WHAT IS GSM?
Genitourinary Syndrome of Menopause​
(and Lactation)
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"Local vaginal hormones will save your life" - Rachel Rubin MD
Genitourinary Syndrome of Menopause is serious; it is not "just a little vaginal dryness."
Every day in our practice, we witness the life-saving impact of low-dose local vaginal estrogen.
In as little as 6-12 weeks our patients experience clear clinical benefits, including fewer urinary tract (UTI) and vaginal infections, reduced antibiotic use, and a lower risk of serious complications from UTIs, such as urosepsis. They report less urgency and bladder pain, improved sexual function, and a restored quality of life.
Vaginal estrogen is the single most effective therapy in our toolkit for treating GSM—regardless of a woman’s stage of life.
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Recurrent UTIs kill our mothers, grandmothers, and wives, and the sad truth is that so many of them are preventable. Local vaginal hormone therapy is a critical preventative treatment and can save the lives of our loved ones.
The true risk lies in not treating GSM.
Everybody deserves access to safe, effective treatment for GSM, whether or not you are our patient.
Please use the resources below to advocate for yourself or your loved ones. For the clinicians, take a look at these resources and learn how to prescribe this critical preventative medication.​
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What does the Medical Research say about GSM?
UTI Reduction
Estrogen isn't the only answer
Vaginal DHEA, a precursor to both estrogen and androgens, is another option that can help relieve GSM symptoms.
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Vaginal estrogen saves money
Using preventative local vaginal estrogen therapy could save Medicare patients $1,226 to $4,888 annually.​
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Genitourinary Syndrome of Lactation
Postpartum, breastfeeding people may also experience GSM-like symptoms that can be treated with local vaginal hormones.​
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No systemic absorption
Local vaginal hormones do not absorb into the bloodstream or change whole-body estrogen levels.
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Breast Cancer
Local vaginal hormones are safe for breast cancer survivors and those currently undergoing breast cancer treatment.
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The risks of not treating GSM outweigh the risks of therapy
Historical misinterpretation of data has scared many clinicians. We need to look at the data analytically.
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Cardiovascular Health
Local vaginal hormones do not increase the risk of cardiovascular events or stroke. In fact, it decreases the risk.
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​​Educational Resources about GSM​​​​​​​​​​​​​​​​​​​​​​​
Our office was instrumental in the publication of the American Urological Association (AUA) guidelines for treating GSM.
Consider bringing these guidelines to your provider.
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The Menopause Society (TMS - formerly NAMS) also supports the use of local vaginal hormones for the treatment of GSM.
(This position statement also discusses systemic hormone therapy).
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​​​​In 2024, we made a "prescriber guide" for local vaginal hormone options that has improved access for countless people around the country. This guide gives prescribers information on how to diagnose and prescribe treatment for GSM.
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There is a whole generation of clinicians who have never been taught what GSM is nor how to write the prescriptions to treat it. We need YOU to help us teach them.
Print this guide and bring it with you to your next appointment.
​Dr. Rachel Rubin and Dr. Ashley Winter, two of the biggest champions of vaginal hormone therapy have answered clinicians' most common questions about evidence-based treatments for GSM.
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Check out the FREE lecture recording below - it's great for Clinicians and for anyone that wants to know more about the different types of treatments.
Based on our patients' questions, we developed a public YouTube channel with FAQs on GSM and vaginal hormones.
This YouTube page is geared toward anyone - our patients, prescribers, and those just wanting to learn more.
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And we're not alone - these medical societies support the use of vaginal estrogen too!
