Vaginal estrogen users more likely to get perioperative UTIs — but it's not what you think. A new study of postmenopausal hip fracture patients found that women already using vaginal estrogen were more likely to experience perioperative UTIs — not because the treatment raises risk, but because they were already a higher-risk group. Researchers say the real issue is poor compliance and prescribing gaps that need urgent attention.
A new study presented at The Menopause Society's annual meeting found that postmenopausal women using vaginal estrogen were more likely to experience perioperative urinary tract infections (UTIs) — but researchers are quick to clarify the nuance. The association reflects the fact that vaginal estrogen users were already a higher-risk group, with a history of recurrent UTIs, rather than the treatment itself causing harm.
The study analyzed 375 postmenopausal women (mean age 80) hospitalized for hip fractures. Only 8.8% reported perioperative vaginal estrogen use, and those users had a significantly higher history of recurrent UTIs compared to non-users. Researchers say the low prescription rate represents a missed opportunity, pointing to poor adherence, caregiver unawareness, and physical limitations post-fracture as key barriers.
By the Numbers:
Why it matters: Vaginal estrogen is a proven tool for reducing recurrent UTIs in postmenopausal women, yet it remains underprescribed — especially in surgical settings. This study highlights an urgent need for better prescribing practices, patient education, and adherence strategies, with low-dose estrogen vaginal rings flagged as a potentially more practical option for this vulnerable population.
