I’m so pleased to share a comprehensive critical review of the top randomized controlled trials about vaginal estrogen vs. placebos in preventing or treating UTIs in postmenopausal women. ~Tracy Sher, PT, MPT, DPT (2022)
UTIs are the most common bacterial infection in (cisgender) women and they increase significantly during menopause (Raz, 2011)
The prevalence of UTIs is 3x times higher in those diagnosed with GSM than controls (Rubin, et al., 2020)
Adding vaginal estrogen treatment has been found to lower vaginal pH, increase lactobacillus in the epithelium of the vagina, and decrease colonization of Enterobacteriaceae (Stavridis, 2013)
There are various types vaginal estrogen treatments – creams, suppositories, rings, and pills (or prasterone DHEA is another option). They are not the same as oral pills or patches- they directly help the local tissue inside the vagina and at the urethra (and parts of the vulva).
Vaginal estrogen can take 2-3 months to work and sometimes specific placement of it is beneficial (at the opening, urethra, or fully inside, etc)
Why isn’t this discussed more? Why isn’t this prescribed more? There was an erroneous black box warning on ALL estrogens and it is taking a long time to reverse.
For a more detailed explanation and the study reviews, please download the full ebook/pdf.
Using antibiotics over and over again may not even be needed if we prevent these issues!
You can ask your GYN about it. This is certainly not individual medical or health advice.
Thanks so much for reading! Please talk to your doctor (or if you’re a medical provider, talk to your patients) about this important topic.
Also, remember that so often the way we get this information is through talking to friends and family. Speak up for those you know who are struggling with recurrent UTIs and see if this could help improve their quality of life.
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