oday, we're tackling another common—but surprisingly under-discussed—cause of painful sex: Genitourinary Syndrome of Menopause (GSM). GSM is a collection of symptoms caused by falling estrogen levels that affect the vagina, vulva, labia, clitoris, bladder, and urethra.

The pelvic floor is a group of 14 muscles located at the bottom of your pelvis. These muscles support your bladder, rectum, and reproductive organs. Imagine a hammock or sling stretching across the bottom of your pelvis. That supportive hammock is your pelvic floor. When it's functioning well, you probably don't think about it. When it's not, you'll know.

Why aren't we talking about perimenopausal sexual dysfunction? Women's health has spent decades being the black sheep of medicine. Conditions affecting millions of women have often been dismissed, minimized, or simply ignored. Sexual health may be one of the best examples. Let's fix that.