History of genitourinary syndrome of menopause
Hello there! It’s Dr. Rachel Daof, DPT, from your friendly neighborhood pelvic therapy clinic in Pasadena, CA, called The Pelvic Model. In celebration of Women’s History Month, I wanted to delve into the history of “vulvovaginal pain” in relation to menopause (now known as Genitourinary Syndrome of Menopause) and its recent developments. So, grab your favorite coffee or green tea, and let's explore the events that have led us to the term Genitourinary Syndrome of Menopause and where we stand today!
Let’s start at a not-so-fun place:
In the early 1900s, a term known as “Senile Vaginitis” was used to describe a condition typically observed in women of menopausal age or those who had undergone ovary removal. Despite its historical usage, the term's choice of "senile" raises questions. It seems to suggest vaginitis caused by age, but over time, we've learned that vulvar pain can persist regardless of age, especially in cases where ovaries have been removed. This connection is significant in understanding Genitourinary Syndrome of Menopause (GSM), as it is hormone-based and not age based.
Enter “vulvovaginal atrophy”:
As medical knowledge progressed, a paradigm shift occurred in the late 20th century, introducing the term "vulvovaginal atrophy." This term emerged as a more comprehensive descriptor, acknowledging both vulvar and vaginal changes. While an improvement from "Senile Vaginitis," it still falls short in capturing the full essence of the condition. Vulvovaginal atrophy primarily alludes to the anatomical structures involved, missing the crucial aspect of the symptoms experienced.
This term, by focusing solely on anatomical changes, overlooks the symptomatic experience, failing to encompass the essence of what individuals with this condition go through. Moreover, the term carries a negative connotation with "atrophy," prompting the need for a more inclusive and palatable term. Additionally, the desire for a more politically correct terminology led to a consideration of words more comfortable for public discussion than "vulva" and "vagina."
We have landed on Genitourinary Syndrome of Menopause:
In 2014, the official name change to Genitourinary Syndrome of Menopause (GSM) marked a significant milestone. GSM encapsulates not only the vulva and vagina but also the lower urinary system. The term reflects a comprehensive understanding of the condition, acknowledging its diverse symptoms affecting various anatomical structures.
OK, so what exactly is GSM?
GSM occurs due to a lack of estrogen and other sex hormones, resulting in changes to the labia majora/minora, clitoris, vestibule/introitus, vagina, urethra, and bladder. This leads to symptoms such as genital dryness, burning, and irritation; sexual discomfort or pain, lack of lubrication, and impaired function; and urinary urgency, dysuria, and recurrent UTIs. People come into our clinic with these symptoms all the time, and it is our job to figure out WHY this is happening. We do a thourough musculoskeletal screening and we have the wherewithal to know when to send you to a specialist to check out your hormones. Here, we know that this discomfort can contribute to pelvic floor muscle dysfunction and further exacerbate pain and urinary issues. More on this topic on another blog post.
Conclusion:
And there you have it! While progress in women’s healthcare has been slow, we are steadily moving towards a more inclusive and understanding space. This includes using terms that avoid harmful language and promote open discussions. Cheers to advancements in women's health!
Til next time,
Rachel
If you have any questions and want to ask us how pelvic therapy can help you, please call us at (323) 403-0234 or click here to schedule a free 15 minute digital consultation.
