Introduction: Menopausal symptoms have defected the quality of life of elderly women. Several studies have examined a nonhormonal bioadhesive moisturizer gel, such as polycarbophil, for genitourinary syndrome of menopause (GSM) therapy. However, there was no such study in Indonesia. Thus, this study aims to compare the efficacy of polycarbophil moisturizer gel and placebo for women with GSM. Materials and methods: A randomized clinical trial with a total of 40 subjects was enrolled in Cipto Mangunkusumo General Hospital, Jakarta from April to December 2019. Subjects were divided into polycarbophil group (n = 21) and the placebo group (n = 19). Polycarbophil and placebo were given two times per week for 3 weeks. Genitourinary syndrome of menopause symptoms (vaginal dryness, itching, dyspareunia, dysuria, and burning sensation) and vaginal health index scores (VHIS), including vaginal elasticity, fluid volume, pH, epithelial integrity, and vaginal moisture, were assessed before and after the intervention. Results: Most of the GSM symptoms, especially vaginal dryness and dyspareunia, improved in week 2 for both interventions. Related to VHIS, polycarbophil gel improved the vaginal fluid volume, pH, and moisture, while placebo improved epithelial integrity. The polycarbophil gel was found to significantly (p <0.001) raise the vaginal pH compared with placebo. Overall, there were 18 subjects (85.7%) from the polycarbophil group who felt an improvement of symptoms after therapy, while only 11 subjects (57.9%) from the control group felt it. Conclusion: Polycarbophil gel may raise vaginal pH in postmenopausal women with GSM. The overall VHIS efficacy between polycarbophil and placebo was relatively the same. © The Author(s). 2022 Open Access.