Ekene Enemchukwu, MD, on vaginal estrogen for genitourinary syndrome of menopause

While vaginal estrogen is the preferred treatment for addressing the long-term symptoms of genitourinary syndrome of menopause (GSM), there are barriers and misconceptions that limit its use, according to Ekene Enemchukwu, MD, MPH, FACS, URPS.

In a recent interview with Urology Times®, Enemchukwu highlighted the background for the study, “Advancing Women’s Health: Addressing Gaps in Genitourinary Syndrome of Menopause,” touching on the clinical presentation of GSM and contemporary treatment options. Data from this study were presented at the Society of Urodynamics, Female Pelvic Medicine, & Urogenital Reconstruction 2025 Winter Meeting in Rancho Mirage, California.

Enemchukwu is an associate professor of urology, and by courtesy, of obstetrics and gynecology (urogynecology), at Stanford Medicine in Palo Alto, California.

Specifically, Enemchukwu explained that many women do not seek treatment for GSM in the first place, due to embarrassment or misconceptions that it is a normal part of aging. When they do seek treatment, they are often told to use an over-the-counter vaginal moisturizer or lubricants, which she says only provide short-term relief.

“To find a therapy that's all encompassing, that manages all of this in a long-term fashion, low-dose vaginal estrogen is the preferred treatment,” she says. “It's safe and it's effective at reducing the genitourinary and sexual symptoms.”

However, Enemchukwu described several barriers that may limit vaginal estrogen use in clinical practice. These include misconceptions about its use, misperceptions about its safety, and cost.