Genitourinary Syndrome of Menopause (GSM): Latest Guidelines, Treatments & Myths Debunked

madman

Super Moderator

The guidelines are in and the myths are out. In this episode of the BackTable Podcast, Dr. Suzette Sutherland hosts Dr. Melissa Kaufman and Dr. Giulia Ippolito to discuss the new 2025 AUA/SUFU guidelines on genitourinary syndrome of menopause (GSM).



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SYNPOSIS

The doctors delve into what GSM is, its symptoms, and the new evidence-based clinical guidelines for screening, diagnosing, and treating this condition. The episode emphasizes shared decision-making, safe use of local low-dose vaginal estrogen, and addresses concerns related to hormone therapy and cancer risks. Additionally, the doctors cover non-hormonal interventions, the role of vaginal moisturizers and lubricants, and the use of vaginal lasers. The importance of follow-up and ongoing patient education is also highlighted. The conversation aims to equip clinicians with the knowledge to better manage GSM and improve patient outcomes.

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TIMESTAMPS

00:00 - Introduction
01:35 - Overview of the 2025 AUA/SUFU Guidelines
02:27 - Guideline Development Process
05:48 - Categories of Guidelines
07:03 - Understanding GSM: Symptoms and Diagnosis
10:28 - Patient Education and Shared Decision Making
15:22 - Hormonal Interventions and Safety Concerns
17:17 - Local Vaginal Estrogen: Recommendations and Usage
23:12 - Compounded Estrogens and Alternative Therapies
25:48 - Understanding Estrogen Dosage Forms
26:11 - Introduction to DHEA and Its Benefits
27:15 - Exploring Ospemifene as an Alternative
28:05 - Guidelines for Treating GSM Symptoms
30:11 - The Role of Vaginal Estrogen in UTI Prevention
33:01 - Non-Hormonal Interventions for GSM
35:39 - Laser Treatments for GSM
39:59 - Addressing Cancer Risks with Vaginal Estrogen
44:48 - Endometrial Surveillance and Follow-Up
49:14 - Advocating for Vaginal Estrogen Use
51:13 - Conclusion and Final Thoughts
 

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Scientific Reference

Lakshman KM, Kaplan B, Travison TG, Basaria S, Knapp PE, Singh AB, LaValley MP, Mazer NA, Bhasin S. The effects of injected testosterone dose and age on the conversion of testosterone to estradiol and dihydrotestosterone in young and older men. J Clin Endocrinol Metab. 2010 Aug;95(8):3955-64.

DOI: 10.1210/jc.2010-0102 | PMID: 20534765 | PMCID: PMC2913038

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