Menopause
ICD-10 N95.1 · ICD-11 GA30.0

Menopause with Genital Dryness, Burning, Dyspareunia, and Urinary Symptoms

Clinical Scenario

This protocol covers postmenopausal women presenting with genitourinary syndrome of menopause (GSM): genital dryness, burning, and irritation; diminished lubrication and pain during sexual activity (dyspareunia); and urinary symptoms including urgency, dysuria, and recurrent urinary tract infections.

Condition

Genitourinary syndrome of menopause encompasses the genital and lower urinary tract symptoms associated with postmenopausal estrogen deficiency. The symptomatic picture spans vaginal discomfort and dyspareunia through to urinary urgency, dysuria, and susceptibility to recurrent infections.

Treatment Approach

The evidence-based first-line approach involves a low-dose local vaginal estrogen preparation — shown to be safe and effective for vulvovaginal symptoms due to estrogen deficiency, with no systemic progestogen required.

The full regimen — including the specific preparation options, scheduling, and duration — is detailed in the complete protocol below.

Clinical Goals

Relief of vulvovaginal symptoms including dryness and dyspareunia, improved sexual function, and relief of urinary symptoms.

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References

Genitourinary syndrome of menopause (GSM) encompasses the genital and lower urinary tract symptoms associated with postmenopausal estrogen deficiency.

Symptoms may include genital dryness, burning and irritation; sexual symptoms of diminished lubrication and pain during sexual activity; and urinary symptoms of urgency, dysuria, and recurrent urinary tract infections.

Low-dose vaginal estrogen preparations are safe and effective treatments for vulvovaginal symptoms due to estrogen deficiency.

Low-dose vaginal estrogen improves sexual function in these women.

Low-dose vaginal estrogen therapy may provide benefit for urinary symptoms, including overactive bladder and urge incontinence, and may aid in prevention of recurrent urinary tract infections.

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