Burning, Dryness, Pain? These New Guidelines Change Everything

‼️ Why the New GSM Guidelines Are a Game Changer for Menopause Care

While genitourinary syndrome of menopause (GSM) may be a mouthful, it’s a term every woman — and every clinician — needs to know.

Because GSM is more than just a clinical acronym. It’s the reason why so many women struggle with:

• Vaginal dryness

• Painful sex

• Burning or urgency when urinating

• Recurrent urinary tract infections

• Feeling like something’s “off” — but no one is listening

Some women laugh it off.
Some are scared.
Some say, “But I’m on the patch…”
Or “I use vaginal moisturizer.”

And still, their symptoms persist.

But now, the 2025 GSM guidelines — developed by American Urological Association (AUA), Society of Urodynamics, Female Pelvic Medicine and Urogenital Reconstruction (SUFU), and American Urogynecologic Society (AUGS) — leave no room for confusion. This is a long-overdue milestone in women’s health.

🔍 What Is Genitourinary Syndrome of Menopause (GSM)?

GSM is a chronic, progressive condition caused by the natural drop in estrogen (and sometimes testosterone) after menopause — or due to hormone suppression like birth control or cancer treatment. It impacts the vulva, vagina, bladder, and urethra.

GSM is common.
It’s treatable.
And now, the guidance is clear.

🔑 GSM Treatment Guidelines 2025: What You Need to Know

These new guidelines represent decades of advocacy and clinical expertise from leaders like Dr. Rachel Rubin and Dr. Jill Krapf, who’ve appeared on Fempower Health and actively work to educate peers, push the FDA, and bring clarity to a historically neglected issue.

Here’s what they confirm:

✅ Ask About GSM — Normalize It

Clinicians must take the lead in asking about urinary, sexual, and vaginal symptoms. Women shouldn’t be left to wonder or feel ashamed.

✅ Local Vaginal Estrogen = Frontline Treatment

Even if you’re already using a hormone patch or systemic therapy, vaginal estrogen is still necessary to treat GSM directly.

✅ DHEA and Ospemifene Are Valid Alternatives

Non-estrogen options like vaginal DHEA (Prasterone) and ospemifene also work — especially when estrogen isn’t preferred.

✅ Vaginal Moisturizers Aren’t Enough

They’re helpful for dryness but do not fix urinary symptoms or tissue atrophy. They’re not a substitute for medical treatment.

✅ Lasers? Still Experimental

Vaginal lasers are not yet considered standard of care. Full disclosure and informed consent are a must.

✅ Breast Cancer? Vaginal Estrogen May Still Be an Option

Even for women with a history of breast cancer, vaginal estrogen may be offered in collaboration with a medical team.

✅ No Cancer Link from Vaginal Estrogen

There is no proven association between local vaginal estrogen and breast or uterine cancer.

✅ No Need for Routine Endometrial Surveillance

Routine monitoring is not required when using vaginal estrogen, DHEA, or ospemifene.

✅ Vaginal Estrogen Prevents Recurrent UTIs

This one is huge: vaginal estrogen is a key preventive therapy for postmenopausal women with frequent urinary tract infections.

💡 Why It Matters: Data ≠ Practice

These guidelines are crystal clear — but clinical guidelines can take years to become routine care.

That’s why education matters.
That’s why advocacy matters.
And that’s why you might need to bring this to your provider.

Doctors are inundated with information. Many may not know these updates yet — but that doesn’t mean they don’t care.

So: bring it up.
Ask for more than the patch.
Ask for more than a moisturizer.
Ask for care based on the most up-to-date science.

📣 Tell a Friend. Share the Guidelines. Speak Up.

I created Fempower Health because too many women feel dismissed, misdiagnosed, and alone. And this is one of the clearest examples of how we can fix that — with knowledge, with advocacy, and with brave clinicians leading the way.

💬 Know your options.
💬 Don’t suffer in silence.
💬 You deserve care that works.

Let’s spread the word.