After menopause, about half of all women experience genital, sexual, and urinary symptoms associated with decreases in estrogen, termed genitourinary syndrome of menopause.
First-line therapies are non-hormonal vaginal lubricants and moisturizers.
For persistent symptoms, prescription estrogen in cream and ring formulations is effective.
Practitioners can use the patient’s most bothersome symptom and her vaginal pH level to assess clinical responses to therapy.
The diagnosis is based on clinical signs and symptoms from the medical history and physical examination.
If the symptoms are not bothersome to the patient, the syndrome does not require treatment.
This is an updated, comprehensive review, which is free for downloading from PubMed.
Phillips NA, Bachmann GA. Genitourinary syndrome of menopause: Common problem, effective treatments. Cleve Clin J Med 2018;85:390-8
Content updated August 2018