Journal of SAFOMS

Register      Login

VOLUME 6 , ISSUE 1 ( January-June, 2018 ) > List of Articles


Recent Advances in the Management for Genitourinary Syndrome of Menopause

Palai Pallavee

Keywords : Genitourinary syndrome of menopause, Menopause, Vulvovaginal atrophy

Citation Information : Pallavee P. Recent Advances in the Management for Genitourinary Syndrome of Menopause. J South Asian Feder Menopause Soc 2018; 6 (1):65-68.

DOI: 10.5005/jp-journals-10032-1139

Published Online: 01-07-2017

Copyright Statement:  Copyright © 2018; The Author(s).


Menopausal women suffer from various symptoms related to genital tract and urinary tract. These symptoms are due to low estrogen level at this stage of life. Although this is commonly termed as vulvovaginal atrophy or atrophic vaginitis, it does not reflect the presence of underlying urinary symptoms. So, to encompass full spectrum of symptoms, a broad term like genitourinary syndrome of menopause (GSM) is being used more recently in place of vulvovaginal atrophy or atrophic vaginitis. It describes various symptoms and signs of menopause which include genital symptoms, such as dryness, irritation and burning, urinary symptoms like urgency, dysuria, and recurrent urinary tract infection (UTI) and sexual symptoms like lack of lubrication and discomfort or pain. Wide range of treatments are available which include nonhormonal black cohosh, a phytoestrogen, lubricants or moisturizers for symptom relief, vaginal estrogen therapies, systemic hormonal therapies (HTs), tissuespecific estrogen complex [combination of selective estrogen receptor modulators (SERM) and estrogen] besides newer therapies. These newer therapy include laser, radiofrequency (RF), and magnetic therapy. As the GSM have negative impact, awareness, recognition and appropriate treatment of GSM will improve the quality of postmenopausal women.

PDF Share
  1. Portman DJ, Gass ML. Vulvovaginal atrophy terminology consensus conference panel. Menopause 2014 Oct;21(10): 1063-1068.
  2. Sturdee DW, Panay N. Recommendations for the management of postmenopausal vaginal atrophy. Climacteric 2010 Dec;13(6):509-522.
  3. Nappi RE, Kokot-Kierepa M. Vaginal health: insights, views & attitudes (VIVA)—results from an international survey. Climacteric 2012 Feb;15(1):36-44.
  4. The North American Menopause Society. Management of symptomatic vulvovaginal atrophy: 2013 position statement of The North American Menopause Society. Menopause 2013 Sep;20(9):888-902.
  5. Iosif CS, Bekassy Z. Prevalence of genito-urinary symptoms in the late menopause. Acta Obstet Gynecol Scand 1984;63(3):257-260.
  6. Stenberg A, Heimer G, Ulmsten U, Cnattingius S. Prevalence of genitourinary and other climacteric symptoms in 61-yearold women. Maturitas 1996 May;24(1-2):31-36.
  7. Nappi RE, Kokot-Kierepa M. Women's voices in the menopause: results from an international survey on vaginal atrophy. Maturitas 2010 Nov;67(3):233-238.
  8. Kingsberg SA, Wysocki S, Magnus L, Krychman ML. Vulvar and vaginal atrophy in postmenopausal women: findings from the REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey. J Sex Med 2013 Jul;10(7):1790-1799.
  9. Chae HD, Choi SY, Cho EJ, Cho YM, Lee SR, Lee ES, Park HM. Awareness and experience of menopausal symptom and hormone therapy in Korean postmenopausal women. J Menopausal Med 2014 Apr;20(1):7-13.
  10. Levine KB, Williams RE, Hartmann KE. Vulvovaginal atrophy is strongly associated with female sexual dysfunction among sexually active postmenopausal women. Menopause 2008 Jul-Aug;15(4 Pt 1):661-666.
  11. Avis NE, Brockwell S, Randolph JF, Jr, Shen S, Cain VS, Ory M, Greendale GA. Longitudinal changes in sexual functioning as women transition through menopause: results from the Study of Women's Health Across the Nation. Menopause 2009 May-Jun;16(3):442-452.
  12. Robinson D, Cardozo LD. The role of estrogens in female lower urinary tract dysfunction. Urology 2003 Oct;62 (4 Suppl 1):45-51.
  13. Hyun HS, Park BR, Kim YS, Mun ST, Bae DH. Urodynamic characterization of postmenopausal women with stress urinary incontinence: retrospective study in incontinent preand post-menopausal women. J Korean Soc Menopause 2010 Dec;16(3):148-152.
  14. Brown JS, Vittinghoff E, Kanaya AM, Agarwal SK, Hulley S, Foxman B. Urinary tract infections in postmenopausal women: effect of hormone therapy and risk factors. Obstet Gynecol 2001 Dec;98(6):1045-1052.
  15. Raz R. Urinary tract infection in postmenopausal women. Korean J Urol 2011 Dec;52(12):801-808.
  16. Nappi RE, Palacios S. Impact of vulvovaginal atrophy on sexual health and quality of life at postmenopause. Climacteric 2014 Feb;17(1):3-9.
  17. Tan O, Bradshaw K, Carr BR. Management of vulvovaginal atrophy-related sexual dysfunction in postmenopausal women: an up-to-date review. Menopause 2012 Jan;19(1): 109-117.
  18. Johnston SL, Farrell SA, Bouchard C, Farrell SA, Beckerson LA, Comeau M, et al. The detection and management of vaginal atrophy. J Obstet Gynaecol Can 2004 May;26(5):503-515.
  19. Nappi RE, Kingsberg S, Maamari R, Simon J. The CLOSER (CLarifying Vaginal Atrophy's Impact On SEx and Relationships) survey: implications of vaginal discomfort in postmenopausal women and in male partners. J Sex Med 2013 Sep;10(9):2232-2241.
  20. The North American Menopause Society. The 2012 hormone therapy position statement of: The North American Menopause Society. Menopause 2012;19(3):257-271.
  21. Pinkerton JV, Stanczyk FZ. Clinical effects of selective estrogen receptor modulators on vulvar and vaginal atrophy. Menopause 2014 Mar;21(3):309-319.
  22. Mirkin S, Komm BS. Tissue-selective estrogen complexes for postmenopausal women. Maturitas 2013 Nov;76(3): 213-220.
  23. Archer DF. Tissue-selective estrogen complexes: a promising option for the comprehensive management of menopausal symptoms. Drugs Aging 2010 Jul;27(7):533-544.
  24. Lobo RA, Pinkerton JV, Gass ML, Dorin MH, Ronkin S, Pickar JH, Constantine G. Evaluation of bazedoxifene/ conjugated estrogens for the treatment of menopausal symptoms and effects on metabolic parameters and overall safety profile. Fertil Steril 2009 Sep;92(3):1025-1038.
  25. Pancholia V. FOGSI connect 2017;3:14-16.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.