GSM explained: when dryness comes with UTIs, urgency and burning

Dryness is rarely “just” dryness. For many people it comes with a cluster of other changes, recurrent UTIs, sudden urgency to pee, burning and itching. There’s a name for that bigger picture: genitourinary syndrome of menopause (GSM).

Understanding GSM can be reassuring. It explains why symptoms that seem unrelated are often connected, helping you understand what’s happening and how to find the right support.

What GSM is, and why the name changed

In 2014, specialist societies adopted the term genitourinary syndrome of menopause (GSM) to replace older language such as “vulvovaginal atrophy” and “atrophic vaginitis.”

The change wasn’t simply about terminology. “Atrophy” can sound frightening and irreversible, whereas GSM reflects a recognised, treatable group of symptoms affecting the vagina, vulva, bladder and urinary tract. It also acknowledges that menopause can affect much more than vaginal dryness alone.

The four pillars of GSM

Vaginal: dryness, soreness, irritation, thinning and reduced lubrication

Urinary: recurrent UTIs, urgency, frequency and burning when passing urine

Sexual: pain (dyspareunia), reduced lubrication and light bleeding with friction

Quality of life: disturbed sleep, discomfort when sitting or exercising, and reduced confidence

Why urinary symptoms often come alongside dryness

Many women are surprised to learn that vaginal dryness, recurrent UTIs and bladder symptoms are often linked.

During and after menopause, the vaginal environment naturally changes. Moisture levels fall and vaginal pH becomes less acidic (more alkaline). At the same time, the number of protective lactobacilli—beneficial bacteria that help maintain vaginal health—also decreases.

These changes make the tissues more vulnerable to irritation and can increase the likelihood of recurrent UTIs, burning, urgency, thrush and bacterial vaginosis. Rather than being separate problems, these symptoms are often part of the same picture.

The science in brief

A healthy vagina is naturally slightly acidic. After menopause, vaginal pH becomes more alkaline, reducing protective lactobacilli and making irritation, recurrent UTIs, thrush and bacterial vaginosis more common.

Supporting moisture and maintaining a healthy vaginal pH can help protect this delicate environment.

Why pH-matched care matters

Keeping vaginal tissue hydrated and maintaining a healthy pH helps support comfort every day, not just during intimacy.

As the vaginal environment becomes more alkaline after menopause, it becomes easier for unwanted bacteria and yeast to thrive. That’s why choosing a pH-matched, iso-osmotic vaginal moisturiser, lubricant and gentle intimate wash matters.

Products that are too alkaline can further disrupt the vaginal environment, whereas pH-matched products are designed to work with your body’s natural balance. Using a moisturiser, lubricant and wash together helps provide consistent support rather than addressing individual symptoms in isolation.

A layered, hormone-free daily approach

Our pH-matched Vaginal Moisturiser and Intimate Foam Wash are designed to support everyday comfort by helping maintain hydration and a healthy vaginal environment.

If you have recurrent UTIs, persistent burning or unusual symptoms, it’s important to speak with your clinician. GSM and infections can overlap, so getting the right diagnosis and treatment is essential.

Sources / further reading

• StatPearls: Genitourinary Syndrome of Menopause (NCBI Bookshelf)  
• AUA/SUFU/AUGS: Genitourinary Syndrome of Menopause Guideline (2025)
• Cleveland Clinic Journal of Medicine: GSM, common problem, effective treatments (2018)

A layered, hormone-free routine can help. Our pH-matched moisturiser and wash are designed to support hydration, maintain a healthy vaginal environment and provide comfort across the whole genitourinary picture.