Source : INDIA TODAY NEWS
A low-dose vaginal estrogen cream, costing little more than a meal in many countries, is gaining attention after urologist Dr. Rachel Rubin said it could dramatically reduce urinary tract infections (UTIs) in older women and potentially prevent life-threatening complications.
Speaking on the podcast, The Diary of a CEO, hosted by entrepreneur Steven Bartlett, Rubin expressed frustration that vaginal estrogen remains underused despite decades of evidence supporting its benefits.
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“This cream can also help prevent death from urinary tract infections,” Rubin said, referring to low-dose vaginal estrogen therapy.
WHY ARE OLDER WOMEN MORE VULNERABLE TO UTIs?
UTIs are among the most common bacterial infections in women. While many infections are easily treated, recurrent UTIs can become a serious problem after menopause.
Falling estrogen levels cause changes in the vaginal and urinary tract tissues. The tissues become thinner and drier, while beneficial bacteria that normally protect against infection decline.
These changes make it easier for harmful bacteria to enter and multiply in the urinary tract.
In some older adults, a UTI can progress beyond the bladder and kidneys, triggering sepsis, a life-threatening reaction to infection.
WHAT DOES VAGINAL ESTROGEN DO?
Unlike hormone replacement therapy taken orally, vaginal estrogen is applied locally as a cream, tablet or ring. The treatment helps restore the health of vaginal and urethral tissues and promotes the growth of protective bacteria.
Research suggests this local treatment can significantly reduce recurrent UTIs in postmenopausal women.
A randomised clinical trial found that women using vaginal estrogen experienced fewer recurrent UTIs than those receiving placebo treatment.
A 2026 systematic review and meta-analysis of randomised controlled trials also reported a protective effect, finding that vaginal estrogen substantially lowered the risk of recurrent UTIs in postmenopausal women.
Earlier reviews, including a Cochrane analysis, similarly concluded that vaginal estrogen reduces recurrent UTIs in postmenopausal women, although benefits varied depending on the formulation used and treatment duration.
BEYOND INFECTION PREVENTION
Doctors say the therapy could help with a broader condition known as genitourinary syndrome of menopause (GSM), which includes symptoms such as vaginal dryness, painful intercourse, urinary urgency and frequent urination.
According to Dr. Rubin and other menopause specialists, many women are unaware that these symptoms are linked to hormonal changes rather than simply ageing.
IS IT SAFE?
Studies suggest that low-dose vaginal estrogen has minimal systemic absorption because it acts primarily on local tissues.
As a result, it is generally considered safer than systemic hormone therapy for many women, though treatment decisions should always be made in consultation with a healthcare provider.
For decades, recurrent UTIs in older women have been managed with repeated courses of antibiotics. Dr. Rubin’s comments have reignited discussion about a therapy that has existed for years but remains unfamiliar to many patients.
The larger question, she suggests, is why a treatment supported by decades of evidence is still not routinely discussed with women entering menopause.
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SOURCE :- TIMES OF INDIA
