"What is Genitourinary Syndrome of Menopause?" Jude Answers Your Questions

But did you know that GSM can also contribute to bladder leaks, incontinence and UTIs? We take a look at your most common questions...

"What exactly is Genitourinary Syndrome of Menopause (GSM)?"

Genitourinary Syndrome of Menopause (GSM) refers to a collection of symptoms that occur due to the decline in oestrogen levels during menopause. It affects the genital and urinary areas, leading to various uncomfortable symptoms such as vaginal dryness, itching, burning, urinary frequency, and discomfort during sexual intercourse.

"So how do I know if I have GSM?"

GSM manifests through a range of symptoms affecting the genital and urinary regions. These may include:

• Vaginal Dryness: Decreased lubrication in the vagina, leading to discomfort and pain during intercourse.

• Vaginal Itching and Burning: Irritation and burning sensations in the vaginal area, often accompanied by itching.

• Urinary Symptoms: Increased frequency of urination, urgency, and sometimes urinary incontinence.

• Vaginal Atrophy: Thinning, inflammation, and dryness of the vaginal walls, which can result in pain and discomfort during sexual activity.

"How does GSM affect my bladder?"

GSM can significantly impact the bladder, leading to a variety of urinary symptoms including leaks, incontinence, and urinary tract infections (UTIs). As oestrogen levels decline during menopause, the tissues in the urethra and bladder can become thinner and less elastic, increasing the likelihood of urinary leakage and incontinence.

But that's not all. Changes in the vaginal microbiome and pH levels associated with GSM can create an environment that is more conducive to bacterial overgrowth, raising the risk of UTIs. These symptoms can not only be physically uncomfortable but also emotionally distressing for women so seeking help early is important.

"How do my hormones contribute to GSM?"

Hormone imbalance, particularly the decline in oestrogen levels during menopause, is the primary cause of GSM. Oestrogen plays a crucial role in maintaining the health and function of the vaginal and urinary tissues. When oestrogen levels decrease, these tissues become thinner, less elastic, and more prone to irritation and inflammation, leading to the symptoms associated with GSM.

"Will GSM go away on its own?"

Unfortunately, GSM typically does not resolve on its own. Without intervention, symptoms may persist and even worsen over time, impacting quality of life and sexual health. However, there are effective treatment options available to manage and alleviate GSM symptoms.

"Are there any risks or side effects associated with vaginal oestrogen therapy?"

Vaginal oestrogen therapy is generally considered safe for most women when used as directed. Since the oestrogen is delivered locally to the vaginal tissues, the risk of systemic side effects is minimal. However, some women may experience mild side effects such as vaginal discharge, irritation, or spotting. It's essential to discuss any concerns with your GP or pharmacist.

"Can GSM make you feel down or depressed?"

GSM can significantly impact women's mental wellbeing, as the distressing symptoms it presents can lead to general discomfort and pain which is tough to manage mentally, as well as physically. It can limit your lifestyle in many ways and overall diminish your quality of life. The discomfort and pain associated with GSM may contribute to feelings of frustration, embarrassment, and even depression or anxiety. That's why it's important to address GSM quickly when you start to notice symptoms.

"Can it affect my sex life?"

GSM can significantly impact your sex life. The symptoms, such as vaginal dryness, itching, and pain during intercourse, can lead to discomfort and reduced sexual satisfaction. These physical challenges may also contribute to emotional distress, anxiety, and avoidance of sexual activity. However, effective treatment options, such as vaginal estrogen therapy and lubricants, can help alleviate symptoms and improve sexual function, enhancing intimacy and enjoyment in your sex life.

"What is the best treatment for GSM?"

The most effective treatment for GSM involves addressing the underlying hormonal imbalance. Vaginal oestrogen therapy is considered the gold standard for managing GSM symptoms. It helps restore oestrogen levels in the vaginal tissues, improving lubrication, elasticity, and overall vaginal health.

Vaginal oestrogen therapy comes in various forms, including vaginal creams, tablets, and rings. These products deliver oestrogen directly to the vaginal tissues, bypassing the bloodstream and minimising systemic effects. They help replenish oestrogen levels in the vaginal tissues, relieving symptoms such as dryness, itching, and discomfort.

Other alternative treatments for GSM include non-hormonal moisturisers that offer long-lasting hydration, water-based lubricants for immediate relief during sexual activity by reducing friction, and lifestyle changes such as wearing breathable cotton underwear, staying hydrated, and avoiding irritants to alleviate GSM symptoms.

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