Understanding Vaginal Atrophy (GSM)
Comfort, confidence, and connection—effective options for dryness, irritation, and painful sex.
GenitoUrinary Syndrome of Menopause (GSM) is the modern term for changes that can occur with lower estrogen: vaginal dryness, burning or irritation, pain with sex, urinary urgency or frequency, and more frequent urinary infections. These symptoms are common—yet very treatable. At Westside Women's Health, we center your comfort and goals with options that actually work.
Fast Facts About GSM
Driven by decreased estrogen affecting vaginal and urinary tissues
Symptoms often worsen over time without treatment
Local therapies act primarily in the vagina/urethra with minimal systemic absorption
Moisturizers, lubricants, pelvic PT, and prescription therapies can all help
Common Symptoms
- Vaginal dryness, burning, or itching
- Pain with intercourse (dyspareunia) or tightness
- Spotting after sex due to tissue fragility
- Urinary urgency, frequency, or recurrent UTIs
- External irritation of the vulva/vestibule
Why It Matters
Discomfort can affect intimacy, exercise, clothing choices, and daily confidence. Because GSM tends to persist or progress without treatment, a proactive plan can restore comfort, reduce infections, and improve quality of life at any stage of menopause.
Diagnosis & Evaluation
Diagnosis is based on your symptoms and a focused pelvic exam. We rule out other causes of irritation or pain (e.g., yeast/BV, skin conditions, pelvic floor tension). If urinary symptoms dominate, we may check a urinalysis/culture or discuss prevention strategies for UTIs.
GSM vs. Yeast Infection
GSM (Vaginal Atrophy)
- Dryness, burning, or pain with sex; tissues appear thin/pale
- Often minimal discharge; pH typically elevated
- Symptoms chronic or progressive without therapy
- Improves with moisturizers and local estrogen/DHEA when appropriate
Yeast Infection
- Intense itching with thick, white discharge
- pH usually normal (≤4.5)
- Often episodic; triggered by antibiotics or other factors
- Responds to antifungal treatment, not estrogen therapy
Treatment Options
We tailor care to your comfort and goals. First-line options include regular vaginal moisturizers (for baseline hydration) and lubricants during intimacy. Local vaginal estrogen (cream, tablet, insert, or ring) can restore tissue health and typically has minimal systemic absorption. Additional options include vaginal DHEA (prasterone) or an oral SERM (ospemifene) for painful sex in appropriate candidates. Pelvic floor physical therapy helps with muscle tightness or insertion pain; dilator therapy can gently improve comfort. We also discuss UTI prevention strategies if urinary symptoms are present. Your plan is personalized and adjustable over time.
What to Bring to Your Appointment
- ✓Symptom timeline (dryness, pain with sex, urinary changes)
- ✓Products you've tried (moisturizers, lubricants) and responses
- ✓Medication/supplement list and past hormone use
- ✓History of UTIs or pelvic floor therapy
- ✓Questions and goals for comfort and intimacy
Frequently Asked Questions
1Is local vaginal estrogen safe?
For many patients, low-dose vaginal estrogen is considered safe and acts locally with minimal systemic absorption. We review your history to choose a formulation and schedule that fit your health profile and comfort.
2What's the difference between moisturizers and lubricants?
Moisturizers are used routinely (e.g., several times per week) to improve baseline hydration. Lubricants are used during intimacy to reduce friction and discomfort. Many people benefit from both.
3How long until I feel better?
Some notice relief within days to weeks using lubricants and moisturizers. With local estrogen or DHEA, tissue changes typically improve over several weeks, with continued gains over months.
4Can GSM cause recurrent UTIs?
Yes. Estrogen loss can affect the urethra and bladder, increasing UTI risk. Restoring vaginal tissue health with local therapies may reduce recurrences as part of a broader prevention plan.
5Do I need treatment forever?
GSM tends to persist. Many choose an ongoing maintenance plan once symptoms improve. We can adjust the dose or schedule over time based on your response and preferences.
Comfort You Can Feel
Whether you want relief from dryness, more comfortable intimacy, or fewer urinary symptoms, we'll create a plan that works for your body and your life.
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