Women’s Health as We Age.
Aging brings changes to a woman’s body, and many of those changes can be understood, addressed, and managed. Education is an important part of helping women remain healthy, active, independent, and confident as they age.
One often overlooked aspect of healthy aging is genitourinary syndrome of menopause (GSM). Understanding GSM—and the role of local vaginal estrogen in treating GSM and helping prevent recurrent urinary tract infections—can make a meaningful difference in a woman’s comfort, independence, urinary and sexual health, and quality of life.
Why Vulvovaginal Estrogen Matters
As estrogen levels decline during and after menopause, the tissues of the vulva, vagina, and urinary tract can become thinner, drier, and more fragile—a collection of changes now known as genitourinary syndrome of menopause (GSM). Low-dose vulvovaginal estrogen can restore estrogen locally to these tissues, helping improve dryness, irritation, burning, discomfort with sexual activity, and other symptoms of vulvovaginal atrophy. It can also improve urinary symptoms and, importantly, is recommended for many postmenopausal women with recurrent urinary tract infections to help reduce the risk of future infections. Because GSM often progresses rather than simply resolving with time, recognizing and treating these changes can be an important part of maintaining comfort, urinary and sexual health, and quality of life as women age.
Understanding GSM
Genitourinary syndrome of menopause (GSM) describes the changes that can occur in the vulva, vagina, bladder, and urinary tract as estrogen levels decline during and after menopause. Symptoms may include vaginal or vulvar dryness, burning, irritation, itching, discomfort with sexual activity, urinary urgency or frequency, painful urination, and recurrent urinary tract infections. Symptoms may be aggravated while seated on a bicycle saddle or after hiking for miles. These symptoms can develop gradually and may worsen over time if untreated. Many women assume these changes are simply an unavoidable part of aging and may never discuss them with a healthcare professional. Recognizing GSM is important because effective treatments are available, including low-dose local vaginal estrogen for many women. Estrogen based cancers and blood clots are no longer recognized as contraindications for low dose topical vaginal estrogen cream.