What are common symptoms of genitourinary syndrome of menopause?

Genitourinary syndrome of menopause (GSM) is characterized by a variety of symptoms resulting from the decrease in estrogen levels during menopause. One of the hallmark presentations of GSM includes vulvar and vaginal dryness, which can be accompanied by itching. This dryness occurs due to the atrophy of the vaginal epithelium, leading to discomfort, irritation, and an increased risk of infections.

Understanding that GSM specifically affects the genitourinary system helps clarify why symptoms like vaginal dryness and irritation are central to the condition's presentation. The lack of estrogen not only leads to changes in moisture levels but also impacts the overall health of vaginal tissues, causing them to become thinner and less elastic.

Other symptoms such as dyspareunia (pain during intercourse) may stem from the aforementioned vaginal dryness, but the symptoms of vulvar and vaginal dryness and itching stand out as primary features directly associated with the genitourinary aspect of menopause. Chronic pelvic pain, while a concern in many gynecological conditions, is not a direct symptom of GSM, which focuses more on the changes in the vaginal and urinary tract environments.

Therefore, the correct answer highlights the most significant and common symptoms related to genitourinary syndrome of menopause, which are lower levels of