1) Genitourinary syndrome of menopause (GSM)—also known as vulvovaginal atrophy, is a chronic and progressive condition affecting the vulvovaginal, sexual, and lower urinary tracts.

2) It arises from hypoestrogenism following menopause, or surgical menopause, leading to a range of distressing symptoms, including vaginal dryness, burning, painful intercourse, urinary incontinence, increased frequency, recurrent urinary tract infections (UTIs), and painful urination. Unlike vasomotor symptoms (VMS), which often improve over time, GSM worsens without effective treatment and can finally lead to atrophy.

3) It affects up to 84% of postmenopausal women, significantly impairing their health, sexual function, and quality of life. In California alone, up to 7.3 million women are affected. Across the U.S. and Europe, an estimated 200 million women suffer from GSM, with global estimates reaching up to 1 billion.

4) However, GSM remains underdiagnosed and undertreated, with only 25% of affected women seeking medical help and just 10% receiving therapy. With increasing life expectancy and an aging population, GSM is not only a medical concern but also a social issue affecting both women and their partners.

5) Estrogen supplementation is considered the standard treatment for GSM. Still, it is not suitable for women with breast cancer or those who prefer to avoid hormone therapy.

6) Several non-hormonal alternatives exist, including lifestyle modifications, nutritional interventions, and energy-based therapies such as laser treatments. However, many of these approaches lack rigorous, placebo-controlled trials, making it difficult to draw objective conclusions regarding their efficacy and safety. Additionally, they address only specific aspects of GSM rather than the full spectrum of symptoms. Moreover, some of these treatments are associated with concerning side effects, limiting their widespread use.

7) Therefore, there is an urgent need to develop a non-hormonal, convenient, and reliable therapy that is suitable for women of all ages and health conditions, improving the overall well-being of postmenopausal women, and benefiting their partners as well.