NAMS Position Statement: The 2020 Genitourinary Syndrome of Menopause Position Statement of the North American Menopause Society

Menopause. 2020;27(9):976-992. 

In This Article


Genitourinary syndrome of menopause describes the symptoms and signs resulting from the effect of estrogen deficiency on the female genitourinary tract, including the vagina, labia, urethra, and bladder.[12] This syndrome includes genital symptoms of dryness, burning, and irritation; urinary symptoms and conditions of dysuria, urgency, and recurrent urinary tract infections (UTIs); and sexual symptoms of pain and dryness. Physical changes and signs are varied. Women may experience some or all of the symptoms and signs, which must be bothersome for a diagnosis of the syndrome. Other causes of similar signs and symptoms must be ruled out, including vulvovaginal dermatoses, infection, or cancer.

Vulvovaginal atrophy is a component of GSM.[13] Although VVA was the commonly used term in the past to describe the genitourinary changes of menopause, it has limitations. Vulvovaginal atrophy describes the appearance of the genital tissues but not the associated symptoms. It does not include urinary tract changes related to estrogen deficiency, and the term atrophy has negative associations for women. The term genitourinary syndrome of menopause was developed during a consensus conference of experts[12] and subsequently was accepted as the preferred term by many medical societies, including The North American Menopause Society and the American College of Obstetricians and Gynecologists.