Embracing Change: Dealing with Genitourinary Menopausal Syndrome Together

If you're experiencing a constant feeling of irritation or dryness in your vagina, or find yourself dealing with increased urinary urges and difficulty holding back when sneezing or jumping, you're not alone! Many women go through these symptoms without knowing that they could be related to genitourinary syndrome of menopause.

This is a delicate and challenging time in many women's lives, and it's critical to recognize and understand what your body is experiencing so you can seek appropriate support and solutions. Remember, what you're experiencing is real and your well-being is important.

That is why in this blog we will explain everything about Genitourinary Syndrome of Menopause (GMS), its causes, symptoms and the available treatment options.

What is Menopause?

Menopause marks the end of menstrual cycles and is diagnosed after 12 months without menstruation. It usually occurs between the ages of 45 and 55, although each woman has her own rhythm. This change occurs due to the decrease in ovarian function and, with it, a reduction in sex hormones such as estrogen and progesterone.

When estrogen levels drop, it means the body is producing less of this essential hormone. Estrogen is critical for many functions in the body, especially in the female reproductive system. This hormone helps regulate the menstrual cycle, maintain the health of vaginal and urinary tract tissues, and promote bone density, among other functions.

The reduction in estrogen levels affects several aspects of our health: 

• Heart and blood vessels: Increased risk of heart disease due to changes in cholesterol and vascular function.
• Bones: Decreased bone density, increasing the risk of osteoporosis.
• Metabolism: Tendency to weight gain and changes in the distribution of body fat.
• Skin and hair: Thinner and less elastic skin, as well as changes in hair texture and growth.

 

One of the systems most affected by the lack of estrogen is precisely the genitourinary system, and it is here where the symptoms of this syndrome appear.

The Impact of Menopause on the Genitourinary System

As we have already detailed, menopause results in a significant drop in estrogen levels. This drop can cause histological (tissue-related) and anatomical changes in the genitourinary structures and tissues and lead to the development of Genitourinary Syndrome of Menopause (GMS), a condition that affects many women but often goes unnoticed.

What is Genitourinary Syndrome of Menopause (GMS)?

SGM is a chronic and progressive condition affecting the genitourinary tract including the bladder, urethra, external genitalia, pelvic floor tissues and vagina.

This syndrome is also known by other names: vaginal atrophy and vulvovaginal atrophy, and although you may hear some specialists and doctors calling it by these terms, they are not very accurate because they leave out multiple areas linked to the genitourinary system that are affected. Likewise, the term “atrophy” is pejorative and gives the impression that the system is “wearing out,” which is far from reality.

Symptoms of Genitourinary Syndrome of Menopause (GMS)

The symptoms of GMS can vary in severity and affect different aspects of your life. Here are the details:

 Vaginal: As estrogen declines, vaginal tissues become thinner and less elastic and drier, which can cause: 

• Vaginal dryness
• Burning or itching
• Pain during sexual intercourse
• Decreased natural lubrication
• Light bleeding or spotting after sex

 

Urinary : The urethra becomes more susceptible to infections, which can lead to urinary symptoms such as incontinence and urgency. 

• Increased urinary frequency
• Urgency to urinate
• Recurrent urinary tract infections
• Urinary incontinence

 

Sexual: Less lubrication and elasticity in the vagina and urethra. 

• Decreased sexual desire
• Pain during penetration
• Difficulty reaching orgasm

 

Although some of the symptoms can be very uncomfortable and significantly affect our daily lives, it is important to understand that each of these symptoms can be treated and prevented, but we must start by visiting a specialist and correctly diagnosing what is happening.

Emotional and Psychological Impact

SGM doesn't just affect your body, it also affects your emotional well-being. Symptoms like vaginal dryness and pain during sex can impact your self-esteem and sexual confidence. It's common to feel frustrated, embarrassed, or isolated, especially if you find it difficult to talk about these issues with your partner or a health care professional.

Anxiety and Depression: Hormonal changes and uncomfortable symptoms of GMS can trigger or worsen mental health issues like anxiety and depression. 

Impact on Relationships: Pain during sex can decrease the desire for intimacy, creating tension between partners and self-esteem issues. Lack of communication about these symptoms can exacerbate misunderstandings and estrangement. 

Treatment Options for SGM

There are several treatment options for GMS, from non-hormonal, more natural and alternative approaches to hormonal therapies. The choice depends on the severity of your symptoms, your overall health condition, and your personal preferences. Here we explain the most common ones, along with their benefits and risks. 

1. Non-hormonal treatments

Vaginal Lubricants and Moisturizers

Description: Vaginal lubricants are used during sex to reduce friction and pain. Intimate moisturizers are applied regularly to maintain vaginal hydration and products such as our Long Lasting also include a high percentage of hyaluronic acid to renew the skin in the area.

Long Lasting Feminine Moisturizing Gel helps balance pH, improving the discomfort of vaginal dryness.

Benefits: They are easily accessible, do not require a prescription, and offer fast relief from dryness.

Risks: May be insufficient for severe symptoms; some products may contain irritating ingredients.

 Laser and Radiofrequency Therapies

Description: These noninvasive therapies use laser or radiofrequency energy to stimulate collagen production and improve the elasticity and moisture of vaginal tissues.

