@stephanie_misanik: Recurrent UTIs in perimenopause aren't just bad luck, and another round of antibiotics isn't the whole answer. A new study of nearly 1.9 million women says vaginal estrogen belongs in the conversation. Researchers looked at women with recurrent UTIs. The ones prescribed vaginal estrogen had about half the sepsis or less, fewer hospital stays and lower death rates over 8 years, in every age group from their 20s to their 90s. Yet only 5.1% were prescribed it. Here's the why. As estrogen falls in perimenopause, the tissue of your vagina and urethra thins, and the protective bacteria that keep things acidic start to disappear. That makes it easier for infections to take hold, over and over. Vaginal estrogen works right there, locally. This is why I say women need both: systemic estradiol for the whole body once estrogen starts to fluctuate in perimenopause, typically in the 40s, and local vaginal estrogen for the vaginal and urinary tissue. They do different jobs. US and Canadian urology guidelines already recommend vaginal estrogen for women in perimenopause and menopause with recurrent UTIs. Not sure if this is perimenopause? Comment HORMONES and I'll send you my free perimenopause checklist, or grab it through the link in my bio. Source: LaClair J, et al. Urology. 2026;215:43-48. doi:10.1016/j.urology.2026.06.004 #perimenopause #vaginalestrogen #utiprevention #menopause #womenshealth

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