Vaginal Health Deep Dive
20 days ago
- Genitourinary Syndrome of Menopause is more than vaginal dryness
GSM can include vaginal dryness, burning, irritation, painful intercourse, urinary urgency, frequent urination, and recurrent UTI-like symptoms. Dr. Enzmann explains that the term replaced “vaginal atrophy” because estrogen loss affects the broader vaginal, bladder, and urinary system—not only sexual comfort. - Symptoms can begin during perimenopause and other low-estrogen stages
While GSM is often associated with postmenopause, symptoms may appear much earlier, including during perimenopause, postpartum breastfeeding, or in some women using hormonal birth control. Declining estrogen can thin vaginal tissue, alter pH, reduce protective lactobacilli, and make the vaginal and urinary tissues more vulnerable to irritation and infection. - Local treatment and microbiome support can make a meaningful difference
Dr. Enzmann discusses local vaginal estrogen, vaginal estrogen tablets, and vaginal DHEA as options for restoring tissue health and reducing symptoms. She also emphasizes careful treatment of BV and yeast, avoiding unnecessary repeated antibiotics when possible, and using lubricants that are less likely to irritate the vaginal microbiome.
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