Genitourinary Syndrome of Menopause is the name for symptoms that affect the genitals and urinary tract. These symptoms are easily treatable, but too many women and doctors aren’t comfortable discussing them.

Regional One Health’s Certified Menopause Practitioners have special training to help women address these concerns and improve their quality of life.

Genitourinary Syndrome of Menopause: It’s a technical term for something very common and very treatable. GSM for short, it is the name given to menopause symptoms that affect the genitals and urinary tract. That can include the following:

  • Vaginal dryness, burning and irritation
  • Lack of lubrication and pain during sex
  • Urgent need to urinate and discomfort when urinating
  • Frequent urinary tract infections


Diane Todd Pace, PhD, APRN, FNP-BC, NCMP, FAANP, FAAN, and Pallavi Khanna, MD, OB/GYN, are Certified Menopause Practitioners at Regional One Health. They say too many women – and even their doctors – aren’t comfortable discussing genitourinary symptoms.

They are working to change that through the menopause practice at Regional One Health and the Transitioning Through Menopause support group.

“Even in the OB/GYN field, our colleagues are not comfortable talking to their patients about this. That needs to change,” Dr. Pace said. “No woman needs to suffer from Genitourinary Syndrome of Menopause, because it’s completely preventable – but most women will get this.”

Dr. Pace explained what happens to women’s bodies during menopause. As estrogen levels fall, lubricants in the vagina like collagen and hyaluronic acid decrease as well. Meanwhile, wrinkles in the vagina called rugae flatten, causing elasticity to decrease.

“The symptoms get worse and worse,” Dr. Pace said. “They won’t improve on their own, but we can help women take care of them.”

It is important for doctors and patients to talk openly about all menopause symptoms, including those of a personal nature, so women can get treatment that improves their quality of life.

The first step is finding a doctor who can help. Regional One Health’s menopause care practice specializes in helping women achieve optimal health as they age. As Certified Menopause Practitioners, Dr. Khanna and Dr. Pace have undergone special training to talk to women about their symptoms and help them improve their quality of life.

They started the support group with the same goal. It provides a welcoming, casual environment where women can learn and get information from experts and one another.

“Women don’t have to suffer with discomfort and a poor sex life just because they don’t want to talk about their symptoms,” Dr. Pace said. “There are a lot of options.”

Some women might be able to treat genitourinary symptoms with over-the-counter products like vaginal lubricants and moisturizers. “Early in menopause or when a woman is in perimenopause, these are often the first line in treating vaginal symptoms,” she said.

Topical estrogen products like inserts or creams also help. “Topical estrogen can help restore the wrinkles,” Dr. Pace said. “It’s like when you put moisturizer on your face, except you don’t want wrinkles on your face and you do want wrinkles in your vagina. They can also reduce the risk of recurrent urinary tract infections by restoring good bacteria and reducing bad bacteria.”

Regional One Health Certified Menopause Practitioners Diane Pace and Pallavi Khanna have special training and expertise to help women with their menopause symptoms.

The products have improved greatly over the years, Dr. Pace said. They used to be messy and uncomfortable, but new versions are much easier to use. However, women must see their doctor for a prescription – estrogen-based products are not available over-the-counter.

The other prescription option is systemic estrogen delivered via pills, patches, suppositories, etc. For women who still have their uterus, estrogen is given with progestin.

Systemic estrogen can have side effects like headache, nausea and vaginal discharge. On the plus side, it can also help with menopause concerns like hot flashes and osteoporosis.

Dr. Pace said hormone treatment requires a careful consultation with a provider. “We are here to give women evidence-based information and empower them to make the choice that is right for them,” she said. “You are responsible for your health, so we try to do shared decision making.”

For more information, contact Regional One Health’s menopause care program at 901-515-3800 or attend the Transitioning Through Menopause support group the first Thursday of each month from noon-1:15 p.m. at the East Campus, 6555 Quince Rd.