The new toolbox for reducing painful sex in menopause.

PURPOSE OF REVIEW: This review addresses the increasing recognition of genitourinary syndrome of menopause and its impact on sexual health, particularly as hormonal changes during menopause can lead to significant discomfort and dysfunction.

RECENT FINDINGS: The literature highlights the multifaceted nature of sexual dysfunction in menopausal women, including genital/vulvovaginal, sexual, and urinary symptoms. Recent studies have explored the effectiveness of various treatments, including hormonal therapies, selective estrogen receptor modulators, and nonhormonal options such as hyaluronic acid and sexual devices. In addition to new guidelines on genitourinary syndrome of menopause published this year, there are some emergent papers highlighting experiences of menopause beyond the heterosexual, partnered, cisgender women which add to the discussion of sexual health in menopause for all.

SUMMARY: Vulvovaginal health impacts sexual health by causing vaginal pain, irritation, and discomfort. There are many tools to address vulvovaginal health, including behavioral, nonhormonal, and hormonal options. Clinicians should be aware of the diverse treatment modalities available and how they can be used often concurrently to improve sexual health and well being in menopause.