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New Guidelines for Managing Genitourinary Syndrome of Menopause

12 October 2020

The North American Menopause Society (NAMS) has updated and expanded its 2013 position statement on the management of the genitourinary syndrome of menopause (GSM), of which symptomatic vulvovaginal atrophy is a part.

The updated statement was presented at the 2020 Virtual NAMS Meeting by Stephanie S. Faubion, MD, Mayo Clinic, Jacksonville, Florida, and colleagues.

"Healthcare providers should educate women about GSM and the urogenital changes that often occur with menopause," the statement reads. "Many women are unaware that vaginal dryness, recurrent urinary tract infections, discomfort with sexual activity, and other GSM symptoms are a consequence of estrogen deficiency. Unlike vasomotor symptoms that typically improve with time, GSM symptoms often worsen in the absence of treatment."

According to the statement over-the-counter vaginal lubricants and moisturizers may sufficiently manage symptoms for some women with milder symptoms, as well as some approved prescription therapies, including vaginal estrogens, dehydroepiandrosterone (DHEA), systemic hormone therapy, and ospemifene.

"The choice of therapy depends on the severity of symptoms, efficacy, and safety of treatments for the individual woman, and patient preference," the authors stressed.

The recommendations include:

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