Pearls & Perspectives: Elevating GSM Care & the Art of Medical Communication, With Rachel Rubin, MD

At the Sexual Medicine Society of North America meeting in Grapevine, Texas, host Amy Pearlman, MD, sat down with Rachel Rubin, MD, to discuss the new Genitourinary Syndrome of Menopause (GSM) guidelines, the evolving relationship between research, advocacy, and communication, and how clinicians can amplify impact through education and collaboration.

Rubin, a urologist specializing in sexual medicine, described the release of the AUA-endorsed GSM guidelines, which are also supported by the Menopause Society, the International Society for the Study of Women’s Sexual Health, and other major professional groups, as “revolutionary.” The cross-specialty endorsement, she explained, officially positions GSM as a urologic and sexual-medicine issue rather than a condition confined to gynecology. The goal, she said, is not only to codify evidence-based management but also to ensure clinicians learn how to implement it in practice.

Rubin emphasized that communication and marketing principles—often overlooked in medicine—are essential for translating guidelines into behavior change. She recalled that recommendations on vaginal estrogen for UTI prevention existed as early as 2019 but had minimal clinical uptake.

Her approach to lecturing, which emphasizes meeting audiences where they are, simplifying complex content, and mixing data with real-world stories, aims to make guidelines actionable immediately.

That philosophy guided her recent FDA testimony advocating removal of the boxed warning from vaginal estrogen products. Preparing for the panel, she said, required the same strategic storytelling and coordination she applies to teaching: balancing emotion, data, and a clear call to action. The resulting five-minute presentation, now publicly available online, doubles as an educational tool clinicians can share with patients to explain the safety and preventive benefits of vaginal estrogen.

Beyond public speaking, Rubin has become a prolific content creator. Through her YouTube channel and social platforms, she distills evidence on hormonal and sexual health into digestible segments—often filmed spontaneously in her office or car. She attributes her success not to polish but to authenticity and repetition. With half the population experiencing menopause, she views social media as a necessary extension of patient education and professional outreach.

Rubin also discussed building her Sexual Medicine and Research Team (SMART), which has grown from a handful of students to hundreds of multidisciplinary contributors worldwide. The grassroots group produces systematic reviews, survey studies, and case reports that broaden sexual-medicine scholarship across specialties.

Looking ahead, Rubin is most enthusiastic about expanding clinician education through structured, CME-accredited courses on hormone-therapy prescribing. Her long-term vision combines research, education, and advocacy: creating a self-sustaining ecosystem in which informed providers, empowered patients, and accessible science drive meaningful change.

References:

1. Kaufman MR, Ackerman AL, Amin KA, et al. The AUA/SUFU/AUGS Guideline on Genitourinary Syndrome of Menopause. J Urol. 2025;214(3):242-250. doi: 10.1097/JU.0000000000004589
   
   
2. American Urological Association. American Urological Association Releases New Guideline on Genitourinary Syndrome of Menopause - American Urological Association. Auanet.org. Published April 28, 2024. Accessed October 12, 2025. https://www.auanet.org/about-us/media-center/press-center/american-urological-association-releases-new-guideline-on-genitourinary-syndrome-of-menopause
   
   

Chapters
00:41 GSM guidelines
5:57 Speaking at the FDA Expert Panel on Menopause and Hormone Replacement Therapy for Women
10:21 Creating content
18:31 Dr Rubin's research