By: Red Hot Mamas
Published: June 8, 2017
Contributed by Dr. Verna Brooks-McKenzie- Red Hot Mamas Medical Expert
Menopause is a normal natural event which occurs during the transition from the reproductive years to post menopause as a result of loss of ovarian follicular function usually due to aging. Surgical menopause is the result of removal of both ovaries. Classic symptoms are hot flashes, night sweats and sleep disorder.
Genitourinary syndrome of menopause (GSM) unlike the term vulvo vaginal atrophy, refers to the signs and symptoms affecting all the genito pelvic anatomic structures such as the mons pubis, labia majora and minora, clitoris, vestibule, introitus (vaginal opening), vagina, urethra and bladder. The symptoms progress, do not resolve without treatment and may have an adverse effects on sexual function resulting in relationship discord. Many women do not report their symptoms because of embarrassment and some view them as an inevitable part of aging.
Signs
- Loss of / sparse pubic hair
- Thinning of vulvar skin
- Mons pubis, labia majora and minora decrease in size
- Fusion of labia minora (in elderly sexually inactive women)
- Receding clitoris (may affect orgasm)
- Loss of vaginal rugae (folds)
- Vaginal shortening
- Thinning of vaginal epithelium (lining)
- Shortening of urethra
Symptoms
- Dyspareunia (painful sex, especially on penetration)
- Lack of vaginal lubrication
- Genital dryness
- Burning, irritation in vagina
- Recurrent urinary tract infection
- Incontinence
- Frequency of urination
Treatment
Education about the cause is important. Vaginal Estrogen (creams, vaginal ring, tablet) is most effective. For mild symptoms vaginal moisturizers inserted into the vagina to provide hydration can be used. Lubricants used during sex, vaginal dilators and having regular sex are other options. Ospemifene (non estrogen) taken orally is FDA approved for the treatment of moderate to severe GSM.