Navigating Genitourinary Syndrome of Menopause

Allison holding a model of a pelvic floor

Navigating Genitourinary Syndrome of Menopause

Allison holding a model of a pelvic floor

Menopause is a natural phase of a woman’s life, marking the end of the reproductive years. While you may be familiar with common symptoms like hot flashes and mood swings, there’s a lesser-known set of symptoms that can have a significant impact on your quality of life: genitourinary symptoms, also referred to as GSM (genitourinary syndrome of menopause). These symptoms revolve around changes that occur in the genital and urinary systems due to hormonal shifts during menopause. 

Menopause may be mandatory, but suffering is not. That’s why understanding what’s unfolding and discovering ways to tackle these symptoms is key – so you can feel like yourself again!

Understanding Genitourinary Symptoms:

  • Vaginal Dryness: Estrogen plays a crucial role in maintaining the health and elasticity of vaginal tissues. As estrogen levels decline during menopause, the vaginal walls can become thinner and less lubricated, leading to dryness, discomfort, and even painful sex.
  • Vaginal Atrophy: This term refers to the thinning, inflammation, and reduced elasticity of vaginal tissues due to decreased estrogen. Vaginal atrophy can cause irritation, burning sensations, and increased vulnerability to urinary tract infections.
  • Urinary Changes: The loss of estrogen can impact the urinary tract as well. Women may experience increased urinary frequency, urgency, and even urinary incontinence. The weakening of pelvic muscles and tissues can contribute to:
    • Stress Incontinence where activities like laughing, sneezing, or lifting can lead to unintended leakage 
    • Urge Incontinence where you get a sudden urge to urinate and can’t get to the bathroom in time
    • Mixed Incontinence…a bit of both happening! 

Managing Genitourinary Symptoms:

  • Moisturize: You likely have a moisturizing regimen for your face, well the tissue of your vulva and vagina needs some extra TLC too! Moisturizers can provide relief from vaginal dryness. My favorite non-hormonal moisturizer is Pure Pharmacy’s Hyaluronic Acid. It’s designed to enhance comfort and alleviate discomfort. 
  • Localized Topical Vaginal Estrogen: The gold standard for treatment for GSM. It can come in the form of creams, rings, or tablets. It can make a world of difference and can be used in conjunction with moisturizers as it’s often prescribed to be used 2-3x/week. You need a prescription from a healthcare provider. See the statement from the North American Menopause Society on localized estrogen therapy and GSM.
  • Pelvic Floor Physical Therapy: These symptoms can be exacerbated by pelvic floor muscle weakness or spasm, poor breath mechanics, abdominal weakness, poor posture, and bladder habits (like going to the bathroom ‘just in case’). A pelvic floor PT is trained to look at the whole picture and give you ways to optimize your pelvic health and put you in control of your bladder once again. 
  • Behavioral Modifications: Managing fluid intake, especially in the evening, can help reduce nighttime urinary frequency. Avoiding caffeine and alcohol, which can irritate the bladder, may also be beneficial.
  • Healthy Lifestyle: A balanced diet rich in nutrients, regular exercise, and proper hydration can contribute to overall well-being, which in turn may alleviate some menopausal symptoms.

Seeking Professional Guidance:

While there are various over-the-counter products and strategies that can provide relief, it’s essential to consult a healthcare provider before embarking on any treatment plan. Individual experiences with genitourinary symptoms can vary, and a healthcare professional can tailor recommendations to your needs and medical history. One thing is certain, these symptoms will not get better on their own, and often can get worse! 

Many women assume that genitourinary symptoms of menopause are just part of getting older. While they can be challenging to navigate, they are manageable with the right approach. By understanding the changes happening within the body and seeking support, you can embrace this new phase with confidence and feel like yourself again!

Written by Allison Poole, PT, MPT, WHC

Allison takes a modern approach to women's hormone and pelvic health by taking the hard work and confusion out of caring for your body. She combines her 20 years of clinical expertise, compassion and personal experience to help women navigate perimenopause and menopause with ease.

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