Vaginal oestrogen is a type of HRT for those going through perimenopause and suffering from dryness and irritation, which are common symptoms. The medication is also very effective at reducing recurrent urine infections (UTIs) after menopause, but a new study has found that this treatment may have even more health benefits.
GP Dr Amir Khan, who is a frequent guest on This Morning and Lorraine, and woman&home's own resident GP, took to social media to talk through the study's results. He said it was one of the "biggest women's health studies of the year" and it could "change how we think about vaginal oestrogen".
Researchers at Albany Medical College used a huge database to look at almost 1.9 million women with recurrent UTIs. They compared the results for those who were using prescribed vaginal oestrogen against those who weren’t. They knew the medication could reduce urine infections in older women, but they also found huge benefits for women across all age groups.
A post shared by Dr Amir Khan GP MBChB(hons)MRCGP DCH DRCOG DipDiab PGCE (@doctoramirkhan)
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The results, published in the journal Urology, showed that women of all ages who used vaginal oestrogen had a lower risk of sepsis, hospitalisation, and early death. The data showed that sepsis occurred in 4.2% to 10.4% of oestrogen recipients versus 8.5% to 24.1% of non-recipients. Hospitalisation occurred in 7.5% to 12.0% of recipients compared with 15.7% to 27.5% of non-recipients. Mortality increased in both groups with age but was lower in the group of women who used vaginal oestrogen.
Dr Khan says the findings are “important because we’ve often thought of vaginal oestrogen as something to consider mainly for older women”. He says the study suggests that women of any age who have low oestrogen levels and regular UTIs may see the benefits of using a gel or cream.
The study concludes: “Vaginal oestrogen prescription within 2 months of UTI diagnosis is associated with lower odds of serious adverse outcomes across age groups.”
The reason this medication can be so effective when it comes to our general health is because it doesn’t just affect our vagina. “It keeps the tissues of the bladder and urethra healthy, maintains the acidic environment, that protective lactobacillus bacteria we love, and makes it much harder for bacteria like E. coli to gain a foothold,” explains Dr Khan.
He says if recurrent UTIs are “ruining your life”, you don’t have to take antibiotics every time. Taking antibiotics too often can cause gut issues, drug resistance, yeast infections, and diarrhoea or vomiting.
“Ask whether vaginal oestrogen could be part of the solution,” says Dr Khan. “This study suggests we may need to start that conversation much earlier than we used to.”
What is vaginal oestrogen?
Vaginal oestrogen is a topical treatment that delivers hormones directly to the tissue, rather than circulating through through the bloodstream like HRT tablets do. They help treat genitourinary syndrome of menopause (GSM), which includes thinning, drying and inflammation of the vagina, vulva and urinary tract.
Dr Khan says: “It’s a tiny dose applied directly where it’s needed, with minimal absorption into the bloodstream.”
It comes as a tablet, cream, gel, pessary or ring that you insert into your vagina. It’s usually only available on prescription, although there are a few brands you can buy from a pharmacy. It can take a few months to start to work fully, but it's thought to have fewer risks than other types of HRT.
Vaginal oestrogen won’t help with other perimenopausal symptoms like hot flushes, insomnia or mood swings.
Speak to your doctor if you want to explore hormone therapy options, including whether it's right for you and any HRT alternatives.
