Menopause affects more than just your hormones—it can transform the health and function of your bladder, vagina, and pelvic floor.
Genitourinary Syndrome of Menopause (GSM), previously referred to as vaginal atrophy, describes these often-overlooked but deeply impactful changes. Despite being common, GSM is rarely talked about openly. It’s time to change that.
What is Genitourinary Syndrome of Menopause (GSM)?
Genitourinary Syndrome of Menopause (GSM) is a medical term that describes the range of urinary, sexual, and vaginal symptoms that result from reduced oestrogen levels during and after menopause. When oestrogen declines, the tissues of the vulva, vagina, bladder, and urethra become thinner, drier, less elastic, and more fragile. These changes can lead to discomfort, pain, and disruptions in daily life.
GSM encompasses what used to be called vaginal atrophy, but with a broader understanding of how menopause affects the entire genitourinary tract—not just the vagina.
Is Genitourinary Syndrome of Menopause different to vulvovaginal atrophy?
In many ways, GSM and vulvovaginal atrophy describe the same condition—but GSM is the more accurate and updated term.
“Vulvovaginal atrophy” focused primarily on the physical changes in the vaginal and vulvar tissue. GSM, on the other hand, recognises that menopause can also impact urinary function and pelvic support. This expanded term helps health professionals better capture the full picture of symptoms that menopausal women may experience.
How common is Genitourinary Syndrome of Menopause?
GSM is extremely common, affecting more than 50% of postmenopausal women. Despite its prevalence, many women do not speak up about their symptoms—either because they don’t realise it’s connected to menopause or because they feel uncomfortable discussing it. But this is something we, as pelvic health specialists, are working to change.
The good news? You’re not alone, and there are effective treatments that can significantly improve your comfort and quality of life.
What are the symptoms of Genitourinary Syndrome of Menopause?
GSM symptoms are typically grouped into three main areas: bladder, bowel, and sexual function.
Bladder Symptoms & Dysfunction
– Urinary urgency (feeling like your bladder is in control)
– Pain or burning with urination
– Recurrent urinary tract infections (UTIs)
– Weak or hesitant urinary stream
– Incomplete bladder emptying
– Urinary incontinence (leaking)
Bowel Symptoms & Dysfunction
– Feeling of incomplete emptying
– Faecal incontinence
– Excessive wiping to feel clean
– Increased time to complete a bowel movement
– Changes in bowel frequency or consistency
Sexual Symptoms & Dysfunction
– Vaginal dryness and irritation
– Pain during or after sex (dyspareunia)
– Post-intercourse bleeding
– Burning or tearing sensations during intimacy
– Decreased libido and reduced clitoral sensation
These symptoms are often tied to vaginal atrophy, the thinning and drying of vaginal tissue due to oestrogen loss. The discomfort may not only affect your sexual health but also your self-confidence and intimate relationships.
Is GSM treatable?
Yes – Genitourinary Syndrome of Menopause is very treatable, and depending on your individual symptoms, experience and goals, we have a diverse toolkit to help manage your pelvic health holistically. These include:
Pelvic floor physiotherapy to support bowel and bladder control
Non-hormonal lubricants and vaginal moisturisers for dryness and discomfort
Topical vaginal oestrogen therapies to restore local tissue health
Systemic hormone therapy, if symptoms are more widespread
Lifestyle changes including pelvic exercises and dietary support
The key is seeking proactive support from your healthcare team, and discussing your symptoms and experiences as openly as possible – there’s no such thing as taboo with us! We can aid and re-train our bodies in very powerful ways, and of course the sooner we start discussing, the closer you are to regaining your peachy, happy self in all areas of your body.
Other Blogs in the Menopause Series
Deep dive into education written by our pelvic physiotherapist, Shauna, all about the menopause – including symptoms, treatment & understanding the range of associated conditions.
Do you want to learn more about pelvic health, specialised to your symptoms?
