Some of you may learn a new term today. GSM is actually used medically to encompass many of the vaginal issues women suffer with once they reach menopause. It´s a term I hope the general population will get to know and understand and where more help and support will become available. No more brushing these problems under the carpet. None of us should have to suffer so many years with GSM.
“Genitourinary syndrome of menopause” (GSM) is a more accurate and inclusive term that describes the multiple changes occurring in the vaginal size, pelvic floor tissues, bladder and urethra, and the loss of sexual function and libido, caused by lowered oestrogen levels during the menopause transition and post menopause.
These genitourinary changes primarily occur in response to reduced oestrogen levels and ageing, and do not settle with time”.
(Kim et.al, 2015)
- 50% of older women have pelvic organ prolapse. (Gerten 2012)
- 1 out of 3 women suffer from sexual pain (Coady, 2015)
- 49% of all women leak urine (Markland, 2011)
Vaginal atrophy affects up to 47% of postmenopausal women, but symptoms are often underreported by patients due to embarrassment discussing “personal” symptoms or a belief that it is normal part of aging (Hoffman et.al 2014).
Before supplementing, consider understanding the colonisation of your microbiome. If you have had any of the issues previously explained and would like to work on your “vaginal status” you can work out how to best support by assessing the microbiome. Invivo clinical in the UK has a test that measures the organisms present in the vaginal area. It is easy to do. For more information on this excellent test, please click on this link:
This link provides a sample report and test instructions. If we wish to order this, let me know. Knowing what you are working with can save you time, money and heartache if you´ve been a sufferer of recurrent vaginal issues.
Additional Tips to protect your vaginal microbiome. Build your lactobacilli. Fermented foods, prebiotics, probiotics with specific lactobacilli strains: as mentioned previously. Invivo healthcare have a range of probiotics also produced to support specific microbiomes.
- Sterilise sex toys.
- Avoid perfumed pads, tampons with bleached cotton etc.
- Avoid perfumed shower gels on the vagina area and avoid washing underwear in perfumed softeners.
- Avoid synthetic fibres in underwear.
- Finally manage your blood sugar levels which impacts the lactobacilli species.
Natural products that may offer relief with vaginal atrophy:
Lubrication is extremely important. You can consider a vaginal lubricant for intercourse, a moisteriser for daily use. INTO THE WYLDE is a natural range to consider. https://intothewylde.com/
Weleda calendula nappy balm can be helpful as a barrier cream.
Oral collagen: vitamin C, zinc, vitamin A and vitamin E help maintain elasticity in the vagina.
Vitamin E Pessaries
- Vitamin E minimum 100iu: capsules vaginally daily over 12 weeks minimum
- Vitamin E suppositories are suggested for relieving the symptoms of vaginal atrophy, especially in women who are unable to use hormone therapy or cope with the associated side effects. (Parmanet.al, 2016)
If the mucosal membrane is damaged, consider oral omega 7, 2 g per day orally.
Sea Buckthorn Oil – Research showed using 3gm oral dosage: 3 month trial duration
- Effects on pH of vagina (lowered)
- Improved Integrity of the vaginal epithelium
- Did not affect measures of burning, itch and irritation.
Black Cohosh/Actaea/Cimicifuga racemosa
- May improve vaginal dryness in postmenopausal women, as
demonstrated in an improvement in the vaginal maturity index due
to increase vaginal superficial cells. (Wuttke et al. 2006)
Fennel creams and or pessaries that contain hyaluronic acid may be helpful
- Vaginal: Effects on vaginal atrophy
- placebo (n=30) or fennel 5% vaginal cream (n=30) administered as one application per day (5g/day) for 8 weeks.
-superficial cells increased significantly in the fennel group after 8 weeks compared to the
-The vaginal pH decreased significantly at the 8- week follow-up in the fennel group compared to the control group
A good resource: https://www.bashh.org/guidelines
ZOE PREDICT STUDY FROM 2022