HEALTHY LIVING


Simple Treatment for UTIs Many doctors unaware of the effectiveness of vaginal estrogen. ::


BY CHRIS ILIADES, M.D. U


rinary tract infections are the most common bacterial infections for postmenopausal women.


They are miserable, painful, and inconvenient. Antibiotics often fail to control


them. However, there is a simple and effective solution that many women are not aware of, and that many healthcare providers are failing to prescribe. “Vaginal estrogen should be


used routinely to treat and prevent recurrent infections, but many doctors are not getting the message,” says Alan D. Garely, M.D., director of urogynecology at Mount Sinai South Nassau and professor of obstetrics and gynecology at Icahn School of Medicine at Mount Sinai, New York. A 2023 study in the American


Journal of Obstetrics & Gynecology illustrates how effective estrogen can be. The study followed nearly 6,000


women, average age 70, diagnosed with recurrent UTI (defined as three or more UTIs in one year confirmed by a urine culture). They were prescribed a low-dose vaginal estrogen cream, and over the next year more than 55% had one or fewer UTIs and more than 30% had none.


HOW ESTROGEN HELPS At menopause estrogen production by the ovaries drops, causing vaginal fluids to dry up and tissues to thin out. One of the first signs for many women is pain during sex, and frequent UTIs often follow. Estrogen helps keep the vaginal


and urethral tissues moist and elastic and helps maintain a healthy


96 NEWSMAX MAXLIFE | APRIL 2025


bacterial balance in the vagina. “Dryness of the vagina and urethra


allows these bacteria to invade the tissues of the vagina and urethra more easily,” explains Garely. Vaginal estrogen, as a cream,


tablet, or ring inserted into the vagina, reverses these changes. Cream, the most common because


it is easy and inexpensive, is applied with a finger or applicator about twice per week. It takes a few months to take full effect, but it will start to prevent infections and sex will become less painful.


WHY IT’S NOT PRESCRIBED Some providers may not be aware of how effective and safe vaginal estrogen is. Systemic estrogen replacement


therapy, used to treat symptoms of menopause such as hot flashes, vaginal dryness, and osteoporosis, is higher dosed and absorbed by the body. As a result it can increase the


risk of heart disease, stroke, blood clots, and breast cancer, especially for women with a history of these problems. Low-dose vaginal estrogen,


however, is only minimally absorbed into the body. Almost all the estrogen stays in the vaginal tissue. “The fear of side effects from


low-dose vaginal estrogen is a misconception held by many doctors. In fact, there is no data to link this estrogen to heart disease, blood clots, or breast cancer,” says Garely.


ROLE OF ANTIBIOTICS Occasional UTIs may respond quickly to a few days of antibiotics, but overuse of antibiotics can lead to bacterial resistance, which is most common with recurrent UTIs. In fact, 70% to 80% of recurrent


UTIs may become resistant to common antibiotics. “A major benefit of vaginal


estrogen is that it prevents future infections, and that cuts down the use of antibiotics and antibiotic resistance,” Garely notes. If you have frequent UTIs after menopause, ask your healthcare provider about vaginal estrogen. “The vaginal estrogen study sheds needed light on the value of low- dose vaginal estrogen, a simple and effective way to treat and prevent UTIs,” says Garely.


VALIANTSIN SUPRUNOVICH/SHUTTERSTOCK


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