The North American Menopause Society (NAMS) recently announced the publication of its 2020 Genitourinary Syndrome of Menopause (GSM) position statement that included updated recommendations on the most current safe and effective therapeutic options for women with GSM.
Despite having a variety of over-the-counter and prescription treatment options, GSM remains underdiagnosed and undertreated. Since the NAMS position statement released in 2013, new data has been published evaluating a variety of therapeutic options used in the management of GSM.
The position statement recommends that treatment for GSM should be selected based on the severity of a patient’s symptoms, the patient’s preference of therapy, and the efficacy and safety of treatments for that specific patient. For women with mild symptoms, over-the-counter nonhormone therapies are recommended. These include lubricants with sexual activity as well as regular use of long-acting vaginal moisturizers.
For patients with moderate to severe GSM, low-dose vaginal estrogens, vaginal dehydroepiandrosterone (DHEA) inserts, systemic estrogen therapy, and ospemifene are recommended. Additionally, transdermal and oral hormone therapy may be effective options for patients experiencing moderate to severe dyspareunia associated with GSM and concurrent vasomotor symptoms.
With regard to endometrial safety, the expert panel noted that long-term studies of vaginal estrogen, vaginal DHEA, and ospemifene, an estrogen agonist/antagonist, are lacking. Moreover, no recommendations could be made regarding energy-based therapies, including laser therapy, due to insufficient placebo-controlled trials.
The full NAMS position statement can be found here.
Disclosure: Multiple authors declared affiliations with industry. Please refer to the original article for a full list of disclosures.
- NAMS releases the 2020 Genitourinary Syndrome of Menopause Position Statement. https://www.eurekalert.org/pub_releases/2020-09/tnam-nrt090120.php. Accessed September 3, 2020.
- The 2020 genitourinary syndrome of menopause position statement of The North American Menopause Society. Menopause. 2020; 27(9):976-992. doi: 10.1097/GME.0000000000001609.