The term ‘Genitourinary Syndrome of Menopause’ emerged in 2014, shedding light on the transformative impact of diminishing estrogen levels during menopause on a woman’s genital health. This syndrome encompasses a spectrum of distressing symptoms, ranging from vaginal dryness to pain during intercourse, and often manifests in physical signs discernible during a medical examination. Understanding these manifestations is crucial for addressing the profound challenges women may face in maintaining urogenital health during this life stage.
‘Genitourinary syndrome of menopause’ was a term coined in 2014 to describe the changes that happen to a woman’s genitals because of the dropping estrogen levels at the time of menopause.
The symptoms that are included in this syndrome are:
- Vaginal and vulval dryness
- Irritation, burning or itching of the vagina and vulva
- Decreased lubrication with sex
- Pain or discomfort during sex
- Bleeding after sex due to small tears in the vagina or vulva
- Loss of desire or ability to feel aroused or have an orgasm
- Burning or pain when passing urine
- Needing to pass urine frequently or wake up at night frequently to pass urine
When your doctor examines you, these are the signs that suggest lack of estrogen in the system:
- Thin parchment like vagina that is pale and tears easily
- Dry vagina that doesn’t have moisture and is not elastic
- Loss of the normal vaginal folds leading to shortening and shrinking
- Small tears and bleeds when inserting a speculum
- Flattened cervix and difficulty obtaining a cervical smear
- Loss of the architecture of the labia minora (the small lips)
- Retraction of the clitoris and even resorption (cannot see the clitoris even after retracting the labia)
- Prolapse or protrusion of the urethral opening
- Tightening or narrowing of the urethral opening
- Shrinking or tightening of the introitus – the entrance to the vagina
- Shrinking or flattening of the hymen
- Change in vaginal pH and presence of inflammation (this used to be called atrophic vaginitis)
- Change in vaginal odor because of infection or altered vaginal flora or incontinence
- Vulval skin changes – thin parchment like, thickened plaques, infections such as candida and tinea, moles, folliculitis (infection of the hair follicles), damage to skin from leaking urine
- Anal skin changes, piles, fissures and a narrowed perineum (the distance from the introitus to the anus decreases as we age and the risk of infection from the bowel increases)
Conclusion:
Of all these symptoms it is vaginal dryness and irritation that is one of the most bothersome symptoms of the menopause, second only to hot flashes. These symptoms cause a lot of irritation that the person can not even do a single work peacefully. Some might go to the extent to threaten the life of a person if it is not treated properly and at the correct time. Spreading awareness about these symptoms to all the people will lead to an exponential decrease in the pain and deaths caused by this.
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References:
The Recent Review of the Genitourinary Syndrome of Menopause. Hyun-Kyung Kim, So-Yeon Kang, Youn-Jee Chung, Jang-Heub Kim, and Mee-Ran KimJ Menopausal Med. 2015 Aug; 21(2): 65–71.Published online 2015 Aug 28. doi: 10.6118/jmm.2015.21.2.65. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561742/