Which of the following is NOT typically associated with Genitourinary Syndrome of Menopause?

• A. Increased lubrication and comfort during intercourse
• B. Vaginal dryness
• C. Dysuria
• D. Decreased libido

Answer: (A)

Genitourinary Syndrome of Menopause arises from reduced estrogen that causes thinning of the vaginal and urethral tissues, decreased lubrication, and a less protective mucosal environment. This leads to vaginal dryness, irritation or burning, and dyspareunia, as well as urinary symptoms like dysuria and even urgency or recurrent infections. It can also contribute to decreased libido because discomfort and tissue changes affect sexual response. An increase in lubrication and comfort during intercourse is not typical of GSM—it reflects the opposite change. The other symptoms listed fit GSM because they stem from mucosal thinning and urinary tract involvement.