What is VSM?

What is VSM?

Not to be confused with VHS (remember those?), VSM stands for vulvovaginal symptoms of menopause. VSM might explain your vaginal and urinary tract concerns you might not have been associating menopause with.  The term GSM or Genitourinary Syndrome of Menopause is the technical term for this condition and has replaced VSM.

VSM can persist and progress over time, so we are here to help you identify the symptoms of VSM and what you can do for relief.

What is VSM (vulvovaginal symptoms of menopause)?

VSM occurs when estrogen levels decline. There are three main forms of estrogen in our body. The primary type and most potent is called estradiol (E2). It is found during the reproductive years. The second is estrone (E1) is found in the body after menopause. Unfortunately, this type of estrogen is not as potent. Lastly, estriol (E3) is the primary form of estrogen during pregnancy.

The vagina thrives on estrogen. When estrogen levels drop, the vaginal walls become thinner, the vagina becomes less lubricated, and the vagina might have less elasticity. It is not uncommon for women to experience vaginal pain and discomfort caused by menopause.

Symptoms of VSM include:

What can I do to find relief from VSM?

There are a few treatment options to relieve vulvovaginal symptoms of menopause. Some vaginal lubricants and moisturizers are available without a prescription as well as options that do require a prescription.  

Personal lubricants and moisturizers

Personal lubricants and moisturizers help supplement the body’s natural lubrication. When they are used daily, they can provide relief from the most severe vaginal dryness, burning, and irritation. This should be your first line of defense.

When looking for a lubricant make sure it is water-based and contains hyaluronic acid and vitamin E. Hyaluronic acid and vitamin E work together to hydrate the delicate skin and deliver intense moisturization. Water-based lubes are ideal for sensitive skin and won’t stain or leave any residue.

Hormone Replacement Therapy

Hormone replacement therapy should not be the first line of treatment. However, some women may find relief from vulvovaginal symptoms of menopause with hormone replacement therapy. Hormone replacement therapy works by replacing the estrogen your body is no longer producing.

 There are two types of hormone therapy:

  • Systemic hormone therapy: Systemic estrogen comes in pill, skin patch, ring, gel, cream, or spray form. It typically contains a higher dose of estrogen that is absorbed throughout the body. It can be used to treat any of the common symptoms of menopause.
  • Low-dose vaginal products: Low-dose vaginal products of estrogen may come in cream, tablet or ring form which helps to minimize the amount of estrogen absorbed by the body. Because of this, low-dose vaginal estrogen is usually only used to treat the vaginal and urinary symptoms of menopause.

Taking estrogen does pose risks. There is an increased risk of endometrial cancer if you still have a uterus. Blood clots, strokes, and heart attacks are also more common in women who are taking estrogen alone. Your healthcare provider may also have you take another hormonal medication called progestin to help minimize the lining of the uterus from building up and becoming precancerous or cancerous.


Vulvovaginal symptoms of menopause are common. Up to 50%- 60% of postmenopausal women experience vaginal dryness and 16% of women experience vaginal pain. When the vaginal walls thin and the Bartholin’s glands (two glands at the entrance of the vagina that aid in lubrication) produce less moisture, daily life and sex can become uncomfortable.

Remember, women spend a third of their lives in a post-menopausal state so be sure you talk to your healthcare practitioner and seek treatment.

About the author
FemmePharma started as a pharmaceutical research and development company more than 20 years ago. We’ve been reinventing women’s healthcare ever since. Please consult your healthcare practitioner to decide which product best meets your needs.