Genitourinary Syndrome of Menopause (GUSM), also known as vaginal atrophy, urogenital atrophy or atrophic vaginitis, refers to changes in the vagina and urethra due to declining estrogen levels in these tissues. As a result of the drop in estrogen these tissues become weakened, thinner, and drier. These symptoms present when women are peri- or postmenopausal.
Genitourinary Syndrome of Menopause Symptoms
Common symptoms of GUSM include:
- Vaginal dryness
- Itching, burning or irritation in the vagina
- Recurrent urinary tract infections
- Urinary frequency
- Urinary urgency
Causes and Risk Factors for Genitourinary Syndrome of Menopause
Genitourinary Syndrome of Menopause typically occurs due to declining estrogen levels in menopause. However, decreased estrogen stimulation of urogenital tissue can also occur in premenopausal women. A decrease in estrogen can also be caused by treatment from surgery, radiation, or hormonal treatment, specifically for breast cancer.
Prevention Strategies for Genitourinary Syndrome of Menopause
There is no way to prevent Genitourinary Syndrome of Menopause as it is a result of decreasing estrogen levels with menopause. However, topical vaginal estrogen can be used to manage the symptoms.
Treatment Options for Genitourinary Syndrome of Menopause
Since there are a variety of conditions that may cause the symptoms associated with Genitourinary Syndrome of Menopause, it is recommended that patients with such complaints see a doctor for further evaluation. A patient history intake will be conducted along with a physical examination for any presenting physical signs.
If diagnosed with GUSM or vaginal atrophy, the most effective treatment for urogenital atrophy is low-dose vaginal estrogen replacement. This topical estrogen comes in a variety of preparations including a cream, suppository and intravaginal ring. It is important to be aware that low-dose vaginal estrogen replacement is not the same as systemic estrogen replacement therapy used to treat hot flashes and bone loss.
Other hormonal treatments:
- Topical estrogen: Available as pills, cream, or rings, and treats the symptoms without the estrogen levels rising in your bloodstream.
- Systemic estrogen therapy: Available as pills, patches, or gels and is often recommended when there are other symptoms of menopause and does not typically treat the vaginal symptoms associated with menopause.
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