Genitourinary syndrome of menopause (GSM) encompasses a range of symptoms resulting from sex steroid deficiency, affecting the vagina, vulva, and lower urinary tract (ie. bladder and urethra). Vulvovaginal symptoms of GSM are characterized by thinning of the vulvar and vaginal tissues, resulting in dryness, irritation, bleeding, itch, and pain. Despite its prevalence, GSM remains underdiagnosed and undertreated, particularly in primary care settings. Recent advancements have introduced new ways of treating hormone deficiency using therapies that incorporate both estrogen and androgen, and oral therapies. This expert brief explores the evolution of targeted prescription treatment options, with a special focus on the two newly Health Canada-approved effective therapies for GSM: prasterone, an inactive precursor of sex steroids that enters the vaginal cells and is converted intracellularly into estrogens and androgens, and ospemifene, a selective estrogen receptor modulator (SERM). Through patient case discussions, this expert brief aims to provide healthcare providers with practical guidance on selecting appropriate candidates for these newer targeted prescription GSM therapies, educating patients on treatment benefits and risks, and integrating these therapies into primary care.
This program has received financial support from Lupin Pharma Canada in the form of an unrestricted educational grant.
