What is the current preferred term for vaginal atrophy?

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Current Preferred Terminology for Vaginal Atrophy

The current preferred term is "Genitourinary Syndrome of Menopause" (GSM), which was formally endorsed in 2014 by the International Society for the Study of Women's Sexual Health (ISSWSH) and The North American Menopause Society (NAMS) to replace the outdated terms "vaginal atrophy," "vulvovaginal atrophy," and "atrophic vaginitis." 1

Why the Terminology Changed

The shift from "vaginal atrophy" to GSM occurred because the older terminology had significant limitations:

  • "Vaginal atrophy" and "vulvovaginal atrophy" failed to capture the full spectrum of symptoms affecting postmenopausal women, as these terms focused narrowly on vaginal tissue changes while ignoring urinary and sexual symptoms. 1, 2

  • The term "atrophic vaginitis" incorrectly implied an inflammatory process when the condition is actually caused by estrogen deficiency, not infection or inflammation. 2

  • GSM is medically more accurate and publicly acceptable because it encompasses the complete range of genitourinary changes related to decreased estrogen and other sex steroids during menopause. 1

What GSM Encompasses

GSM is defined as a collection of symptoms and signs involving changes to multiple structures:

  • Genital structures affected: labia majora/minora, clitoris, vestibule/introitus, vagina, urethra, and bladder. 1

  • Genital symptoms: dryness, burning, and irritation. 1, 2

  • Sexual symptoms: lack of lubrication, discomfort or pain during intercourse (dyspareunia), and impaired sexual function. 1, 2

  • Urinary symptoms: urgency, dysuria, and recurrent urinary tract infections. 1, 2

Clinical Application

  • Women may present with some or all of these symptoms, which must be bothersome to the patient and not better explained by another diagnosis. 1

  • GSM is a chronic, progressive condition that primarily affects postmenopausal women but can also occur in premenopausal women with hypoestrogenic states. 3

  • Unlike vasomotor symptoms that often resolve over time, GSM symptoms typically persist indefinitely and may worsen without treatment. 4, 5

The adoption of GSM terminology represents a significant improvement in clinical communication, as it acknowledges that estrogen deficiency affects not just the vagina but the entire genitourinary system, and it removes the stigma associated with terms like "atrophy" that may discourage women from seeking treatment. 2, 6

References

2
Research

The Recent Review of the Genitourinary Syndrome of Menopause.

Journal of menopausal medicine, 2015

4
Guideline

Vaginal Atrophy Management

Praxis Medical Insights: Practical Summaries of Clinical Guidelines, 2026

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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