What is Genitourinary Syndrome of Menopause (GSM)?
Genitourinary syndrome of menopause (GSM) is a prevalent condition that can affect up to 84% of postmenopausal women, but its impact on women going through perimenopause is also significant. While often not discussed openly, GSM manifests with symptoms such as vaginal dryness, itching, burning, irritation, pain during sexual activities, frequent urination, and a heightened risk of urinary tract infections. The hormonal changes during perimenopause and menopause, particularly the decrease in estrogen levels, are key contributors to GSM.
The Role of Estrogen
Estrogen, a hormone crucial for the health and functionality of vaginal and urinary tissues, diminishes during perimenopause and menopause. In normal circumstances, estrogen aids in maintaining the vaginal lining's growth, sustaining a healthy vaginal pH, and boosting lubrication. However, when estrogen levels drop, the vaginal walls can become thinner, less elastic, and dry, leading to the uncomfortable symptoms of GSM. Furthermore, the reduction in muscle tone due to estrogen loss can weaken pelvic floor muscles, potentially causing urinary incontinence and prolapse.
Treatment Options for GSM
Fortunately, effective treatments exist to combat GSM. In a holistic naturopathic approach, three primary solutions are recommended to alleviate urinary and vaginal symptoms: vaginal estrogen, hyaluronic acid, and pelvic floor physiotherapy.
Vaginal Estrogen: One of the most efficient treatments for GSM, vaginal estrogen, can be administered through creams, tablets, or rings. Vaginal estrogen aids in restoring vaginal health by enhancing the thickness and elasticity of vaginal tissues while promoting lubrication.
Hyaluronic Acid: Another natural remedy for GSM is the use of hyaluronic acid. This substance occurs naturally in the body and helps keep tissues hydrated and supple. When applied topically to the vagina, hyaluronic acid can enhance both the quality and quantity of vaginal moisture.
Pelvic Floor Physiotherapy: Referring patients to pelvic floor physiotherapy is another effective strategy in addressing GSM symptoms. These physiotherapy exercises target strengthening the pelvic floor muscles, which may weaken due to GSM, thereby improving conditions like urinary incontinence, prolapse, and recurrent urinary tract infections.
Genitourinary syndrome of menopause remains a significant health concern for many women, and is often under-discussed despite its prevalence. The hormonal changes during perimenopause and menopause can lead to various uncomfortable symptoms associated with GSM. However, with effective treatments like vaginal estrogen, hyaluronic acid, and pelvic floor physiotherapy, these symptoms can be managed efficiently. If you are experiencing any GSM symptoms, do not hesitate to seek support and guidance at Juniper Family Health. We are here to help!
In health and happiness,
Dr. Meghan van Drimmelen, ND | Naturopath Victoria BC
References & Resources:
The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society.