Genitourinary syndrome of menopause (GSM)
Also called vaginal atrophy, atrophic vaginitis, vaginal dryness
Reviewed August 2026 against NHS, NIH and WHO references.
In short
Genitourinary syndrome of menopause, or GSM, covers the vaginal and urinary changes caused by lower estrogen: dryness, irritation, pain during sex, and more frequent or urgent urination and urinary infections. Unlike hot flashes, it tends to persist or worsen over time, and it responds well to local vaginal estrogen.
One name for a cluster of changes
GSM is a newer, broader term that replaced 'vaginal atrophy'. The name changed because the same drop in estrogen that dries and thins the vaginal tissue also affects the bladder and urethra. So GSM covers both: dryness, soreness, itching and pain during sex, plus urinary urgency, frequency and repeated urinary tract infections.
Why it does not just go away
Unlike hot flashes, which often ease over time, GSM tends to persist or slowly worsen if untreated, because the tissue keeps responding to the ongoing low estrogen level. It is very common and treatable, yet it goes unmentioned in many appointments, so it often goes unaddressed for years.
What helps
Non-hormonal vaginal moisturizers and lubricants can ease symptoms. For more than mild changes, low-dose vaginal estrogen, delivered as a cream, tablet, gel or ring, treats the tissue directly with very little absorbed into the bloodstream, so it can often be used even when systemic hormone therapy is not suitable.
Keep going
Related terms
Sources
This definition is for general information only and is not medical advice. Menopause care depends on your individual health history. Please talk to a qualified clinician about what is right for you.