Genitourinary Syndrome of Menopause (GSM) is a common but often overlooked part of menopause. It happens because lower oestrogen levels cause changes in the vaginal, vulvar, and urinary tissues.
These tissues become thinner, drier, less elastic, and more sensitive, which can lead to uncomfortable symptoms.
More than 50% of postmenopausal women experience GSM, yet many women assume it’s “just something to live with” and never talk about it. The reality is that GSM can significantly impact your daily comfort, intimacy, and confidence, but it is very treatable.
Daily-Life Examples Women Recognise
GSM doesn’t just show up during intimacy, it can affect everyday activities. Some situations you may notice:
- Cycling or horseback riding becomes uncomfortable or even painful
- Jumping on a trampoline or playing with the kids may cause mild leakage
- Laughing, coughing, or sneezing can lead to unexpected urinary leaks
- Wearing tight jeans or activewear may irritate sensitive tissues
- Sexual intimacy becomes uncomfortable or painful due to dryness
- Sitting for long periods can feel uncomfortable or itchy
These examples are very common, but many women suffer in silence because they think it’s “normal.” In reality, recognising symptoms early and seeking care can restore comfort, confidence, and sexual wellbeing.
Treatment Options
The good news is that GSM is highly treatable, and most women experience significant improvement. Treatment depends on your needs:
1. Lifestyle & Self-care
- Use vaginal moisturisers or lubricants regularly
- Avoid harsh soaps or scented products
- Gentle pelvic floor exercises
2. Local Oestrogen Therapy
- Vaginal creams, ovules, tablets, or rings can restore tissue health
- Works directly where it’s needed and is low-dose and safe
- Some countries offer DHEA (Intrarosa) for specific cases. This is a vaginal treatment that contains prasterone. Unlike regular vaginal oestrogen, which directly replaces oestrogen in the tissue, prasterone is converted by your body into small amounts of oestrogen and testosterone locally, improving elasticity, moisture, and sensitivity.
3. Systemic HRT
If you also experience other menopause symptoms such as hot flushes, brain fog, joint aches, or fatigue, systemic HRT may be the best option for you.
Many women notice that, in addition to relieving these general menopause symptoms, systemic HRT can also improve GSM symptoms, like vaginal dryness, sensitivity, and discomfort. When needed, vaginal oestrogens can be added alongside systemic HRT.
4. Emerging Treatments
- Laser or energy-based therapies can be given in specialised clinics, for cases not responding to other treatments
You do not have to accept discomfort as part of menopause. With the right care, you can regain comfort, confidence, and freedom in daily life.
Take action today: Book a consultation with me, Dr Femke, or join the She Pura Vida platform to explore personalised options and support. Every woman’s body is unique, so together we find what works best for you.