Genitourinary Syndrome and Menopause

Genitourinary atrophy is a phenomenon that occurs when the body produces smaller quantities of the hormone estrogen.

Genitourinary atrophy is a phenomenon that occurs when the body produces smaller quantities of the hormone estrogen.

Genitourinary atrophy is a phenomenon that occurs when the body produces smaller quantities of the hormone estrogen. This happens mostly after menopause and is characterized by the drying, thinning, and inflammation of the vaginal walls. This results in discomfort during urination and sexual intercourse. Since it affects both the urinary and vaginal functions, it is medically referred to as the genitourinary syndrome of menopause (GSM).  

What are the symptoms of genitourinary atrophy?  

Common symptoms of genitourinary atrophy are:  

  • Vaginal dryness, vaginal burning, and vaginal discharge  
  • Itching in the genitals and fissures in the perineum
  • Burning sensation while urinating  
  • Frequent urination  
  • Urinary incontinence – urge incontinence (inability to hold urine once he  urge sets in) 
  • Urinary tract infections  
  • Bleeding after intercourse  
  • Uncomfortable intercourse  
  • Absence of vaginal lubrication during sex  
  • Tightening and shortening of the vaginal canal 

What are the causes of genitourinary atrophy?  

Genitourinary atrophy is caused due to low levels of estrogen production in the body. Less estrogen leads to thinning and drying of the vaginal walls and making them less elastic and more fragile.  The reasons that may cause low levels of estrogen production are as follows: 

  • Post-menopausal period  
  • Peri-menopausal period  
  • After the surgical removal of ovaries  
  • During breastfeeding  
  • After undergoing pelvic radiation therapy for cancer  
  • After undergoing chemotherapy for cancer  
  • After taking hormonal treatment for breast cancer  
  • Certain medications, such as birth control pills, affect the production of estrogen in the body.  

The symptoms of GSM may start to appear when your body is leading up to menopause.  Sometimes, they do not appear until several years into menopause. Though this is a common condition, all menopausal women will not necessarily experience these symptoms.  Some severe cases of vaginal atrophy may lead to complications such as vaginal infections and urinary tract problems.  

Lack of sexual activity, smoking, and no vaginal births make a woman more prone to GSM.  

How to prevent genitourinary atrophy?  

Genitourinary syndrome of menopause (GSM) can be prevented by having regular sexual intercourse. Sexual activity increases the blood flow to your vagina, enabling the vaginal tissues to stay healthy and elastic.  You also completely need to stop the use of tobacco. 

What is the treatment for genitourinary atrophy?  

Sexually active people are less prone to getting vaginal atrophy. If you experience dryness during intercourse, you may use water OR SILICONE based lubricants to lubricate it. If you still experience pain during intercourse, consult your doctor, and explore other treatment options. Being sexually active is the key to tackle vaginal atrophy.  

In some cases, doctors may suggest hormonal therapy that helps thicken the vaginal walls and alleviate other GSM symptoms.  

For dryness and burning you can use moisturizers. It is good to use iso-osmolar or silicon based lubricants. Glycerin based lubricants should be avoided in women prone to yeast infections. 

Special Thanks to Dr Meeta Singh (MBBS, MD Ob Gyn) for the expert advice.

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