GSM - Genitourinary Syndrome of Menopause

Symptoms, Risks, Vaginal Estrogen, Pelvic Floor PT & Radiofrequency Options

This Peri & Pause episode features Jamie Gallagher, a nationally board-certified family nurse practitioner and Menopause Society certified practitioner, discussing genitourinary syndrome of menopause (GSM), the updated term replacing “vaginal atrophy” because it affects both vaginal and urinary tissues. They explain how declining estrogen causes tissue thinning that can lead to dryness, burning, itching without discharge, pain or bleeding with sex, urinary leakage, increased UTIs, and even life-threatening urosepsis, noting symptoms are often underreported and frequently dismissed as “normal.” First-line options include vaginal moisturizers and lubricants, with vaginal estrogen emphasized as key and not “duplicate therapy” with systemic hormones. Additional approaches include pelvic floor physical therapy and emerging energy-based radiofrequency (including microneedling RF) to stimulate collagen, improve continence and tissue health, with a typical three-treatment series and annual maintenance.

00:00 Welcome to Peri & Pause

00:39 What Is GSM

02:01 Why It Matters

03:32 Estrogen and Tissue Changes

05:10 How Common and Why Silent

06:42 Diagnosis and First Steps

08:31 Vaginal Estrogen Options

10:35 Beyond Estrogen Treatments

12:03 Radiofrequency Explained

13:36 Practice Mission Break