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Treatment patterns for genitourinary syndrome of menopause: a TriNetX analysis
Anushka Ghosh1, Maria J D'Amico1, Yash B Shah1
1Department of Urology, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA 19107, USA.
The Canadian Journal of Urology
|January 7, 2026
Summary
Most women diagnosed with genitourinary syndrome of menopause (GSM) do not receive treatment. Topical estrogen is the most common therapy for GSM, while newer treatments remain underutilized.
Area of Science:
- Women's Health
- Menopause Management
- Pharmacology
Background:
- Genitourinary syndrome of menopause (GSM) is a common condition affecting postmenopausal women.
- GSM significantly impacts quality of life but is often underdiagnosed and undertreated.
- Understanding current treatment trends is crucial for improving patient care.
Purpose of the Study:
- To evaluate real-world treatment patterns for genitourinary syndrome of menopause (GSM).
- To identify current management practices and gaps in care for GSM.
- To analyze the utilization of different therapeutic options for GSM.
Main Methods:
- Utilized the TriNetX database to identify patients diagnosed with postmenopausal atrophic vaginitis (ICD N95.2).
- Analyzed treatment data from 2004-2024 using RxNorm and ICD codes for various therapies.
- Collected demographic information including patient age and sex.
Main Results:
- Over 2.8 million GSM cases were identified, with 71.22% receiving no treatment.
- Among treated patients, topical estrogen was the most frequent single intervention (88.64%).
- Hormone replacement therapy (HRT) and newer agents like Prasterone and Ospemifene were significantly underutilized.
Conclusions:
- A substantial majority of women diagnosed with GSM remain untreated.
- Topical estrogen is the predominant treatment, indicating potential underutilization of newer therapies.
- Further research is needed to understand barriers to treatment access and utilization for GSM.
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