What’s Going On ‘Down There’ Genitourinary Syndrome of Menopause (GSM)?

The current thinking is that around 50% of post-menopausal women will suffer from Genitourinary Syndrome of Menopause (GSM).

It may not be a symptom you experience during perimenopause. Still, it can be more of a slow burner and develop over time.

I think this should be considered a long-term health risk along with Osteoporosis or Heart Disease.

Declining Estrogen levels during Perimenopause and after Menopause cause changes in our vaginal health; the walls become thinner, dryer and more inflamed.

This can lead to the following symptoms.

• Dryness

• Itching

• Soreness

• Burning

• Painful sex

• Urinary Incontinence

• Frequent UTIs

• Urge Incontinence 

• Light bleeding

Thinning of the tissues in and around the vagina causes decreased flexibility, elasticity and reduced mucus production leading to soreness and painful sex.

If you are still having periods, you may even find using a tampon uncomfortable.

Also, lower Estrogen causes the ph. Level in the vaginal to go higher; this can lead to an overgrowth of bacteria and increased instances of UTIs and Thrush, causing itching and burning

It also increases the risk of urinary system atrophy (genitourinary atrophy). Symptoms of GA related urinary tract problems include more frequent or urgent urination and Incontinence.

Unfortunately, reports suggest that almost half of women do not seek help from medical professionals for their symptoms. 

Due, in some part, to us being made to believe that it is just another Menopause issue to resign ourselves to.

But also, as with most things Menopause, it’s not spoken about but can have an effect not just physically but emotionally and mentally.

I remember taking my dogs for a walk, and after around 15 minutes, trying to remember exactly when I sat in a sandbox…. with no underwear on! I was so uncomfortable.

In severe cases, some women can find it impossible to sit for long periods; this symptom can profoundly impact our quality of life.

Prevention and lifestyle

In addition to taking medication, you can make specific lifestyle changes.

• Wearing cotton underwear and loose-fitting clothing can improve symptoms. 

• Loose cotton clothing improves air circulation around the genitals, making them a less ideal environment for bacteria to grow.

• Avoiding perfumed soaps and shower gels, I have recently switched my fabric conditioner to a hypoallergenic one because of irritation.

• Lubricants, pessaries and topical estrogen creams can be found over the counter.

HRT

HRT in the form of oral tablets, gels and patches can help reduce or clear the symptoms of GSM very effectively and Vaginal Estrogen is considered safe for use with systemic (oral, gels and patches) and for those who have had Breast Cancer

Also, in the UK, Gina is available over the counter; it will require a consultation with a pharmacist who will check for contra-indications with any current medications. More Info Here

This type of HRT is specifically for the symptoms of GSM. It is important to note that this type of HRT will not relieve any other symptoms associated with Menopause. 

Remember, Menopause is not something you must endure or ‘get through’; treatments are available.

We do not need to suffer in silence (as has been expected of us) or wait until our symptoms are too much to bear

We are allowed to have a quality of life during and after our Menopause.

You might be interested in my post Why Estrogen Matters and if you want to learn more about

Perimenopause you might like my Navigating the Change Masterclass