*News FLASH -My reviews of recently published menopause research.
Title: Vaginal Estrogen Prescription is Associated with Reduced Risk of Serious Adverse Outcomes in Women of All Age Groups with Recurrent Urinary Tract Infection: An Epic Cosmos Database Analysis. Urology. 2026.
To determine if postmenopausal women who use a local vaginal estrogen are less likely to develop sepsis, be hospitalized, or die after recurrent urinary tract infections.
Urinary tract infections (UTIs) are the second most common infection in the United States. 40% of women who get a UTI end up with a repeat infection. Recurrent urinary tract infections are defined as more than 2 infections within 6 months or more than 3 infections within 1 year. In the general population, 1 in 4 women with a urinary infection ends up with recurrent infections, but post-menopause, that number climbs to 55%.
The reason is straightforward. It’s not just the vulva and vagina that change when your estrogen tank is on empty. The urinary tract is rich in estrogen receptors, so the tissue along it also becomes dry, thin, and much more prone to infection. In addition, postmenopause, healthy vaginal lactobacilli get wiped out, allowing the bad bacteria to take up residence in the urethra and making the urinary tract even more prone to infection. These changes in the vulva, vagina, and bladder are all part of genitourinary syndrome of menopause (GSM).
If a UTI is untreated, bacteria have the potential to invade the kidneys and quickly turn into pyelonephritis, which is a lot more serious. If bacteria enter the bloodstream, sepsis sets in. Urosepsis occurs in 1.6% of women who develop a post menopause urinary tract infection. This may sound like a rare event, but since there are 75 million postmenopausal women, it is a significant number.
Sepsis can result in complications such as kidney failure, blood clots, heart problems, loss of limb, and even death in up to 30% of cases. Urosepsis accounts for roughly 25% to 30% of all sepsis cases.
Urinary tract infections are more than unpleasant- they are potentially life-threatening.
Urinary tract infections are preventable with the use of a local vaginal estrogen, DHEA, or ospemifene.
Only one of four women with recurrent UTI receives a prescription for a local vaginal estrogen.
304 million patient records were reviewed
1,891,956 women with recurrent UTI were included and divided into 2 groups
Group 1: Post menopause women who received a vaginal estrogen prescription within 2 months of their second UTI
Group 2: Post menopause women who never received a vaginal estrogen prescription
Both Group 1 and Group 2 were followed for 8 years to determine who developed sepsis, was admitted to the hospital, or died.
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