Genitourinary syndrome of menopause (GSM): recommendations from the Fifth International Consultation on Sexual Medicine (ICSM 2024)
Bibliographic record
Abstract
INTRODUCTION: Genitourinary syndrome of menopause (GSM) encompasses a cluster of sexual symptoms like dyspareunia associated with genital and urinary symptoms like urinary urgency, which may be variably reported in the clinical setting. OBJECTIVES: To provide a comprehensive guide for healthcare professionals (HCPs) in sexual medicine, helping them effectively recognize and manage GSM, a very common chronic and progressive condition with an impact on quality of life and intimate relationships. METHODS: An expert committee, invited from seven countries by the 5th International Consultation on Sexual Medicine (ICSM), was comprised of eight researchers and clinicians with expertise in menopause medicine, for the purpose of reviewing and grading the scientific evidence on nosology, etiology, diagnosis, and treatment of GSM. RESULTS: Presence of at least one GSM symptom ranges from 14% to 87% in postmenopausal women, with vaginal dryness and dyspareunia being the two most common symptoms. A summary of the recommendations on GSM management deriving from the evaluation of data, subject to its quality published in the scientific literature, is provided. CONCLUSIONS: GSM is a relatively new disorder with an expanded definition to further the older long-recognized condition of vulvovaginal atrophy (VVA) in postmenopausal women to include urinary symptoms and anchor the disorder to menopause and the hypoestrogenic state. This new disorder has provided renewed incentives to formalize a significant amount of multidisciplinary research in the last decade. However, many areas ranging from epidemiology to tailored effective and safe treatment options in clinical practice still require in-depth additional investigations.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.011 | 0.033 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.002 | 0.003 |
| Bibliometrics | 0.007 | 0.003 |
| Science and technology studies | 0.002 | 0.001 |
| Scholarly communication | 0.002 | 0.002 |
| Open science | 0.004 | 0.003 |
| Research integrity | 0.010 | 0.007 |
| Insufficient payload (model declined to judge) | 0.007 | 0.003 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".