Abstract: Background: Genitourinary Syndrome of Menopause (GSM) is a multifactorial condition associated with the hypoestrogenic state of menopause, encompassing genital, urinary, and sexual symptoms that significantly impair quality of life in post-menopausal women.
Aim and objective: To study the clinical manifestations, pathophysiology, etiology, evaluation, and management strategies of GSM, and to compare findings with current literature.
Material and Methods: A case-control study was conducted on 60 postmenopausal women (30 GSM cases and 30 controls) over 12 months (jan 2024 to jan 2025) in Department of Obstetrics and gynaecology at tertiary care centre. Symptoms, clinical findings, vaginal pH, Vaginal Maturation Index (VMI), and estradiol levels were analyzed.
Results: GSM was significantly associated with vaginal dryness (100%), dyspareunia (86.7%), and urinary symptoms (90%) affecting more than 50% of post-menopausal patient. Vaginal pH was elevated in cases (6.57 vs 4.70), while VMI (18.7 vs 65.1) and estradiol levels (8.6 vs pg/18.5mL) were markedly reduced compared to controls (all p<0.001).
Conclusion: These findings confirm GSM as a distinct hypoestrogenic disorder characterized by both clinical and biochemical abnormalities. Vaginal dryness emerged as the most consistent symptom, while pH and VMI provide reliable diagnostic support. The results highlight the importance of early recognition and management of GSM, particularly with localized estrogen therapy, main cornerstone of treatment and other options like laser therapy and selective estrogen receptor modulator are being explored.
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