It’s Time to Rethink the Name – Why “Genitourinary Syndrome of Menopause” (GSM) Needs a Rebrand

Language matters in healthcare. The words we use shape who feels seen, who seeks care and who gets left out.

Genitourinary Syndrome of Menopause (GSM) was created to better describe vulvar, vaginal, bladder and sexual health symptoms linked to a decline in estrogen. It was a step forward from outdated terms but we are finding that it is now too narrow.

As Dr. Rachel Rubin recently pointed out in her post – many people experience “GSM” symptoms outside of menopause. This is because the tissues in our bodies don’t care why hormones shift, they simply respond to the hormonal environment.

Hormone-related genitourinary symptoms are not exclusive to menopause. Similar tissue changes occur with:

  • Lactation and postpartum states
  • Endocrine disorders
  • Gender-affirming hormone therapy
  • Cancer treatments
  • Certain medications
  • Hormonal contraceptives

Tying these symptoms only to menopause risks delayed diagnosis, invalidation of younger patients and chestfeeding parents and exclusion of transgender and nonbinary individuals.

So What Are The Next Steps?

A more inclusive terms to use may be: “Genitourinary Syndrome” (GS) or “Hormone-Associated Genitourinary Syndrome”

GS refers to symptoms such as:

  • Vaginal dryness or burning
  • Pain with penetration
  • Urinary urgency or recurrent UTIs
  • Pelvic pain
  • Decreased lubrication
  • Tissue thinning and sensitivity

These symptoms are common, treatable and are not limited to menopause.

This matters because you can be:

  • 28 and chestfeeding
  • 35 on hormonal birth control
  • 30 on testosterone
  • 25 with hypothalamic amenorrhea
  • 42 in cancer treatment

…and experience the same tissue-level changes labeled “GSM.”

Where Pelvic Physical Therapy Fits In

At KPP, we treat the functional impact of hormone-related tissue changes regardless of cause. Pelvic physical therapy can support folks who are postpartum, on hormone therapy, undergoing cancer treatment, using hormonal contraception and/or managing endocrine disorders through:

  • Tissue mobility and desensitization
  • Pelvic floor coordination and relaxation
  • Bladder and bowel retraining
  • Pain education and sexual function support
  • Trauma-informed, affirming care

We believe care should reflect the individual. Your symptoms are real. They are common. And they deserve accurate language… Maybe it’s time our terminology does the same.