Genitourinary Syndrome of Menopause refers to changes in which areas due to estrogen loss?

• A. Genitals, bladder/urethra, pelvic floor, and libido
• B. Muscles of the legs
• C. Hair and nails
• D. Lungs and airways

Answer: (A)

GSM arises from estrogen loss causing thinning, drying, and reduced elasticity of genital and urinary tissues, along with changes in pelvic support and sexual function. The genital tissues become thinner and drier, leading to irritation and discomfort with intercourse. The urethra and bladder lining also thin, which can cause urinary symptoms such as urgency, frequency, burning, and a higher risk of infections. Estrogen helps maintain the supportive connective tissues of the pelvic floor, so its loss can affect pelvic support and contribute to urinary symptoms. Sexual function may decline with reduced lubrication and sensation, lowering libido. These interconnected changes in the genitals, bladder/urethra, pelvic floor, and sexual function define GSM. Areas like leg muscles, hair and nails, or lungs are not the primary targets of estrogen-loss–related GSM.