Causes

Genitourinary syndrome of menopause is caused by a decrease in estrogen production. Less estrogen makes your vaginal tissues thinner, drier, less elastic and more fragile.

A drop in estrogen levels may occur:

• After menopause
• During the years leading up to menopause (perimenopause)
• After surgical removal of both ovaries (surgical menopause)
• During breast-feeding
• While taking medications that can affect estrogen levels, such as some birth control pills
• After pelvic radiation therapy for cancer
• After chemotherapy for cancer
• As a side effect of breast cancer hormonal treatment

GSM signs and symptoms may begin to bother you during the years leading up to menopause, or they may not become a problem until several years into menopause. Although the condition is common, not all menopausal women experience GSM. Regular sexual activity, with or without a partner, can help you maintain healthy vaginal tissues.