Genitourinary syndrome of menopause (GSM), previously called vaginal atrophy or atrophic vulvovaginitis, is a group of symptoms that occur in the genital and urinary areas when the body’s estrogen levels drop around and after menopause. A decline in estrogen can happen for many other reasons other than perimenopause and menopause, including during breastfeeding, after surgical removal of the ovaries, due to certain autoimmune (when the body’s immune system mistakenly attacks its own healthy cells and tissues) conditions or while taking medications that impact estrogen level (e.g. birth control or hormonal therapy for breast cancer).
GSM affects tissues of the vulva (the outer genital area), the vagina, the urethra (the tube where urine passes through), and the bladder. Because these estrogen-related changes involve both the genital and urinary systems, we now call it genitourinary syndrome of menopause. This term is more representative of the range of affected tissues and related symptoms.
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