New term will banish stigma, educate providers on postmenopausal problems

Talking about genital, sexual, and urinary problems can be uncomfortable for postmenopausal women and their doctors. Having a term that doesn't carry stigma, isn't embarrassing to say, and is medically accurate could go a long way in helping women get the help they need and allowing them to make smarter healthcare decisions. That term is "genitourinary syndrome of menopause" or GSM, developed and endorsed by The North American Menopause Society (NAMS) and the International Society for the Study of Women's Sexual Health (ISSWSH). The article about the term's development is published online today in the NAMS journal Menopause.

Various terms have been used to refer to the genital problems can have when estrogen drops after menopause, including "atrophic vaginitis" and "vulvovaginal atrophy." The first implies infection or inflammation, which isn't the main problem. The second uses "vaginal," which is embarrassing for many to say. And "atrophy" implies that something is wasting away from disuse,—a misperception that doesn't account for the many women who want to continue their sex lives free of pain after menopause. What's more, the terms ignore the urinary symptoms that come along with these genital changes, including urgency (that "gotta go" problem), painful urination, and recurring .

The vagina; the area around it (the "vestibule"), which includes the urethra; and the lower end of the bladder (the "trigone") all have the same embryologic origin and are rich in estrogen receptors. The vestibule is also rich in androgen receptors. In these areas, the low hormone levels after menopause result in thinning tissue, loss of elasticity, fewer blood vessels, dryness, and physical changes that can make intercourse painful and the urethra easily irritated.

A panel of NAMS and ISSWSH menopause experts met at a consensus conference to scrutinize all that's known about the changes in these tissues after menopause and to hash out a term that fits that knowledge, doesn't stigmatize women who face these changes, and isn't embarrassing to say publicly. The panel decided the term should include both genital and urinary changes ("genitourinary"), show that it is a whole group of signs and symptoms ("syndrome"), and link the changes to their principal cause ("menopause"). With members' support, both the NAMS and ISSWSH boards endorsed the term.

Although GSM affects about half of all , many don't know that it is hormonal and that treatments are available, such as vaginal moisturizers, vaginal estrogen, and an oral medication that acts like estrogen in the vagina. In addition, because women are so uncomfortable talking about these problems, only a small percentage bring them up with their healthcare providers, and only about 1 in 10 providers brings up the symptoms with patients, surveys show.

"The term 'GSM' will make discussing the problems so much easier, similar to the way 'ED' changed our ability to talk about impotence,'" says NAMS Executive Director Margery Gass, MD, a member of the consensus conference panel of NAMS and ISSWSH experts.

The panelists have also begun to develop a tool to help standardize a physical examination to look for these changes. That means not only will patients and be able to talk about these problems more easily, but also that providers will be able to make the diagnosis swiftly and accurately to get women the treatment they need.

More information: The article "Genitourinary Syndrome of Menopause: New Terminology for Vulvovaginal Atrophy from the International Society for the Study of Women's Sexual Health and The North American Menopause Society" will be published in the October 2014 print edition of Menopause.

add to favorites email to friend print save as pdf

Related Stories

NAMS issues new guidance on vulvovaginal atrophy

Aug 29, 2013

Symptoms of vulvovaginal atrophy (VVA), such as lack of lubrication, irritated tissues, painful urination, and pain with intercourse, affect as many as 45% of women after menopause. That's according to The North American ...

PMS may spell menopause symptoms later—but not hot flashes

May 21, 2014

Having premenstrual syndrome (PMS) before menopause does not mean women will be troubled by hot flashes afterward. But they may face more menopause complaints other than hot flashes, such as trouble with memory and concentration, ...

Treatment helps sex stage a comeback after menopause

Jun 05, 2013

A satisfying sex life is an important contributor to older adults' quality of life, but the sexual pain that can come after menopause can rob women and their partners of that satisfaction. Treatment can help restore it, shows ...

Low Vitamin D may not be a culprit in menopause symptoms

Apr 16, 2014

A new study from the Women's Health Initiative (WHI) shows no significant connection between vitamin D levels and menopause symptoms. The study was published online today in Menopause, the journal of The North American Menopa ...

Recommended for you

Pot-infused edibles: One toke over the line in Colorado?

6 minutes ago

Marijuana shops have sprouted across Denver ever since Colorado legalized the drug for adults in January, but the popularity of pot-infused edibles has surprised authorities, and parents are seeking a ban ahead of Halloween.

US sues Gerber over claims on infant formula

2 hours ago

US government regulators announced Thursday they were suing Gerber, the well-known baby food maker, for claiming that its Good Start Gentle formula can prevent or reduce allergies in children.

Blending faith and science to combat obesity

6 hours ago

Science and religion may seem like uneasy partners at times, but when it comes to promoting healthy lifestyles, one UConn Health researcher has shown they can be an effective combination.

User comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.