Bone Dry to Oh My!
What is Genitourinary Syndrome of Menopause (GSM)?
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Let's talk about something that affects many women but isn't discussed nearly enough - Genitourinary Syndrome of Menopause (GSM). It's a fancy name for a group of symptoms that happen "down there" when your estrogen levels drop during menopause. Unlike hot flashes that typically fade over time, GSM symptoms tend to stick around or even worsen if not addressed. The good news? There's plenty we can do about it!
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Why Does GSM Happen?
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Think of estrogen as a kind of natural moisturizer and tissue-strengthener for your genital and urinary areas. When estrogen levels drop, several changes happen:
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The tissues of your vagina and urethra become thinner
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Blood flow to your genital region decreases
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Natural lubrication diminishes
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Vaginal tissues lose some of their stretchiness
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The vaginal environment becomes less acidic
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Pelvic floor muscles may weaken
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Tissues lose some of their collagen and elasticity
It's like when skin gets drier and less elastic as we age, but in this case, it's happening to more sensitive areas!
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You're definitely not alone! GSM affects:
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About 50-70% of women after menopause
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Many women during perimenopause (those transitional years before periods stop completely)
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Surprisingly, only about 1 in 4 women talk to their healthcare providers about it
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What Might You Notice?
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Vaginal and Vulvar Changes
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Dryness (like your body's natural lubricant has gone on vacation)
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Burning, irritation, or itching
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Discomfort or pain during sex
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Occasional spotting after intercourse
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Vagina feeling less elastic or responsive
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Urinary Changes
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Feeling like you need to dash to the bathroom more often
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Getting up at night to pee
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More frequent urinary tract infections
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Leaking when you cough, laugh, or exercise
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Sudden, strong urges to urinate
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Discomfort when you pee
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Changes in Sexual Function
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Less desire for sex
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More difficulty becoming aroused
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Changes in how orgasms feel
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Avoiding intimacy because it's uncomfortable
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How Common is GSM?
Treatment Options - What Works?
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Vaginal Moisturizers and Lubricants
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What they are: Think of moisturizers as daily body lotion for your vagina, while lubricants are like chapstick you apply just before you need it (during sex), they often contain hyaluronic acid
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How well they work: About 60-70% of women feel improvement in dryness and comfort
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Perfect for: Anyone looking for a simple, non-hormonal place to start
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Vaginal Estrogen
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What it is: Low-dose estrogen applied right where you need it (creams, tiny tablets, or flexible rings)
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How well it works: Impressive! 80-90% of women notice significant improvement
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Perfect for: Moderate to severe symptoms that moisturizers aren't helping enough
DHEA
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What it is: A vaginal insert that your body converts to helpful hormones right in the vaginal tissues
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How well it works: About 60-70% effectiveness for reducing pain during sex and dryness
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Perfect for: Women looking for an alternative hormonal approach
Here's something many women don't know: pelvic floor physiotherapy can be a game-changer for GSM symptoms! A pelvic health physiotherapist can provide specialized care that makes a real difference.
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How Pelvic Floor Therapy Helps:
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Boosts blood flow to your intimate tissues, enhancing natural moisture and tissue health
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Strengthens and coordinates your pelvic floor muscles, reducing those annoying leaks and urinary symptoms
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Enhances sexual pleasure by improving awareness and function of muscles involved in arousal and orgasm
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Releases tender spots and muscle tension that might be contributing to pain during sex
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Improves tissue flexibility through gentle techniques and appropriate exercises
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Teaches you practical strategies about positions and activities that feel good, not painful
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What to Expect When You Visit a Pelvic Floor Physiotherapist:
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A friendly, professional assessment of how your pelvic floor muscles are working
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A personalized exercise program just for you
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Techniques to help your pelvic muscles relax and work together properly
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Guidance on tools like vaginal dilators if they might help
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Self-massage techniques you can do at home
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Practical tips to reduce those frequent bathroom trips
Does It Really Work?
The research says yes! Women with GSM who work with pelvic health physiotherapists typically experience:
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70-80% fewer episodes of urinary leakage
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Noticeable improvement in sexual enjoyment
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Better arousal, orgasm, and satisfaction
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Less pain during intimacy
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Improved confidence and quality of life
Pelvic Floor Physiotherapy Your Secret Weapon
Simple Lifestyle Changes That Make A Difference
Alongside medical treatments and pelvic floor therapy, these everyday changes can help:
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Regular sexual activity (with a partner or solo) increases blood flow to your intimate areas
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Moving your body regularly improves overall circulation
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Maintaining a comfortable weight reduces pressure on your pelvic floor
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Skipping harsh soaps and scented products in your genital area
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Drinking enough water throughout the day
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Finding ways to manage stress like yoga, meditation, or whatever helps you relax
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Quitting smoking, which can improve blood flow to all tissues
Mixing and Matching for Best Results
Most women find that combining approaches works best. For example:
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Using vaginal moisturizers while also doing your pelvic floor exercises
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Trying low-dose vaginal estrogen alongside pelvic floor physiotherapy
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Using lubricants for intimacy while maintaining a regular pelvic floor exercise routine
Your Brighter Future
GSM isn't just something you have to put up with as part of getting older. With the right approach, you can feel dramatically better and enjoy this phase of life.
Remember:
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These symptoms are not "just part of aging" that you need to endure
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There are effective treatments that can make a real difference in how you feel
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Pelvic floor physiotherapy offers multiple benefits without medication side effects
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It's never too late to feel better!
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By working with healthcare providers, especially pelvic health physiotherapists, you can create a plan that addresses your specific concerns. With the right care, you can reduce discomfort, enhance intimate experiences, decrease those annoying leaks, and feel more confident in your body again.
When to Reach Out for Help
Consider talking to a healthcare provider if:
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Vaginal dryness is making you uncomfortable day-to-day
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Sex has become painful or something you avoid
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Urinary symptoms are cramping your lifestyle
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Any GSM symptom is bothering you or making you worry
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Your journey to feeling better starts with a conversation. You deserve to feel comfortable in your body at every age!