Genitourinary syndrome of menopause

See ((Vulvovaginal atrophy))

A common , underrecognized, and undertreated process that results from decreased estrogen levels.

It affects almost 50% post menopausal women.

This syndrome can occur in other low estrogen states, such as postpartum, during lactation, and with aromatase inhibitors.

Decreased estrogen levels after menopause lead to the genitourinary syndrome of menopause (GSM), previously known as vulvovaginal atrophy. 


In the Women’s Health Initiative Trial the administration of oral systemic estrogens increased urinary urgency, but the  use a vaginal estrogen diminished urinary urgency and decreased the risk of recurrent urinary tract infections.

Also referred to as vulvovaginal atrophy, vaginal atrophy, and atrophic vaginitis.

Involves the vulvar, vaginal and lower urinary tract tissues.

Is a chronic and progressive process and symptomatology resolves only with treatment.

Associated with 59% likelihood of symptoms decreasing sexual activity enjoyment , and 23% reporting adverse affects of general enjoyment of life.

Vaginal laser therapy for GSM revealed no statistical significant difference in patient reported outcomes, physician reported outcomes, or histologic outcomes.
Among  women with postmenopausal vaginal symptoms, treatment with fractional carbon dioxide laser versus sham treatment did not significantly improve vaginal symptoms after 12 months.

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