Genitourinary Syndrome of Menopause: Symptoms and Solutions

In Menopause/Perimenopause by Stephanie PrendergastLeave a Comment

By Stephanie Prendergast, MPT, PHRC Los Angeles

Did you know that the term Genitourinary Syndrome of Menopause (GSM) was introduced as recently as 2014? What!? Women have been going through menopause as long as we have been on the planet. Why are we talking about it? Because too many women are currently suffering with treatable symptoms because of conflicting & misinformation. If you follow us you know that the same symptoms also affect pre-menopausal women, and there is significant overlap between symptoms of premenopausal and menopausal hormone deficiencies and pelvic floor dysfunction. Therefore, we as pelvic floor physical therapists need to know how to tell the difference to best help our patients recover!


Did you know….


The bothersome symptoms of menopause are extremely underdiagnosed despite the fact menopause is currently affecting 50 million people in the US. This is because of embarrassment, the fact we have normalized the symptoms, and the lack of appropriate medical care.


Current research has refuted past research stating all hormone therapy is dangerous, yet many people are told otherwise. We suggest working with a menopause specialist. 

Two societies listing reliable providers include:


The ideal age for women to start hormone therapy is within 5 years of their last period. Experienced doctors can help navigate options! We are talking about this because the symptoms of pelvic floor dysfunction and GSM overlap. 


Physical therapy can not undo hormone insufficiencies & we know the most effective treatment for people is a combo of medical management & PFPT. Need more medical evidence-based information? We recommend checking out:

Genitourinary Syndrome of Menopause symptoms pt 2

Hormone insufficiency can result in inter-labial and vaginal itching. Other dermatologic issues such as Lichen Sclerosus and cutaneous yeast infections are just two of the many factors to also be considered.


Unfortunately people are vulnerable to recurrent vaginal and urinary tract infections in menopause due to:

  • pH and tissue changes
  • incomplete bladder emptying
  • pelvic organ prolapse compromising urinary function


Recurrent infections are a leading cause of pelvic floor dysfunction! They must be stopped or the noxious visceral-somatic input can cause further pain and dysfunction after the infection is cleared.  Furthermore, if the infections are  left untreated without hormone therapy infections continue to occur and the consequences can be severe. Woman can develop unprovoked pain, sex may be impossible, and undetected UTIs can lead to kidney problems and more sinister issues.


We encourage people to work with a menopause expert to monitor, prevent, and treat these issues as they are serious and treatable! We need to normalize the conversation about what happens during GSM, it is nothing to be embarrassed about and with the right care vulva owners can live their best lives! Pelvic floor physical therapy and medical management go hand in hand. 


Related Blogs:

Perimenopause Facts: It Starts Earlier than You Think

Midlife Sex Crisis: What Are My Perimenopause Options?

Patient Success Story: Dealing with Prolapse and Menopause

Hormonal Changes in Menopause and What You Can Do About It


Related Videos:


Are you unable to come see us in person? We offer virtual physical therapy appointments too!

In addition to virtual consultation with our physical therapists, we also offer integrative health services with Jandra Mueller, DPT, MS. Jandra is a pelvic floor physical therapist who also has her Master’s degree in Integrative Health and Nutrition. She offers services such as hormone testing via the DUTCH test, comprehensive stool testing for gastrointestinal health concerns, and integrative health coaching and meal planning. For more information about her services and to schedule, please visit our Integrative Health website page

PHRC is also offering individualized movement sessions, hosted by Melissa Patrick, DPT. Melissa is a pelvic floor physical therapist at the Berkeley and San Francisco locations. Patients can expect a one hour 1-on-1 private session with Melissa Patrick, an experienced yoga instructor and pelvic floor physical therapist. Melissa will take a complete medical history, consider questions and concerns that the person may have, and discuss goals for the movement sessions. Melissa will provide the person with a tailored set of postures and mindfulness techniques to address the musculoskeletal needs of the individual. To schedule a 1-on-1 appointment visit us online.


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