Genitourinary Syndrome of Menopause: Management Strategies for the Clinician

Stephanie S. Faubion, Richa Sood, Ekta Kapoor

Research output: Contribution to journalReview article

22 Citations (Scopus)

Abstract

Genitourinary syndrome of menopause (GSM), previously known as atrophic vaginitis or vulvovaginal atrophy, affects more than half of postmenopausal women. Caused by low estrogen levels after menopause, it results in bothersome symptoms, including vaginal dryness, itching, dyspareunia, urinary urgency and increased frequency, and urinary tract infections. Even though women with GSM can have sexual dysfunction that interferes with partner relationships, women are often embarrassed to seek treatment, and health care professionals do not always actively screen for GSM. As a result, GSM remains underdiagnosed and undertreated. Several effective treatments exist, but low-dose vaginal estrogen therapy is the criterion standard. It is effective and safe for most patients, but caution is suggested for survivors of hormone-sensitive cancers. Newer treatment options include selective estrogen receptor modulators, vaginal dehydroepiandrosterone, and laser therapy. Nonprescription treatments include vaginal lubricants, moisturizers, and dilators. Pelvic floor physical therapy may be indicated for some women with concomitant pelvic floor muscle dysfunction. Sex therapy may be helpful for women with sexual dysfunction. This concise review presents a practical approach to the evaluation and management of GSM for the primary care physician.

Original languageEnglish (US)
Pages (from-to)1842-1849
Number of pages8
JournalMayo Clinic Proceedings
Volume92
Issue number12
DOIs
StatePublished - Dec 1 2017

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Menopause
Pelvic Floor
Therapeutics
Atrophic Vaginitis
Estrogens
Dyspareunia
Selective Estrogen Receptor Modulators
Lubricants
Dehydroepiandrosterone
Primary Care Physicians
Laser Therapy
Pruritus
Urinary Tract Infections
Atrophy
Survivors
Hormones
Delivery of Health Care
Muscles
Neoplasms

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Genitourinary Syndrome of Menopause : Management Strategies for the Clinician. / Faubion, Stephanie S.; Sood, Richa; Kapoor, Ekta.

In: Mayo Clinic Proceedings, Vol. 92, No. 12, 01.12.2017, p. 1842-1849.

Research output: Contribution to journalReview article

Faubion, Stephanie S. ; Sood, Richa ; Kapoor, Ekta. / Genitourinary Syndrome of Menopause : Management Strategies for the Clinician. In: Mayo Clinic Proceedings. 2017 ; Vol. 92, No. 12. pp. 1842-1849.
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