Which local therapy is recommended for genitourinary syndrome of menopause?

Which local therapy is recommended for genitourinary syndrome of menopause?

• A. Vaginal estrogen
• B. Systemic estrogen
• C. Oral progestin
• D. Topical testosterone

Answer: (A)

Genitourinary syndrome of menopause is caused by estrogen deficiency leading to thinning, inflammation, and dryness of the vaginal and urethral tissues. Using estrogen directly on the vaginal mucosa replenishes estrogen where it's needed, which stimulates epithelial maturation, increases tissue thickness, improves blood flow, boosts lubrication, and helps normalize the vaginal environment. This targeted, local approach relieves dryness, burning, itching, dyspareunia, and some urinary symptoms with minimal systemic absorption, offering a favorable safety profile. That’s why vaginal estrogen is the preferred local therapy. Systemic estrogen would address broader menopausal symptoms but isn’t as targeted and carries more systemic exposure; oral progestin and topical testosterone are not standard first-line treatments for GSM.

Genitourinary syndrome of menopause is caused by estrogen deficiency leading to thinning, inflammation, and dryness of the vaginal and urethral tissues. Using estrogen directly on the vaginal mucosa replenishes estrogen where it's needed, which stimulates epithelial maturation, increases tissue thickness, improves blood flow, boosts lubrication, and helps normalize the vaginal environment. This targeted, local approach relieves dryness, burning, itching, dyspareunia, and some urinary symptoms with minimal systemic absorption, offering a favorable safety profile. That’s why vaginal estrogen is the preferred local therapy. Systemic estrogen would address broader menopausal symptoms but isn’t as targeted and carries more systemic exposure; oral progestin and topical testosterone are not standard first-line treatments for GSM.