Genitourinary Syndrome of Lactation: A Missing Piece in Postpartum Care—With Insights from a Pelvic Physical Therapist
A recent publication in Sexual Medicine Reviews has introduced a critical but often overlooked concept in postpartum health: Genitourinary Syndrome of Lactation (GSL). Modeled after the well-established “Genitourinary Syndrome of Menopause” (GSM), this term describes the hormonal shifts during lactation that can lead to a variety of urogenital symptoms in new mothers. The key takeaway? Postpartum discomfort isn’t always just part of the healing process—it can be a sign of something treatable and manageable.
What Is Genitourinary Syndrome of Lactation?
During lactation, elevated prolactin levels suppress estrogen production. This resulting state of hypoestrogenism can lead to:
Vaginal dryness
Burning or irritation
Decreased vaginal elasticity
Pain during intercourse (dyspareunia)
Increased urinary frequency or urgency
These symptoms are common, but they’re often dismissed or misattributed to “normal postpartum healing.” Unfortunately, this oversight can cause prolonged discomfort and negatively impact intimacy, pelvic function, and quality of life.
A Pelvic Physical Therapist’s Perspective
From the perspective of a pelvic physical therapist (PT), GSL offers a valuable framework for understanding and validating the complaints many postpartum clients bring to the clinic—but which have historically lacked a name or coordinated care plan.
What Can a Pelvic PT Do for GSL?
Pelvic physical therapists are uniquely positioned to:
Assess tissue health: Identifying atrophy, irritation, or hypersensitivity of vulvovaginal tissues
Provide education: Helping new parents understand how hormonal shifts influence their pelvic floor and sexual health
Offer non-invasive treatments: Such as pelvic floor relaxation techniques, desensitization, and tissue mobilization. This is key in addressing the primary symptoms of urinary incontinence, pain with intimacy, urinary urgency and frequency, as well as helping to improve strength and support of the pelvic floor to optimize postpartum health!
Collaborate with providers: Referring to OB-GYNs or urologists when localized estrogen therapy or other interventions may be needed.
Perhaps most importantly, pelvic PTs create a safe, supportive environment where new parents can discuss symptoms that are often shrouded in silence or shame and can provide non-invasive treatments for all the primary symptoms!
Why This Matters
By naming and normalizing GSL, we:
Empower birthing people with knowledge and validation
Encourage interdisciplinary collaboration between OB-GYNs, pelvic PTs, and lactation consultants
Highlight the need for routine screening of genitourinary symptoms during postpartum checkups
Early identification and treatment can help avoid chronic pelvic floor dysfunction, sexual pain, and urinary issues later on.
Final Thoughts
Genitourinary Syndrome of Lactation is more than a clinical term—it’s a call to action. By integrating this concept into postpartum care, and involving pelvic physical therapists as key providers, we can better address the needs of lactating individuals who deserve to heal fully—not just physically, but functionally and emotionally.
For clinicians, doulas, and parents alike, this is a step toward whole-body postpartum care that finally includes the pelvic floor.
Read the full study here: https://pubmed.ncbi.nlm.nih.gov/38757214/
At Women in Motion our pelvic floor therapists specialize in orthopedics, pelvic health, obstetrics and midlife care offering the full spectrum of care that you need for this phase of life!
Book your consultation today!
Want to learn more about lactation? Check out our breastfeeding class which is taught by our lactation consultant and pelvic floor therapist
