New Guidelines for Genitourinary Syndrome of Menopause (GSM): What Every Woman Needs to Know

New Guidelines for Genitourinary Syndrome of Menopause (GSM): What Every Woman Needs to Know

If you're navigating midlife changes and finding yourself dealing with vaginal dryness, burning, discomfort during intimacy, or recurrent urinary symptoms, you're not alone. These concerns are common—and they have a name: Genitourinary Syndrome of Menopause (GSM).

Recently, the American Urological Association (AUA), in partnership with the American Urogynecologic Society (AUGS) and other leading organizations, released updated clinical guidelines for evaluating and treating GSM. These updates are a game changer for women seeking lasting, evidence-based solutions.

What Is GSM?

GSM is a chronic, progressive condition caused by the decline in estrogen during and after menopause. It affects the vulva, vagina, and lower urinary tract, and it can significantly reduce a woman’s quality of life. This syndrome is far more than just dryness—it impacts daily comfort, relationships, sexual health, and emotional well-being.

Common Symptoms of GSM

• Vaginal dryness, itching, or burning

• Pain during intercourse (dyspareunia)

• Decreased lubrication and sexual satisfaction

• Recurrent urinary tract infections

• Urinary urgency or incontinence

• Painful urination

Despite how common these symptoms are, many women delay seeking treatment due to embarrassment or the belief that these changes are “just part of aging.” The good news is: they are treatable.

What’s New in the AUA Guidelines?

The latest guidelines from the AUA highlight a more supportive, patient-centered approach to diagnosing and managing GSM. Here are the key changes:

Symptom-Based Diagnosis

GSM can now be diagnosed based solely on your symptoms—no need for hormone tests or invasive assessments. If you’re experiencing these changes, that’s reason enough to seek help.

Shared Decision-Making

These updates encourage meaningful conversations between patient and provider, with treatment tailored to your goals, preferences, and medical history.

Local Vaginal Estrogen as First-Line Treatment

Low-dose vaginal estrogen—available as a cream, tablet, insert, or ring—is now considered the most effective first-line treatment for GSM. It relieves dryness, pain, and urinary discomfort with a strong safety profile.

Non-Estrogen Hormonal Options

For those who cannot or prefer not to use estrogen, options like vaginal DHEA or the oral medication ospemifene offer additional relief.

Pelvic Floor Physical Therapy

Recognized as a valuable intervention, pelvic floor therapy can be especially helpful for urinary leakage, pelvic pain, and painful intercourse.

How I Can Help at Mountain Modern Aesthetics & Wellness

At Mountain Modern Aesthetics & Wellness, I provide a thoughtful, evidence-based approach to treating GSM and restoring your quality of life. As a hormone and wellness specialist with over 22 years of nursing experience, I work with you to create a personalized care plan that may include:

Bioidentical Hormone Replacement Therapy (HRT)

I offer tailored hormone therapy solutions designed to address the root cause of GSM and support whole-body hormone balance.

Customized Local Vaginal Estrogen Treatments

We’ll determine the best delivery method for your body and lifestyle, whether that’s a cream, vaginal insert, or ring.

Non-Hormonal Therapies and Support

If hormone therapy isn’t right for you, I’ll guide you through effective alternatives, including high-quality vaginal moisturizers, lubricants, and referrals for pelvic floor therapy.

Whole-Woman Care

GSM is just one piece of the wellness puzzle. I help women navigate energy loss, sleep disruption, weight changes, and more—through personalized hormone optimization and holistic care.

Ready to Feel Like Yourself Again?

You don’t have to live with the discomfort of GSM. Relief is possible, and you deserve to feel confident, comfortable, and vibrant at every stage of life. If you're experiencing symptoms of genitourinary syndrome of menopause, I invite you to schedule a consultation at Mountain Modern Aesthetics & Wellness.

Together, we’ll create a plan to restore balance, intimacy, and well-being.

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Mountain Modern Aesthetics & Wellness

Jennifer Graham, AGCNS-BC

Owner | Hormone & Wellness Specialist