Menopause comes with so many symptoms women need to deal with. From physical to psychological ones, most of the symptoms aren’t visible, but some of them are definitely embarrassing to talk about. This is the case of vulvovaginal atrophy and of atrophic vaginitis, a condition involving both the genitals and urinary tract (see all signs and symptoms below). Mentioning “vulva” and “vagina”, and also including the term “atrophy”, which generally has negative connotations, these names are not comfortably used in general discussions and tend to be excluded.
So the Board of Directors of the International Society for the Study of Women’s Sexual Health (ISSWSH) and the Board of Trustees of The North American Menopause Society (NAMS) acknowledged the need to review the current terminology associated to these conditions. Their conclusions have recently been published in the Journal of The North American Menopause Society.
After thorough analysis of the clinical and basic science, diagnosis and therapy options, and public perceptions, the panel concluded that the terms vulvovaginal atrophy and atrophic vaginitis are not the best choice to describe the actual signs and symptoms that impact the genitourinary system during menopause. The current terminology refers only to the vulva and vagina, missing out on the lower urinary tract, and could be understood as an inflammation or infection, which is not part of the condition.
So it has beed decided that the new name for vulvovaginal atrophy is genitourinary syndrome of menopause (GSM), a term that is more accurate and better describes the whole areas affected. The panel anticipates that the term “genitourinary syndrome of menopause” will be a more acceptable term for women and will become more and more used by clinical specialists, researchers, affected women, the media, the public, etc.
Genitourinary Syndrome of Menopause (GSM): symptoms and signs
Symptoms:
- Genital dryness
- Decreased lubrication with sexual activity
- Discomfort or pain with sexual activity
- Post-coital bleeding
- Decreased arousal, orgasm, desire
- Irritation/Burning/Itching of vulva or vagina
- Dysuria
- Urinary frequency/urgency
Signs:
- Decreased moisture
- Decreased elasticity
- Labia minora resorption
- Pallor/Erythema
- Loss of vaginal rugae
- Tissue fragility/fissures/petechiae
- Urethral eversion or prolapse
- Loss of hymenal remnants
- Prominence of urethral meatus
- Introital retraction
- Recurrent urinary tract infections