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BackTable / Urology / Topic / Condition

Genitourinary Syndrome of Menopause

Genitourinary syndrome of menopause (GSM) includes genital, sexual, and urinary symptoms of menopause associated with physical changes of the lower urinary tract, along with the vulva and vagina. Genital symptoms include dryness, burning, and irritation, and sexual symptoms include lack of lubrication, pain, and impaired function. These symptoms are related to the lower levels of estrogen circulating in a woman’s body after menopause. Urgency, dysuria, and recurrent urinary tract infections are urinary symptoms of GSM. Around 20%-50% of postmenopausal women experience urgency and stress-related UI.

Genitourinary Syndrome of Menopause Condition Overview

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Ep 117 Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic with Dr. Rachel Rubin
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Genitourinary Syndrome of Menopause Diagnosis

A full patient history should be performed before diagnosing genitourinary syndrome of menopause. The genitourinary region can be irritated by lubricants, soaps, and powders, and antiestrogen medications can also cause symptoms of genitourinary syndrome of menopause in premenopausal women. Along with the patient’s history, a pelvic examination should be performed to check for lesions, labial fusion, friable epithelium, and introital stenosis. Laboratory tests are helpful in making a diagnosis. Cytology, ultrasound, vaginal culture, Pap test, are useful in assessing the symptoms of genitourinary syndrome of menopause. Differential diagnoses include bacterial vaginosis, trichomoniasis, and candidiasis.

Genitourinary Syndrome of Menopause Podcasts

Listen to leading physicians discuss genitourinary syndrome of menopause on the BackTable Urology Podcast. Get tips, tricks, and expert guidance from your peers and level up your practice.

Genitourinary Syndrome of Menopause Treatment

First line therapies, such as long-acting vaginal moisturizers and low-dose vaginal estrogen, are used to treat postmennopausal women with vulvovaginal symptoms that are unrelated to sexual activity. If symptoms are related to sexual activity, a more complex treatment regimen is used. Systemic therapies include hormone therapy, selective ER modulators, bazedoxifene, and conjugated estrogens while local treatments can be hormonal or non-hormonal. Vaginal creams, intravaginal tablets, and intravaginal rings are all forms of low dose vaginal estrogen therapies. Non-hormonal therapies can be effective in women at risk for estrogen responsive neoplasia.

Genitourinary Syndrome of Menopause Articles

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Genitourinary Syndrome of Menopause Demos

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Genitourinary Syndrome of Menopause Tools

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References

[1] Kim, H.-K., Kang, S.-Y., Chung, Y.-J., Kim, J.-H., & Kim, M.-R. (2015, August 28). The recent review of the Genitourinary Syndrome of Menopause. Journal of menopausal medicine. Retrieved November 5, 2021, from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561742/
[2] Gandhi, J., Chen, A., Dagur, G., Suh, Y., Smith, N., Cali, B., & Khan, S. A. (2016, December). Genitourinary syndrome of menopause: an overview of clinical manifestations, pathophysiology, etiology, evaluation, and management. AJOG. Retrieved November 5, 2021, from https://www.ajog.org/article/S0002-9378(16)30518-X/pdf

Disclaimer: The Materials available on https://www.BackTable.com/ are for informational and educational purposes only and are not a substitute for the professional judgment of a healthcare professional in diagnosing and treating patients. The opinions expressed by participants of the BackTable Podcast belong solely to the participants, and do not necessarily reflect the views of BackTable.

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Podcasts

Genitourinary Syndrome of Menopause (GSM): Improving a DRY Topic with Dr. Rachel Rubin on the BackTable Urology Podcast)
Breaking Down Interstitial Cystitis with Dr. Esther Han on the BackTable Urology Podcast)
Women's Sexual Health with Dr. Ashley Winter on the BackTable Urology Podcast)
Management of Cystitis & Pelvic Pain Syndrome with Dr. Yahir Santiago-Lastra and Dr. Jose Silva on the BackTable Urology Podcast)
Optimizing Bladder Health in BPH Treatment Strategies with Dr. Shawn West on the BackTable Urology Podcast)

Articles

A surgeon performing a urinary diversion with cystectomy to treat complications of genitourinary syndrome of menopause

Genitourinary Syndrome of Menopause: Procedural & Surgical Management

Female physician talking to a patient about genitourinary syndrome of menopause

Treatment of Genitourinary Syndrome of Menopause

Contributors

Dr. Esther Han on the BackTable Urology Podcast

Dr. Esther Han

Dr. Ashley Winter on the BackTable Urology Podcast

Dr. Ashley Winter

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