Understanding urogenital syndrome of menopause: an evolving
physiological process
Ovarian oestrogen secretion falls significantly and persistently at menopause. Structural and functional changes affect vaginal, vulvar and urinary tissues. Mucosa thins, loses suppleness and blood supply, hydration and protection, causing irritation, dryness and discomfort. Reduced connective tissue and fibroblast collagen and elastin production worsen fragility. Protective lactobacilli decline, raising pH and infection susceptibility. Progressive changes explain slowly developing symptoms, sometimes years after menopause.
What are the symptoms of
urogenital syndrome of
menopause?
Symptoms vary but follow similar progression. Dryness often appears first, with discomfort, burning or painful intercourse (dyspareunia). Vulvar tightness, fragility, chronic irritation, itching or burning may occur. Mucosa is vulnerable to microtrauma and infection. Urinary symptoms include frequency, sometimes burning, and recurrent cystitis. Weakened support may cause leakage with exertion, coughing or laughing (stress incontinence). Atrophic labia majora lose protective volume, causing irritation, sensitivity and recurrent fungal infections. Vaginal laxity may create widening, reduced sensation and lower sexual satisfaction.
Often considered normal or inevitable, these symptoms can nevertheless be effectively relieved through modern therapies.
Effects on quality of life
and psychological balance
Beyond physical discomfort, the syndrome affects quality of life, confidence and psychological balance. Painful intercourse can affect couples' intimacy, reduce desire or lead to avoidance. Anatomical changes may cause embarrassment or shame. Leakage or recurrent infection can create lost control and affect social life. Consultation restores dialogue, explains objectively and offers adapted solutions. Early care generally restores satisfactory quality of life.
How is the syndrome diagnosed:
urogenital syndrome of
menopause?
Diagnosis involves detailed discussion, symptom analysis and vulvovaginal examination of quality, hydration, suppleness, lesions, redness and irritation. Urinalysis or sometimes urodynamics assesses urinary symptoms. It establishes atrophy severity, complications such as infection or fissures and appropriate treatment. Assessment is individual because symptom combinations vary. A specialist gynaecological consultation makes this diagnosis.
Non-invasive therapeutic solutions
Non-invasive options are often first-line. Local moisturisers and lubricants temporarily relieve dryness and irritation, improving comfort without addressing hormonal causes.
Regenerative aesthetic treatments
PRP, hyaluronic acid or vaginal laser biostimulation offers preventive and restorative tissue care, improving structure, function and quality for comfort, anatomical balance and lasting quality of life.
PRP (Platelet-Rich Plasma) uses own-blood growth factors injected into vaginal or vulvar mucosa to stimulate collagen, blood supply and regeneration. Biocompatible without reaction risk, it accompanies other techniques for optimal results. Biostimulation effectively treats atrophic mucosa, visibly improving comfort, hydration and tissue quality.
Hyaluronic acid deeply hydrates mucosa, improves quality and protective function and reduces dryness. Labia majora injections correct atrophy, restore volume and mechanical protection, limiting irritation, sensitivity and recurrent infection. Sometimes G-spot injection improves sensitivity and sexual comfort. Structural, hydrating and protective support preserves vulvovaginal anatomy and function.
Vaginal laser is a major non-hormonal advance. Controlled heat promotes collagen, firmness and mucosal elasticity, toning and strengthening vaginal tissues. Improved vascularity and natural lubrication address dryness and daily comfort. Effects on periurethral support may help certain stress incontinence cases through pelvic floor strengthening.
Prices
Prices depend on care type, product and functional, regenerative or anatomical goals.
Hyaluronic acid costs 600 CHF per syringe. Consultation determines numbers by indication, atrophy or dryness and goals. Immediate effects average one year.
Vaginal laser costs 600 CHF per session, generally three around six weeks apart, then annual maintenance for tone, lubrication or stress incontinence.
Autologous regenerative PRP costs 500 CHF per session, usually two initially one month apart then annual maintenance for quality. Consultation personalises choices to needs, indication and intimate anatomy.
What is the role of pelvic floor rehabilitation and medical follow-up?
Pelvic rehabilitation may complement care, particularly incontinence or laxity. It strengthens pelvic floor muscles, tone and stability. Follow-up monitors symptoms, adjusts treatment and ensures tolerance, particularly as the syndrome evolves. Approaches combine according to needs and goals.
Prevention and early action: comprehensive care
Preventive monitoring is recommended even if onset is years after menopause. Hydration, regular gynaecological follow-up and attention to discomfort support intervention before deterioration. Specialist consultation confidentially provides reliable information and personalised options.
Psychological support and dialogue
Discussing symptoms may feel delicate, but they are common and legitimate consultation topics. Doctors also provide psychological support through explanations of mechanisms, options and progression. Dialogue clarifies expectations, restores confidence and supports care respecting integrity and comfort.
Treatment now goes beyond relief to restore structure and function and preserve long-term intimate well-being.
The 2025 guidelines on genitourinary syndrome of menopause draw on an analysis of hormonal and non-hormonal treatments. They favour symptom-based diagnosis and shared decision-making; low-dose vaginal oestrogens have the strongest evidence. Consultation allows treatment to be selected according to the patient’s symptoms, history and preferences.
A multicentre placebo-controlled trial found improvement in dryness and pain during intercourse twelve weeks after a vaginal injection of hyaluronic acid. Sexual function scores also improved more in the treated group. This publication documents a non-hormonal option for some women with vulvovaginal atrophy, using a specifically studied formulation.
Extended follow-up of the previous hyaluronic acid trial shows that vulvovaginal symptoms and sexual function scores remained improved for up to one year compared with their levels before treatment. After twelve weeks, patients and doctors knew which treatment had been received, and participants in the control group could also be treated. These results describe maintenance of the observed benefits but do not allow comparison of treatment effectiveness with placebo over a full year.
Frequently asked questions about genitourinary syndrome of menopause
Which aesthetic medicine treatments improve menopausal vaginal dryness?
Specific hyaluronic acid deeply rehydrates mucosa, restoring suppleness and protection. Vaginal laser stimulates collagen and vascularity for lasting natural lubrication without hormones.
Can vaginal laser treat lost vaginal tone?
Yes, collagen stimulation and improved elastic fibres strengthen mucosa for firmness, sensitivity and comfort without surgery or activity interruption.
Can hyaluronic acid treat labia majora atrophy?
It restores volume and protection with natural, lasting results.
How can aesthetic medicine help postmenopausal stress leakage?
For mild to moderate cases, laser improves perineal support tone and regenerates periurethral structures, supporting the urethra and reducing leakage without surgery or invasive devices.
Are intimate aesthetic treatments painful?
Most injections and laser cause little pain and are well tolerated. Cream or local anaesthesia may be used. Sensations are generally moderate and temporary.
How many sessions provide lasting results?
One to three may suffice by treatment and tissue condition. Laser often needs two to three sessions spaced several weeks apart. Hyaluronic acid may provide lasting visible results in one session, with possible maintenance at 12 to 18 months.
Are benefits purely aesthetic?
No. They also improve hydration, quality, comfort, protection and intercourse and reduce certain urinary disorders.
Can several areas be treated together?
According to indication and assessment, laser and hyaluronic acid may combine in one session for overall comfort, volume or tone correction.
Are results immediately visible?
Hyaluronic acid is immediate, particularly labia majora. Laser develops over weeks through regeneration, collagen and tone.
