Dermatologists Urged to Recognize and Treat Genitourinary Syndrome of Menopause
Up to 84 Percent of Postmenopausal Women are Affected by This Underdiagnosed Condition That Seriously Impacts Quality of Life
Genitourinary syndrome of menopause (GSM), formerly known as vulvovaginal atrophy, affects up to 84 percent of postmenopausal women, though it’s frequently underrecognized in dermatology clinics. Nonetheless, dermatologists are well-positioned to diagnose and treat it, according to Shoshana Marmon, M.D., Ph.D., assistant professor of dermatology and chair of the American Academy of Dermatology’s (AAD) Menopause and Women’s Health in Dermatology Quality Improvement Workgroup. The workgroup’s recommendations were recently published in the Journal of the American Academy of Dermatology.
“Dermatologists frequently manage chronic vulvovaginal conditions like lichen sclerosis, and lichen simplex chronicus,” says Dr. Marmon. “These are often present with itching, burning, pain, or fissuring—symptoms that overlap with GSM. Because we routinely examine vulvovaginal skin and are trained in mucocutaneous disease, dermatologists are in a unique position to recognize GSM early and accurately.”
Dermatologic literature primarily highlights energy-based technologies to treat GSM, such as laser and radiofrequency devices, which are not FDA approved for this indication and are typically supported by low-quality evidence. “In contrast, low-dose vaginal estrogen is the gold-standard therapy with decades of strong clinical data, but it remains significantly underutilized,” Dr. Marmon says.
“Menopause is a universal experience, yet most clinicians have not received sufficient training in this area,” says Dr. Marmon. “When a midlife woman presents with hair loss or acne, it should become more routine to ask about vaginal dryness. Many women are reluctant to mention it—whether out of embarrassment or the belief that it’s simply a normal part of aging. Our AAD-endorsed article encourages dermatologists to take a more active role in diagnosing and treating GSM.”
