LAUSR

Genitourinary syndrome of menopause (GSM), also known as vulvovaginal atrophy (VVA), is a progressive condition well known to clinicians who care for menopausal women. Such clinicians recognize that while GSM adversely affects quality of life, including sexual function, in nearly half of midlife and older women, most such women are neither diagnosed with nor treated for this condition. Symptoms characteristic of GSM include vaginal dryness, genital pruritis, dyspareunia, urinary urgency/frequency and an elevated risk of urinary tract infections, all of which are likely to persist or progress without treatment [1]. Low levels of estrogen associated with natural or surgical menopause represent a key factor in the etiology of GSM. The high prevalence of GSM in other hypoestrogenemic states, including lactation, premature ovarian insufficiency, ovarian damage from chemotherapy or radiation, and use of GnRH agonists, aromatase inhibitors, or other anti-estrogenic medications highlights a central role of estrogen in maintaining normal vaginal function.