Non-hormonal strategies for treating genitourinary syndrome of menopause: a concise review

ABSTRACT

Genitourinary Syndrome of Menopause (GSM) is a common, chronic condition in post‑menopausal women, marked by vaginal dryness, irritation and dyspareunia. It can markedly reduce life’s quality, particularly in women who cannot use hormone therapy, such as breast‑cancer survivors. Non‑hormonal strategies therefore represent an essential therapeutic way. This narrative review examines the efficacy and safety of central‑nervous‑system agents (flibanserin, bremelanotide), vaginal moisturisers and lubricants, laser and radio‑frequency devices, pelvic‑floor physiotherapy, dietary measures and cognitive‑behavioural therapy. Overall, these interventions relieve GSM symptoms and improve sexual function with few adverse effects, although robust long‑term data are still lacking. Tailored treatment plans that respect individual needs and preferences are crucial, and further research is required to confirm the generalisability of current findings across different populations.

Key words
Genitourinary syndrome of menopause; vulvovaginal atrophy; climacteric; non-hormonal treatment; quality of life.