Going through a bit of a DRY spell?
Genitourinary Syndrome of Menopause (GSM) is a common condition caused by hormonal changes during menopause that affects the vagina, vulva, bladder, and urinary tract. Symptoms may include vaginal dryness, burning, itching, pain with intercourse, reduced lubrication, urinary urgency or leakage, and recurrent urinary tract infections (UTIs). These symptoms can also affect sexual comfort, desire, and overall quality of life.
GSM is a chronic condition that often worsens over time without treatment, but effective therapies are available. Treatment options may include:
- Vaginal moisturizers and lubricants
- Vaginal estrogen therapy (creams, tablets, ovules, or rings)
- Prasterone (vaginal DHEA)
- Ospemifene (oral medication)
Sexual concerns during menopause are common and can have physical, emotional, and relationship-related causes. Treatment is individualized and may include hormone therapy, medications to help improve desire and sexual comfort or referrals to counselling, or pelvic floor physiotherapy.
Pelvic floor physiotherapy can be especially helpful for pelvic pain, muscle tightness, or discomfort with penetration. Psychological therapies such as cognitive behavioural therapy (CBT), mindfulness-based therapy, couples counselling, and sex therapy may also improve sexual well-being and intimacy.
For some individuals experiencing low sexual desire related to menopause, medications such as flibanserin or transdermal testosterone therapy may be considered. Testosterone therapy has been shown to improve sexual desire, arousal, and sexual satisfaction in appropriate patients.
