MEANING THRU MEDIA: The Posters
Women’s Health as We Age.
Aging brings changes to a woman’s body, and many of those changes can be understood, addressed, and managed. Education is an important part of helping women remain healthy, active, independent, and confident as they age.
One often overlooked aspect of healthy aging is genitourinary syndrome of menopause (GSM). Understanding GSM—and the role of local vaginal estrogen in treating GSM and helping prevent recurrent urinary tract infections—can make a meaningful difference in a woman’s comfort, independence, urinary and sexual health, and quality of life.
Why Vulvovaginal Estrogen Matters
As estrogen levels decline during and after menopause, the tissues of the vulva, vagina, and urinary tract can become thinner, drier, and more fragile—a collection of changes now known as genitourinary syndrome of menopause (GSM). Low-dose vulvovaginal estrogen can restore estrogen locally to these tissues, helping improve dryness, irritation, burning, discomfort with sexual activity, and other symptoms of vulvovaginal atrophy. It can also improve urinary symptoms and, importantly, is recommended for many postmenopausal women with recurrent urinary tract infections to help reduce the risk of future infections. Because GSM often progresses rather than simply resolving with time, recognizing and treating these changes can be an important part of maintaining comfort, urinary and sexual health, and quality of life as women age.
Understanding GSM
Genitourinary syndrome of menopause (GSM) describes the changes that can occur in the vulva, vagina, bladder, and urinary tract as estrogen levels decline during and after menopause. Symptoms may include vaginal or vulvar dryness, burning, irritation, itching, discomfort with sexual activity, urinary urgency or frequency, painful urination, and recurrent urinary tract infections. Symptoms may be aggravated while seated on a bicycle saddle or after hiking for miles. These symptoms can develop gradually and may worsen over time if untreated. Many women assume these changes are simply an unavoidable part of aging and may never discuss them with a healthcare professional. Recognizing GSM is important because effective treatments are available, including low-dose local vaginal estrogen for many women. Estrogen based cancers and blood clots are no longer recognized as contraindications for low dose topical vaginal estrogen cream.
THE FACTS
More than 300,000 women are hospitalized annually in the USA with UTIs.
Each year, UTIs contribute to roughly 27,000 deaths of US women, including about 11,000 involving sepsis.
Topical estrogen can reduce the risk of UTI by over 50%
Vulvovaginal estrogen is a safe option for aging women regardless of prior clot or cancer history
Vaginal estrogen and UTI prevention
After menopause, falling estrogen thins the tissues of the vagina and urethra and changes the vaginal environment. Protective Lactobacillus bacteria decline and the vaginal pH rises, which makes it easier for the bacteria that cause bladder infections to take hold. Low-dose vaginal (topical) estrogen restores these tissues and a healthy, acidic vaginal environment.
In randomized trials, vaginal estrogen cut recurrent UTIs in postmenopausal women by more than half, reducing risk by about 58% compared with placebo. Estrogen taken by mouth did not have this effect.
Vaginal estrogen comes as a cream, tablet, insert or ring. It works locally, and very little reaches the bloodstream. It is recommended by the American Urological Association for peri- and postmenopausal women with recurrent UTIs, and it is a safe, inexpensive, antibiotic-free option for most women.
Discuss topical estrogen with your healthcare provider.
Dr. Rachel Rubin on HRT & Menopause (Mel Robbins Podcast)
In this 2-hour conversation, urologist and sexual medicine specialist Dr. Rachel Rubin explains, in plain language, how falling hormones affect far more than hot flashes. She describes genitourinary syndrome of menopause: the dryness, painful sex, urinary urgency, leakage and recurring UTIs that many women are told are just part of getting older. She explains why low-dose vaginal estrogen is safe, inexpensive, and can cut recurrent UTIs by more than half.
She also covers how the 2002 Women's Health Initiative study frightened a generation of women and doctors away from hormone therapy, what has changed since then, and the different roles of estrogen, progesterone and testosterone, including testosterone for low libido.
The message throughout: these symptoms are common and treatable, and you deserve a provider who takes them seriously.
Runtime: about 2 hr 14 min. Released March 2026.