way to effective treatment and improved quality of life.
Dr. Melody Rodarte always says, “There’s no trophy for toughing it out alone.” You deserve care that respects and celebrates your health journey.
The Impact of GSM on Urinary Health
Many women are surprised to learn how closely urinary health is linked to menopause. The loss of estrogen affects the bladder and urethra, leading to symptoms such as:
- Increased Urinary Tract Infections (UTIs): Changes in vaginal and urinary tract microbiota can predispose postmenopausal women to recurrent UTIs. (Rahardjo et al., 2021)
- Urinary Urgency and Frequency: The thinning of urethral tissue can lead to overactive bladder symptoms, causing frequent trips to the bathroom.
- Stress Urinary Incontinence (SUI): Weakened pelvic floor muscles may result in urine leakage during physical activities like sneezing, coughing, or exercising.
The Impact of GSM on Sexual Health
Sexual health is another critical aspect of GSM that can deeply influence emotional well-being and intimacy. Painful intercourse due to vaginal dryness or atrophy often leads to decreased sexual activity, which can ultimately strain relationships and erode self-confidence.
Women may also experience a decreased libido, influenced by both hormonal changes and the discomfort caused by GSM. This multifaceted impact on sexual health underscores the importance of holistic approaches to treatment.
Intimacy doesn’t have to fade with age—it might just need a little support to keep things exciting and comfortable. To address this, we’ve introduced the O-Shot, a natural treatment option that uses your body’s own growth factors to rejuvenate tissue, improve lubrication, and enhance sexual satisfaction.
Evidence-Based Treatment Options
Thankfully, GSM is treatable, and there is a range of solutions tailored to individual needs. These are a few medical and lifestyle approaches we can consider:
1. Hormonal Therapies
- Topical Estrogen: Low-dose vaginal estrogen creams, tablets, or rings effectively restore vaginal tissue health without significantly affecting systemic hormone levels. (The North American Menopause Society [NAMS], 2020)
- Bioidentical Hormone Replacement Therapy (BHRT): For women experiencing multiple menopausal symptoms, HRT can address GSM alongside hot flashes, mood changes, and more. However, it’s essential to discuss risks and benefits with your provider.
2. Non-Hormonal Options
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- Vaginal Moisturizers and Lubricants: These over-the-counter solutions provide temporary relief from dryness and discomfort during intercourse.
- Laser and Energy-Based Therapies: Vaginal rejuvenation treatments using fractional CO2 lasers or radiofrequency energy have shown promise in improving GSM symptoms by stimulating collagen production and enhancing tissue elasticity. (Krapf et al., 2021)
- O-Shot: A platelet-rich plasma (PRP) treatment that uses your body’s own growth factors to rejuvenate vaginal tissue, improving sensitivity, lubrication, and overall vaginal health.
3. Pelvic Floor Physical Therapy
Strengthening pelvic floor muscles through guided physical therapy can alleviate urinary symptoms and improve sexual function. A tailored exercise program, often including Kegel exercises, is a cornerstone of pelvic health management.
4. Dietary and Lifestyle Modifications
- Hydration and Nutrition: A diet rich in phytoestrogens (found in soy, flaxseeds, and legumes) may provide mild estrogenic effects.
- Probiotics: Maintaining a healthy vaginal microbiome is critical. Probiotic supplements targeting urinary and vaginal health can be beneficial. (Hempel et al., 2019)
- Regular Sexual Activity: Engaging in sexual activity—with or without a partner—promotes blood flow and maintains vaginal elasticity.
The Role of Mind-Body Wellness
While medical treatments address the physical symptoms of GSM, emotional well-being is equally important. Mind-body practices such as yoga, meditation, and mindfulness can reduce stress and improve pelvic floor function. Additionally, open communication with partners fosters emotional intimacy and mutual understanding.
When to Seek Help
If GSM symptoms are interfering with your daily life, it’s time to consult a healthcare provider. Functional medicine practitioners and gynecologists specializing in menopausal care can offer personalized treatment plans tailored to your unique needs.
Remember: Asking for help isn’t a weakness—it’s your superpower. Taking charge of your health is the ultimate act of self-care, and we’re here to help you reclaim your vitality and confidence!
Looking Ahead: Breaking Barriers in Menopause Care
The conversation around menopause is changing, and women’s voices are at the forefront. Innovations in medicine and wellness offer more options than ever before to manage GSM so you can thrive through menopause. By embracing these solutions and advocating for open dialogue, we can destigmatize GSM and ensure every woman feels supported during this transformative phase of life.
Final Thoughts
GSM may be a natural part of menopause, but it doesn’t have to define your experience. By empowering yourself with knowledge, evidence-based treatments, and the support of a compassionate healthcare team, you can approach this phase with confidence and grace. You deserve to feel empowered, informed, and in control of your health at every stage of life.
Ready to take control of your journey? As an all-female team, we understand the unique challenges of menopause and are here to support you. Come in for a consultation – we’d love to walk you through your options and create a plan personalized to you so you can thrive through this new chapter with confidence.
References:
- Rahardjo, H. E., Widjanarko, B., & Raharjanti, R. (2021). Postmenopausal atrophic vaginitis: A narrative review of clinical management. Journal of Menopausal Medicine, 27(1), 7-14.
- The North American Menopause Society. (2020). Hormone therapy position statement of The North American Menopause Society. Menopause, 27(9), 973-990.
- Krapf, J. M., Simon, J. A., & Wekselman, K. (2021). Energy-based treatments for genitourinary syndrome of menopause: Consensus and controversies. Journal of Women’s Health, 30(4), 524-531.
- Hempel, S., Newberry, S. J., Maher, A. R., Wang, Z., & Miles, J. N. V. (2019). Probiotics for the prevention and treatment of postmenopausal vaginal health: Systematic review and meta-analysis. BMC Women’s Health, 19(1), 36.
- Shifren, J. L., & Gass, M. L. S. (2020). The role of local estrogen therapy in genitourinary syndrome of menopause. Obstetrics & Gynecology Clinics of North America, 47(2), 257-268.
