Genitourinary Syndrome of Menopause is caused by loss of which hormone?

• A. Estrogen
• B. Testosterone
• C. Progesterone
• D. Thyroxine

Answer: (A)

GSM arises from estrogen loss after menopause. Estrogen keeps the vaginal and urethral mucosa thick, well vascularized, and lubricated, and it helps maintain a healthy, acidic environment that supports the normal vaginal flora. When estrogen levels drop, the vaginal epithelium thins and dries out, elasticity decreases, lubrication diminishes, and the urethral lining becomes thinner as well. These changes lead to symptoms like vaginal dryness, itching, burning, dyspareunia, and urinary symptoms such as urgency or recurrent infections. The other hormones listed don’t drive these mucosal changes—testosterone is more about libido, while progesterone and thyroxine aren’t the primary factors in GSM.