GENITOURINARY SYNDROME OF MENOPAUSE: CLINICAL INSIGHTS AND ADVANCES IN MANAGEMENT
Main Article Content
Keywords
Genitourinary syndrome of menopause, hypoestrogenism, vaginal atrophy, dyspareunia, estrogen therapy.
Abstract
Background: Genitourinary Syndrome of Menopause (GSM) is a chronic and progressive condition caused by estrogen deficiency, affecting the genital, urinary, and sexual health of postmenopausal women. Despite its high prevalence, GSM remains underdiagnosed due to lack of awareness and social stigma.
Objective: To evaluate the clinical manifestations, pathophysiology, etiology, diagnostic modalities, and management strategies of GSM, and to compare findings with current literature.
Methods: A case-control study was conducted at a tertiary care center over 12 months (January 2024–January 2025), including 100 postmenopausal women—50 with clinically diagnosed GSM and 50 asymptomatic controls. Clinical evaluation, vaginal pH measurement, vaginal maturation index (VMI), and serum estradiol levels were assessed and compared between the two groups.
Results: GSM symptoms such as vaginal dryness (100%), dyspareunia (86%), and urinary complaints (92%) were common among cases. Vaginal pH was significantly elevated (6.68±0.33 vs. 4.71±0.22; p<0.001), and VMI and serum estradiol levels were significantly lower in GSM cases compared to controls (p<0.001).
Conclusion: GSM significantly impacts the quality of life of postmenopausal women but is often overlooked. Accurate diagnosis through clinical and cytological assessment and timely intervention with individualized treatment plans, including local estrogen therapy and emerging non-hormonal options, are essential for optimal care.
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Dr. Roli Agarwal
Assistant Professor, Department of Obstetrics and Gynaecology, Teerthankar Mahavir University, Moradabad, Uttar Pradesh, India.
Dr. Sheetal Agarwal
Assitant Professor, Department of Microbiology, Hind Institute of Medical Sciences, Lucknow, Uttar Pradesh, India.
Dr. Nagma Khanam
Assistant Professor, Department of Obstetrics and Gynaecology, Teerthankar Mahavir University, Moradabad, Uttar Pradesh, India.
Dr. Mahvish Shafiq
Assistant Professor, Department of Obstetrics and Gynaecology, Integral Institute of Medical Science and Technology, Lucknow, Uttar Pradesh, India.