About 50% of menopausal women experience genitourinary syndrome of menopause (GSM) that involves changes to the genitals, including the vagina, urethra and bladder. When estrogen levels drop during menopause, it can cause the GSM symptoms of vaginal dryness, itching, burning, frequent urinary tract infections and pain during sex. Replenishing the hormone through vaginal estrogen is an effective GSM treatment. But many breast cancer survivors either can't or don't want to use estrogen.

More than 4 million people in the U.S. are breast cancer survivors. GSM affects up to 70% of these survivors. Medications that stop the body from producing estrogen can prevent or stop the spread of breast cancer. However, these antiestrogen therapies, called aromatase inhibitors, also can exacerbate

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