GSM: Little Acronym, Big Impact

Last week, ObGyn.net reported that a name change for conditions experienced by women after menopause developed and endorsed by The North American Menopause Society (NAMS) and the International Society for the Study of Women’s Sexual Health (ISSWSH) has been put forth in the journal Menopause. The new term is genitourinary syndrome of menopause (GSM), and the impetus behind its creation is to foster better communication between patients and physicians.

"The term ‘GSM’ will make discussing the problems so much easier," NAMS Executive Director Margery Gass, MD, said in a press release.

Surveys show that 40% of women are waiting for their doctors to ask about symptoms, but NAMS reports that "only a small percentage bring them up with their healthcare providers, and only about 1 in 10 providers brings up the symptoms with patients." Physicians obviously can't effectively treat patients if neither party is willing to discuss difficulties with urinary or sexual health, and patients may not know that there are treatments available for GSM.

Do Words Matter?

Previously used terms for signs and symptoms of GSM, such as vaginal atrophy or atrophic vaginitis, may be uncomfortable for patients to actually say to their doctors. In addition, some of the terms are outdated and either sound, or actually are, inaccurate. Patients may shy away from discussing symptoms if they feel they don't have the proper vocabulary. A neutral term for symptoms could help patients through their difficulties in broaching a topic that not only is uncomfortable to talk about but also is described by words that can be near-impossible to pronounce. Physicians may have greater success in diagnosing and treating GSM by using terms that are easily understood and that the patient doesn't find embarrassing.

Erasing the Stigma

There are many reasons patients might avoid a discussion about more personal symptoms, including a lack of trust, a belief that no effective treatments are available, and a fear of being judged, ignored, or ridiculed. A name change for a disorder is not novel: in the case of erectile dysfunction or ED (once called impotence), a new name for the disorder has changed the landscape for men with the condition.

With approximately half of postmenopausal women living with symptoms of GSM, and yet only a fraction discussing it with their physicians, underdiagnosis and undertreatment is clearly widespread. Not only is a name change overdue, so is the discussion surrounding the needs of postmenopausal women. The term GSM may help many women and their doctors on a path to diagnosis and treatment, but the real win here is the public discourse on health care for women after menopause.

References:

Kingsberg SA, Wysocki S, Magnus L, Krychman ML. Vulvar and vaginal atrophy in postmenopausal women: Findings from the REVIVE (REal Women's VIews of Treatment Options for Menopausal Vaginal ChangEs) survey. J Sex Med. 2013;10:1790–1799. Available at: http://onlinelibrary.wiley.com/doi/10.1111/jsm.12190/abstract. Accessed September 12, 2014.