Genitourinary Syndrome of Menopause (GSM)

D. M. Kiaku, E. N. Ngoma

Vaginal dryness; Genitourinary syndrome of menopause; Sexual health; Vaginal estrogen; Lubricants; Moisturizers

Vaginal dryness is a common yet frequently underrecognized condition that affects women of all ages, particularly during the menopausal transition and postmenopausal period. It is a hallmark symptom of the Genitourinary Syndrome of Menopause (GSM) and may also result from breastfeeding, hypoestrogenism, cancer therapies, medications, autoimmune disorders, or other medical conditions. Beyond physical discomfort, vaginal dryness negatively impacts sexual function, intimate relationships, and overall quality of life. This educational video provides an evidence-based review of the pathophysiology, clinical presentation, diagnosis, and management of vaginal dryness. It emphasizes the importance of a comprehensive clinical evaluation, including history taking, physical examination, and identification of reversible causes. Current treatment options are presented according to the latest international recommendations, including non-hormonal therapies (vaginal moisturizers and lubricants), local hormonal therapies (vaginal estrogen and prasterone), and selected emerging interventions. The presentation also discusses the limitations of energy based devices due to insufficient long-term evidence. Particular emphasis is placed on the 2025 AUA/SUFU/AUGS Guideline, endorsed by the International Society for the Study of Women's Sexual Health (ISSWSH) and The Menopause Society, which advocates individualized management through shared decision-making between clinicians and patients. By integrating current scientific evidence with practical clinical recommendations, this video aims to improve healthcare professionals' knowledge and confidence in recognizing and managing vaginal dryness, ultimately enhancing women's sexual health and quality of life.

None.

None.

1. Faubion SS, Shifren JL, Stuenkel CA. Management of genitourinary syndrome of menopause. JAMA. 2022;327(14):1381-1382.

2. The American Urological Association, Society of Urodynamics, Female Pelvic Medicine & Urogenital Reconstruction, and American Urogynecologic Society.

Genitourinary Syndrome of Menopause Guideline. 2025.

3. Parish SJ, Nappi RE, Krychman ML, et al. Impact of vulvovaginal health on sexual function and quality of life. J Sex Med. 2021;18(3):407-419.

4. Portman DJ, Gass MLS. Genitourinary syndrome of menopause: New terminology for vulvovaginal atrophy. Menopause. 2014;21(10):1063-1068.

5. Kingsberg SA, Schaffir J, Faught BM, et al. Female sexual health: Barriers, assessment, and treatment options. Obstet Gynecol. 2019;134(5):e143-e157.