What is genitourinary syndrome of menopause (GSM)?

• A. A neurological disorder
• B. A dermatologic condition
• C. A collection of symptoms including vaginal dryness, irritation, and urinary symptoms due to estrogen deficiency
• D. A cardiac syndrome

Answer: (C)

Genitourinary syndrome of menopause is the collection of symptoms that results from reduced estrogen affecting the genital and urinary tissues after menopause. The hallmark features involve vaginal dryness, irritation or itching, burning, and pain with intercourse, along with urinary symptoms such as urgency, frequency, burning on urination, and sometimes recurrent urinary infections. Estrogen deficiency causes thinning of the vaginal epithelium, decreased lubrication, loss of elasticity, and a higher vaginal pH, which together irritate mucosal tissues and disrupt the normal vaginal flora, leading to both vaginal and urinary symptoms. This is not a neurological, dermatologic, or cardiac condition; those descriptions point to other organ systems.