Genitourinary Syndrome of Menopause (GSM): Thrive’s Comprehensive Approach

Genitourinary Syndrome of Menopause (GSM) is a chronic, progressive condition affecting the vaginal, vulvar, and urinary tissues as a result of declining estrogen levels during menopause. Despite impacting an estimated 50–70% of postmenopausal women, GSM remains underdiagnosed and undertreated—often leaving women to assume symptoms are a normal or unavoidable part of aging.   This is no longer the case! 

At Thrive Healthcare, our team of three board-certified OB/GYNs and menopause-certified providers specializes in evidence-based, personalized care for women navigating midlife and beyond. We believe women deserve both education and access to the full spectrum of modern treatment options for GSM.

 

What Is Genitourinary Syndrome of Menopause?

GSM refers to a group of symptoms caused by estrogen deficiency that affects the vagina, vulva, bladder, and urethra. Estrogen plays a critical role in maintaining vaginal tissue thickness, elasticity, blood flow, collagen content, and a healthy vaginal microbiome. When estrogen levels decline, these tissues become thinner, drier, less elastic, and more fragile.  As a result, women can experience a wide array of symptoms, including: 

• Vaginal dryness, burning, or irritation
• Pain with intercourse (dyspareunia)
• Decreased lubrication and elasticity
• Vulvar discomfort or tissue fragility
• Urinary urgency, frequency, or burning
• Recurrent urinary tract infections
• Decreased sexual satisfaction or confidence

These symptoms can significantly affect quality of life, intimacy, physical activity, sleep, and emotional well-being. Unlike hot flashes or night sweats, GSM does not improve on its own and typically worsens over time without treatment. Fortunately, GSM is easily addressed and can be treated with a variety of available options. 

 

Evidence-Based Treatment Options for GSM

Vaginal Estrogen Therapy: The Gold Standard

Low-dose vaginal estrogen is the most well-studied and effective treatment for GSM and is considered first-line therapy for most women. Vaginal estrogen is available in the form of creams, tablets, and vaginal rings.  It is covered by most insurance plans and affordable.  

Benefits of vaginal estrogen include: 

• Restoration of vaginal tissue thickness and elasticity
• Improved lubrication and comfort
• Normalization of vaginal pH and microbiome
• Reduction in pain with intercourse
• Improvement in urinary symptoms and reduction in recurrent UTIs

Vaginal estrogen works locally, with minimal systemic absorption, and is considered safe for most women when appropriately prescribed—even many who cannot take systemic hormone therapy. Individual risk assessment is always part of care at Thrive Healthcare.

Other Hormonal therapy options: 

Vaginal DHEA (Prasterone) is a daily intravaginal insert of DHEA.   This is available as a brand (Intrarosa) or can be compounded along with hyaluronic acid and Vit E for enhanced moisturizing and tissue support

Oral Ospemifene (Osphena) is a non-estrogen pill (SERM = selective estrogen receptor modulator ) that acts on vaginal tissues  to relieve symptoms, offering an alternative to vaginal estrogen products, especially for those who can’t use them

Systemic Hormone Therapy: Pills, patches, or gels can also provide vaginal benefits to many women.  However, some women, despite using systemic therapy, still may need to combine this with local therapies

Advanced Non-Hormonal & Adjunctive Treatments: InMode Women’s Health Technologies

For women who prefer non-hormonal options, cannot use estrogen, or who are not achieving adequate results with hormone therapy (systemic or local), Thrive offers state-of-the-art vaginal treatments that address the structural and neuromuscular changes of GSM.   The providers at Thrive have seen significant advances in female pelvic health treatments over the past 30 years of their careers and are excited to highlight the InMode platform of services.  All three of the following treatments are well-tolerated and require little to no downtime.

Learn More About InMode Services

FormaV  – This is painless in-office treatment that uses gentle radiofrequency (RF) energy to increase blood flow and stimulate collagen production.  It helps to improve vaginal elasticity, moisture, and comfort with intercourse. This procedure takes about 20 min, with the best results observed after 3 treatments.   It is ideal for vaginal dryness, mild laxity, and discomfort

VTone – This treatment helps strengthen the pelvic floor muscles and can improve vaginal tone, bladder control, and sexual function.   VTone can be a helpful adjunct to pelvic floor physical therapy for postpartum, perimenopausal, and menopausal women.  Most patients report improved bladder control and pelvic tone after a few in-office treatments.  

Morpheus8V is the most advanced modality, combining microneedling with radiofrequency energy.  By targeting the deeper vaginal tissue layers,  Morpheus8V promotes collagen remodeling, tissue thickening, and structural support.   It is very effective for more advanced GSM symptoms, tissue thinning, and laxity. 

 

Personalized, Comprehensive Care at Thrive Healthcare

There is no one-size-fits-all solution for GSM. Many women experience the best outcomes with combination therapy, such as vaginal estrogen paired with InMode treatments, addressing both the hormonal deficiency and the structural tissue changes associated with menopause.

At Thrive Healthcare, treatment plans are individualized based on:

• Symptom severity
• Medical and gynecologic history
• Hormone tolerance or contraindications
• Urinary and sexual health concerns
• Personal goals and preferences

Our menopause-certified providers take the time to educate patients, answer questions, and design care plans that align with both medical needs and lifestyle goals.   GSM is common, treatable, and not something women should suffer through in silence. With today’s therapies, women can experience meaningful improvement in comfort, confidence, sexual health, and quality of life.

If you are experiencing symptoms of GSM, a consultation with Thrive Healthcare can help you understand your options and determine the most effective path forward.

Expert care. Modern solutions. Personalized treatment.