There’s a quiet transition many women move through that isn’t spoken about nearly enough. Genitourinary Syndrome of Menopause, or GSM often arrives during perimenopause or menopause. If that phrase feels clinical, that’s because it comes from a world that hasn’t always known how to speak lovingly about vulvas and the seasons of change our bodies move through, so let’s soften it.
GSM can occur when estrogen begins to step back during menopause and perimenopause. Estrogen isn’t something that is only required for periods or fertility. It’s a nourishing, plumping, hydrating, blood-flow-loving hormone that keeps the tissues of the vagina, vulva, urethra, and bladder juicy, elastic, and resilient.
When estrogen levels drop, those tissues can begin to thin, become dry and more sensitive and while this can feel disheartening, it is all a natural transition of your body as we age gracefully.
How GSM Can Show Up
In the vagina, GSM can show up as dryness, irritation, burning, or that quiet sense of “something feels different down there.” Sex or penetration may have gone from feeling fun to starting to feel uncomfortable or even painful. This is due to your tissue having less natural lubrication and stretch. The vaginal walls can become less elastic, and the natural microbiome can shift, sometimes leading to recurrent infections or that persistent feeling of imbalance. Many women are told this is “just aging” and something to put up with, but your body is asking for tender care.
The bladder and urinary tract are part of this story too. The urethra is estrogen-sensitive, and when those tissues begin to thin, you might notice increased urgency, needing to pee more often, leaks when you laugh or sneeze, or a burning sensation that feels like a UTI even when tests come back clear. It can feel confusing and sometimes a little scary, especially if no one ever explained that menopause doesn’t just happen in your ovaries but also in your pelvis, your tissues and your nervous system!
Reconnecting with the Pelvic Floor
This is where coming back into relationship with your pelvic floor can be deeply healing. The pelvic floor is more than just a set of muscles to clench and release. It is an integrated system of muscles, fascia, and nerves that responds to breath, emotional state, arousal, and rest. When GSM is present, the pelvic floor can often become either weak and sleepy or tight and guarding, or sometimes both at once. Conscious pelvic floor exercises can increase blood flow, improve muscle tone, and help reawaken sensation in the vagina and bladder. Blood flow is the medicine here, bringing a sense of aliveness back into tissues that may feel dull. For those wanting deeper guidance, this 90-minute workshop on pelvic floor training, with womens health physio offers a compassionate, educational way to understand what’s happening in the body and how to support it.
This is also where sensual, embodied tools like yoni eggs can be supportive when used with intention. At Yoni Pleasure Palace, we believe yoni eggs are about connection and not striving for some mythical ideal of tightness. When you gently work with a yoni egg, you’re inviting awareness back into your pelvic bowl while encouraging subtle engagement and relaxation of the vaginal walls. The gentle weight of a yoni egg can stimulate circulation and proprioception, helping your nervous system remember that this part of you is alive and worthy of pleasure and care.
For many women navigating GSM, this kind of practice can feel profoundly reclaiming. Instead of dreading dryness, leaks, and discomfort, you meet yourself with understanding of this change. You might discover that pleasure deepens rather than disappears, becoming less about friction and more about presence (with lots of lube!). When the pelvic floor is supported and engaged in a balanced way, bladder control can improve and that constant background worry about accidents can ease.
Lube Is A Support Tool
For those of us who didn’t grow up seeing lubricant as a normal part of intimacy, simply having a good quality oil or water-based lube on hand can be a quietly radical act. Keeping it nearby “just in case” helps remove pressure from the body to perform or produce something it may no longer do in the same way.... and that’s okay. Reaching for lube doesn't mean something is wrong, it’s a supportive tool that enhances pleasure and reduces friction that can otherwise irritate thinning, estrogen-sensitive vaginal walls.
So where do I start you ask?
Different types of lubricants can offer different kinds of support. Water-based lubricants tend to be light and easy to clean, making them a gentle everyday option, especially for sensitive tissues. Oil-based lubricants can feel deeply nourishing and long-lasting, offering a sense of cushioning and hydration, though they aren’t compatible with latex condoms and may not be suited for everyone. Exploring what feels best for your body can be part of reconnecting with pleasure rather than rushing toward an outcome.
Let's debunk those beliefs that lube is only for “problems,” or that it means desire has faded and use it as our ally instead. Reminding yourself that it allows intimacy to remain playful and enjoyable rather than something to push through or endure.
There Is No One Right Way Through Menopause
There’s also an emotional layer here that deserves love. GSM can impact how we feel about intimacy, it can make us feel less desirable and that we have an age limit on pleasure. Working with your pelvic floor while using yoni eggs can become a ritual of self-trust, a quiet way of saying, “I’m still here and I’m still allowed to feel good in my body.”
Of course, GSM exists on a spectrum, and every body is different. Pelvic floor exercises and yoni egg practices can be beautiful allies, especially alongside other supports like vaginal moisturisers and lubricants, or medical guidance if you choose that path. There’s no one right way to move through menopause. What matters is that you’re informed and educated to make decisions with what feels right to you.
Menopause invites a different kind of relationship with the body that requires listening rather than pushing through. Experiences like GSM are not problems to silence, but signals asking for thoughtful attention. When we respond with care, the bladder and vagina stay present. There is something quietly meaningful about that choice, to remain connected rather than turn away.
With Love,
Mikay x