Benefits: They do not require hormones and can improve the quality of vaginal tissue.

Risks: They are expensive, require multiple sessions and are not suitable for all women. 

2. Local Hormonal Therapies

Vaginal Estrogen

Description: Application of estrogen in the form of creams, tablets or rings directly into the vagina to restore hormonal levels in local tissues.

Benefits: Effective relief of vaginal and urinary symptoms; lower systemic risks compared to systemic hormone therapy.

Risks: May not be suitable for women with a history of breast cancer or other hormonal problems. 

Combined therapy with estrogen and progesterone

Description: For women who still have a uterus, a combination of estrogen and progesterone may be used to protect the endometrium while treating the symptoms of GMS.

Benefits: Protection of the endometrium and effective relief of symptoms.

Risks: Risk of systemic side effects, including deep vein thrombosis and breast cancer. 

3. Systemic Hormonal Therapies

Hormone Replacement Therapy (HRT)

Description: Administration of estrogens and, in some cases, progesterone, to treat the symptoms of menopause at a systemic level.

Benefits: Relief of general menopausal symptoms such as hot flashes, along with symptoms of GMS.

Risks: Increased risk of breast cancer, stroke, and heart disease in some women. 

4. Alternative and Complementary Therapies

Phytoestrogens and Natural Supplements

Description: Herbal supplements containing estrogen-like compounds, such as soy and flaxseed. Our Happy Pee, for example, is a nutritional supplement specially designed to strengthen and safeguard the balance of the female urinary system and is excellent in preventing cystitis. Likewise, our Zenbiotic, thanks to the benefits of probiotics, fights genital infections naturally. 

Benefits: They may offer relief to women who cannot or prefer not to use hormonal therapies.

Risks: Variable effects and lack of solid scientific evidence in some cases.

Pelvic Floor Exercise 

Exercises such as Kegel exercises strengthen the pelvic floor muscles, which can improve incontinence and other urinary symptoms. To train the area, we can recommend our Vagiyoga, a pelvic floor rehabilitator that consists of an advanced Kegel exercise device specifically designed to restore pelvic floor muscle tone, helping you strengthen the area, prevent urinary incontinence, add creativity to your sex life and improve your mood. To use Vagiyoga, Zenzsual intimate lubricant gels can be useful, facilitating a more comfortable and effective practice by keeping the area well lubricated and without irritation.

 Where do I start?

Get a pelvic health assessment: A pelvic health assessment helps you understand the status of your pelvic organs, including your uterus, ovaries, bladder, and rectum. This assessment is essential for detecting gynecological problems, such as infections, cysts, fibroids, or pelvic organ prolapse, and for assessing pelvic floor muscle tone.

Depending on the initial findings, your doctor may recommend additional tests, such as a pelvic ultrasound, a Pap test, laboratory tests (for example, tests to check for infections), or urodynamic studies to assess bladder function.

Include healthy nutrition and exercise in your routine: Staying active and exercising your pelvic floor will not only help with your posture, but can help reduce urinary incontinence. Eating a healthy diet that includes enough fiber and water can help you avoid constipation and therefore reduce the chances of a prolapse.

Questions and Answers (Q&A)

 Q: When should I consider treatment for SGM?

A: If you experience symptoms that affect your quality of life, such as vaginal dryness, pain during sex, or urinary problems, it is advisable to consult a health care professional. You do not need to wait until symptoms become severe to seek help. 

Q : Is vaginal estrogen use safe for all women?

A: Vaginal estrogen is generally considered safe, especially because it acts locally and has fewer systemic risks than oral hormone therapy. However, it is not suitable for all women, particularly those with a history of breast cancer or certain hormonal conditions. It is crucial to discuss this with your doctor before starting any hormonal treatment.

Q : Are non-hormonal treatments effective for GMS?

A: Non-hormonal treatments, such as vaginal lubricants and moisturizers, can be very effective in relieving mild symptoms. For more severe symptoms, additional treatments, such as laser therapies or even vaginal estrogen, may be considered. Every case is unique, and it is important to find the treatment that works best for you. 

Q : What can I do if I'm having trouble talking about SGM with my doctor?

A: It may be helpful to prepare a list of your symptoms and concerns before your appointment. Remember that GMS is a common and treatable medical condition; health care professionals are trained to help you. If you still feel uncomfortable, consider finding a women's health specialist or a professional you feel more comfortable with. 

Final Considerations

Genitourinary Syndrome of Menopause is a common, but often underestimated condition that can profoundly impact women’s quality of life. Although it is a topic that can be difficult to address, it is crucial that we understand that we are not alone and that there are multiple treatment options available that can be tailored to our individual needs.

It is critical that if you are experiencing symptoms of GMS, you speak to a healthcare professional. A doctor or gynecologist can help you assess your symptoms, discuss treatment options, and recommend the best strategy to effectively manage GMS.

Remember: your health and well-being are a priority. If you are experiencing symptoms of GMS, do not hesitate to consult a health professional for guidance and support.

References:

North American Menopause Society (NAMS)

Menopause Matters: Online Forum on SGM

Menopause Coaching, GGS Academy