Genitourinary Syndrome of Menopause and Female Sexual Dysfunction

Genitourinary syndrome of menopause (GSM) is a prevalent condition affecting 50% of postmenopausal women and causing a significant impact on a women’s health-related quality of life. With an aging population, more women are being affected by GSM and the health burden this poses is increasing. The pathophysiology of GSM is a decrease in circulating oestrogens after the menopause leading to the sequalae of GSM. GSM symptoms include not only vaginal symptoms of dryness, burning and irritation but also lower urinary tract and sexual function symptoms. There is currently a lack of patient understanding and awareness of GSM, and an associated lack of knowledge from healthcare providers. GSM has been shown to have a close relationship with female sexual dysfunction and with increasing age comes increasing prevalence of both. Evidence shows that by treating GSM, female sexual dysfunction improves. The mainstay of treatment is with local oestrogen therapy which has shown to improve sexual dysfunction and GSM symptoms. Alternative options for treatment are also available with local testosterone and dehydroepiandrosterone (DHEA) as well as novel treatment with vaginal laser and lifestyle modifications.