Genitourinary syndrome of menopause (GSM) — formerly called vulvovaginal atrophy — is associated with all of the following EXCEPT:

• A Decrease in vaginal rugae
• B Proliferative vaginal epithelium with superficial cell predominance ✓
• C Alkalinisation of vaginal pH (pH > 4.5)
• D Increased susceptibility to urinary tract infections

Explanation

In GSM, estrogen deficiency causes vaginal epithelium to become atrophic — the epithelium thins and shows predominance of parabasal cells (immature, non-cornified), NOT superficial cells. Superficial cells (cornified) predominate in estrogen-replete states. Vaginal pH rises above 4.5 due to loss of lactobacilli and Döderlein's bacilli. Loss of rugae and increased UTI susceptibility are both features of GSM.

Reference: Shaw's Textbook of Gynaecology, 17th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.