Genitourinary Syndrome of Menopause: Epidemiology, Physiopathology, Clinical Manifestation and Diagnostic

Abstract

Genitourinary syndrome of menopause (GSM) is a term used to define a compilation of signs and symptoms arising from decreased estrogenic stimulation of the vulvovaginal and lower urinary tract. Among 27–84% of women in postmenopausal are affected for symptoms of GSM, and these can unquestionably impair health, sexual function, consequently the quality of life of these women. The main signs and symptoms of GSM include, among others, burning, irritation, vulvovaginal dryness, dyspareunia, urinary symptoms of urgency, dysuria, or recurrent urinary tract infection. The diagnosis can be made through anamnesis, questionnaires, physical exams, and, sometimes, complementary exams. Objective vaginal assessment is essential and can be complemented by using the Vaginal Health Index (VHI), Vaginal Maturation Index (VMI), or vaginal pH measurement. The acknowledgment of this condition by health professionals is crucial for its identification and proper management and exclusion of other conditions that make a differential diagnosis with it.

Recurrent and complicated urinary tract infections in women: Utility of advanced testing to enhance care

“…cUTI encompasses a wide spectrum of patients 2 . Focusing primarily on post‐menopausal females, these individuals are highly susceptible to UTI largely due to a hypoestrogenic state 32,33 . Genitourinary syndrome of menopause (GSM) describes the vaginal and urinary symptom sequelae after loss of estrogen to the genitals and urinary tract and is generally treated with transvaginal estrogen 33 .…”

Investigation on prevalence and risk factors associated with genitourinary syndrome of menopause in middle-aged and older women in Beijing community: a cross sectional study

“…If the total score is < 15, it is considered that there is vulvovaginal atrophy (VVA) [19]. Participants were also inquired about the presence of VVA symptoms: vaginal pain, dyspareunia, vaginal pruritus and vaginal burning [1].…”

“…Menopause is a condition resulting from estrogen deficiency [1]. The average age of natural menopause is 48.9 years in Chinese woman and it evidences that onethird of women's life is spent in menopause and post menopause [2].…”

Efficacy and safety of carbon dioxide laser therapy compared with sham for genitourinary syndrome of menopause management: a meta-analysis of randomized clinical trials

“…2,3 The prevalence of GSM is estimated to be 27% to 84% among postmenopausal women, and it can cause significant disruption to their health and sexual function resulting in a decrease in their quality of life. 4 Symptomatic treatment of GSM is usually provided for the most disturbing symptoms, and it may involve multiple approaches such as local, systemic, hormonal, or combination therapy. 5 The use of vaginal moisturizers and lubricants, as well as continued sexual activity and vaginal exercise, are often chosen as the initial treatment of GSM.…”

“…Symptoms can include vaginal dryness, irritation, soreness, dyspareunia, dysuria, and vaginal discharge, whereas the signs of GSM include thinning, dryness, and pallor of the vaginal mucosa and flattened labia majora 2,3 . The prevalence of GSM is estimated to be 27% to 84% among postmenopausal women, and it can cause significant disruption to their health and sexual function resulting in a decrease in their quality of life 4 …”