The genitourinary syndrome of menopause (GSM) is a new term that describes various menopausal symptoms and signs including not only genital and sexual symptoms but also urinary symptoms related to a decreased estrogen level in menopause. Since the GSM may have a negative impact on the quality of life of postmenopausal women, women should be made aware of these problems and treated with an appropriate effective therapy. Thus, in this review, we introduce new terminology and discuss the importance and the role played by the vaginal microbiota in the vaginal health, as well as available therapeutic alternatives.