What is GSM?

What is genitourinary syndrome of menopause (GSM)?

When a woman goes through menopause, her estrogen levels decrease along with the levels of other steroid hormones. These decreases can lead to changes in certain areas of the body.  The tissues in the vagina, vulva, and supporting the bladder are especially dependent on estrogen.

For example, estrogen helps keep the vagina moist and flexible. When estrogen levels decline, the vaginal tissue loses the ability to lubricate itself resulting in dryness and itchiness.  Over time the tissue becomes thinner, more fragile and it can bleed easily.  Sometimes the opening to the vagina becomes smaller and intercourse can become uncomfortable or even painful.


Women who have had breast cancer and who are taking certain medications like Tamoxifen can also suffer from these same symptoms since their treatments purposefully cause a very low estrogen or “no estrogen” state.


Together these symptoms are now called the genitourinary syndrome of menopause (GSM).

(The older term for these symptoms, which you may have heard, was vulvovaginal atrophy).


About 50% of postmenopausal women and up to 75% of women who have had breast cancer will experience symptoms of GSM.


Symptoms include:

  • Dryness, itchiness, or burning sensations, and irritation in the genital area
  • Poor vaginal lubrication during sex, discomfort or pain with intercourse, and a decrease in sensation or enjoyment.
  • An urgent need to urinate, painful urination, or recurrent urinary tract infections (UTIs)


Women do not need to have all the symptoms to be diagnosed with GSM.
GSM is a chronic and progressive condition. Unlike hot flashes, the symptoms will not get better over time, in fact, they will only get worse.  Symptoms can, however, be managed with treatment.


Traditionally, the treatment for GSM was to replace the estrogen in a woman’s body by taking pills, using patches, rings, or by using topical creams or estrogen tablets in the vagina.  Many women find these treatments messy or tedious to use.  Other women prefer to avoid hormones.  In the case of women who have had breast cancer, estrogen replacement is not allowed.


The MonaLisa Touch® has the benefit of revitalizing and rejuvenating the vaginal tissue without the use of any hormones.