The Nu Guide: Everything you need to know about GSM (genito-urinary syndrome of menopause)
As we journey through life, our bodies go through natural changes, and it's important to understand how they can impact our wellbeing. For menopausal women, these changes often involve the vulva, vagina and urinary system, mostly because of decreasing levels of the hormone estrogen. This collection of symptoms, known as the genito-urinary syndrome of menopause (GSM), affects up to 50% of postmenopausal women and may cause dryness, irritation, itching, recurrent infections and pain during intercourse.
Unlike some menopausal symptoms that usually fade over time, genito-urinary problems tend to persist and even worsen with age. It's essential to recognise that these symptoms are associated with both menopause and the natural process of ageing.
So why is estrogen the superhero for genital health? This area of a woman’s body needs a good dose of estrogen to keep everything in check. Estrogen receptors in the vaginal tissue keep the walls thick and elastic when stimulated by the hormone. However, as estrogen levels decrease, dryness in the vulva and vagina becomes a common occurrence. Additionally, the natural acidity of the pre-menopausal vagina may become more alkaline during menopause, making it more susceptible to urinary tract infections (UTIs) and vaginitis. Fun times, not.
The vulval area also undergoes age-related changes, like a reduction in fatty tissue that can lead to some contracting of the labia majora and clitoral hood. It's like a little remodeling project down there. Plus, the pelvic floor muscles may decide to take it easy, leading to more bathroom breaks and a bit of a struggle to control things.
If you're in the midst of these changes, it's crucial to be aware of the symptoms. Think irritation, burning, itching, discomfort during intercourse, dryness, light bleeding, inflammation, and funky discharge. Yeah, it's a lot!
But, fear not! Managing these symptoms involves a bit of lifestyle adjustment and, in some cases, considering treatments. Here are some friendly recommendations to ease the discomfort:
Choose comfy cotton undies and change them daily. Heck, consider going commando, especially when hitting the hay
Give tight-fitting undies, pantyhose, jeans, and trousers a break. They can make things a bit sweaty down there. Oh, and ditch the damp or wet swimwear and exercise gear
Use non-perfumed or gentle washing products for your clothes. No need for fabric softeners
Say no to feminine hygiene sprays, douching, scented pads, tampons, and fancy toilet paper
Hold off on shaving or waxing the genital area, especially if irritation is already present
Keep it simple with plain water when washing the genital area. Soaps, bubble baths, and shower gels can be a bit much
And when it comes to sexual activities, consider using a natural lubricant like Nu Balm. Your doctor can also guide you on hormonal preparations like ovestin cream to bring back some elasticity and blood flow
Now, if you've been pondering low dose topical estrogen therapy, here's the lowdown. It's designed to target the estrogen-hungry tissues of the vagina, vulva, and urethra, working locally to amp up the skin's quality. By restoring acidity levels and promoting thickness and lubrication, this treatment can be a game-changer for those pesky GSM symptoms in the vulvo-vaginal area. And the best part? It's like a VIP treatment just for your lady bits, with minimal risk of side effects on other organs.
So, if you're considering this, chat with your medical team, especially if you're undergoing cancer treatment or have a history of it. Studies have given the green light for women using vaginal estrogen during breast cancer treatment – no increased risk of recurrence!
You can find intravaginal estrogen in various forms, from tablets to creams and ring pessaries. Your doctor can walk you through the funded and non-funded options. Just keep in mind, for optimal results, you'll need to commit to estrogen use daily for at least 2 weeks, then continue with maintenance treatment as directed by your healthcare pro.
And if you want to dive deeper into the details, check out these references:
