What GSM includes
Genitourinary syndrome of menopause covers dryness, burning, irritation, tissue thinning, pain with sex, urinary urgency and frequency, and recurrent urinary tract infections.
Unlike hot flashes, these symptoms usually do not resolve on their own and tend to progress without treatment.
Treatment options
- Low-dose vaginal estrogen, which acts locally with minimal systemic absorption
- Vaginal DHEA and other prescription options where appropriate
- Non-hormonal moisturizers used regularly, and lubricants used for intercourse
- Pelvic floor physical therapy referral when muscle guarding or pain is part of the picture
Safety questions people ask first
Vaginal estrogen is dosed differently from systemic hormone therapy, and candidacy is assessed individually — including for people with a personal or family history of breast cancer, which is a conversation worth having rather than an automatic no.
Questions people ask
- Can vaginal symptoms be treated without systemic hormones?
- Yes. Local treatment can be used on its own, alongside systemic therapy, or with non-hormonal options only.
- Do recurrent UTIs relate to menopause?
- They can. Tissue and microbiome changes after menopause are a recognized contributor to recurrent urinary tract infections.
This page is general health information, not medical advice. Care decisions are made individually in a visit.