Women's Health April 1, 2026 0 Comments

Unlock the One Women’s Health Secret Experts Don’t Want You to Know—Train Smart, Live Strong!

Ever feel like your body is playing tricks on you—especially when you think you’ve finally kicked a pesky problem to the curb? That was me with urinary tract infections (UTIs) for most of my twenties. I blamed everything from “bad hygiene” to not drinking enough cranberry juice, only to end up twice in the hospital battling infections that just wouldn’t quit. Fast forward thirty years, I thought those days were behind me, until menopause came knocking and out popped the UTIs again, this time sneaking in with a relentless urge to pee. Talk about a rude awakening! What I didn’t know then—and what many of us don’t hear—is that shifting hormone levels could be the stealthy puppeteer behind these symptoms. It turns out, a little-known condition called genitourinary syndrome of menopause (GSM) might be the culprit affecting women not just during menopause, but at various life stages. Luckily, there’s a bright side: a safe, effective, and surprisingly affordable treatment that the medical world hasn’t shouted about loud enough—vaginal estrogen. Intrigued? You should be. Because knowledge is more than power—it’s relief, and maybe even a return to feeling like yourself again. LEARN MORE

4 min read

For most of my twenties, I had recurring urinary tract infections, or UTIs. They were painful and embarrassing because I thought it was a poor hygiene issue. I tried peeing after sex, cranberry juice, and antibiotics. They usually went away, but twice the infections spread to my kidneys and put me in the hospital. Even then, doctors simply told me to “be more careful” (whatever that meant), prescribed me antibiotics, and sent me on my way.

Thirty years later, I thought that chapter of my life was over. Then menopause hit. Suddenly, the UTIs came back—along with a constant, uncomfortable feeling that I needed to pee all the time. I had no idea why.

Then, I interviewed Rachel Rubin, MD, a urologist and sexual health expert, on my podcast, and she explained something that left me speechless.

“One of the biggest drivers of UTIs in women of all ages is rarely part of the conversation: changing hormone levels,” she said. And she wasn’t just talking about perimenopause and menopause. Hormones fluctuate throughout women’s entire lives: during puberty, menstruation, pregnancy, breastfeeding, and beyond—meaning women of all ages can be affected.

Dr. Rubin went on to explain: “Those shifting hormone levels directly impact the vagina, leading to dryness, itching, irritation, and painful sex. Changes in the vaginal microbiome also cause bad bacteria to flourish and, potentially, enter the urinary tract.”

The Diagnosis No One Talks About

As your hormones change, Dr. Rubin said women can “suddenly experience a whole range of issues impacting their sexual health, including urinary frequency and urgency, pelvic pain, and recurrent UTIs.” Together, these symptoms are known as genitourinary syndrome of menopause, or GSM, for short.

I had never heard of the term before, but I had almost all the symptoms.

She explained that GSM can happen during low-estrogen states, including perimenopause, menopause, postpartum, lactation, or while taking medications that can affect your hormones (such as certain acne medications or forms of birth control). In other words, despite the name, GSM is not something that happens only in menopause. It can happen at any stage of life when your hormones are out of balance.

I sat there thinking about my own experience, both in my 20s and now in my late 50s. I thought about my daughters on acne medication and birth control. I thought about my grandmother, who struggled with bladder infections in a nursing home. I thought about my mom, and how, for many older women, a UTI is not just a nuisance, but something that can turn serious very quickly and lead to kidney infections, sepsis, and death. I thought about how an estimated three million people a year visit the emergency room for UTI complications and how women are disproportionately affected by these complications.

The Treatment That Should Be Everywhere—But Isn’t

Here’s the part I want you to know, because it made me angry: there is a safe, effective, inexpensive treatment that can reduce UTIs by more than 50% and relieve GSM symptoms, but most women have never been told about it: vaginal estrogen.

“Delivered locally in low doses, vaginal estrogen or DHEA, which comes in a cream, tablet, ring, or a suppository, doesn’t even raise systemic estrogen levels,” Dr. Rubin said. “It drastically reduces the likelihood of UTIs by more than 50% and also relieves other symptoms of GSM.”

This treatment is cost-effective as well. Dr. Rubin shared that a tube of estradiol estrogen cream can cost as little as $13 for a 2.5-month supply. “So, that means, for about $7 a month, you can prevent UTIs by more than half.”

I’m on an estrogen patch, I take progesterone, and I am in frequent communication with my doctor about my symptoms of menopause. And yet here was Dr. Rubin telling me that I—and so many women in different life stages that I love and care about—might benefit from vaginal estrogen.

None of us even knew it was an option.

And the reason why is infuriating: Two decades of misinformation around hormone therapy scared many doctors away from prescribing even the safest forms of estrogen, including vaginal estrogen. But thankfully, this is beginning to change.

Last year, the American Urological Association released evidence‑based guidelines recommending vaginal hormone therapy, which the Menopause Society endorsed. In February, the FDA finally approved the first updated label, removing the outdated black box warning.

While you currently need a prescription to get access to estrogen cream, Dr. Rubin is currently fighting to make vaginal estrogen available over the counter.

What Women Need to Do Right Now

This is not just about UTIs. This is about you and the women you love finally getting the information you need. You don’t have to suffer in silence or in shame. There is a safe, effective treatment available: vaginal estrogen.

If you are in your 40s, 50s, or 60s, or you love someone who is, you need to know this. If you have a daughter on birth control or acne medication that may affect her hormones, you need to know this. If your partner is breastfeeding, you need to know this. If you have a wife, mother, or grandmother, you need to know this.

Ask your clinician about GSM and vaginal estrogen. And if you have a woman in your life who is struggling with dementia, please share this information with her caregivers and advocate on her behalf.

Share this with the women you love, not to scare them, but to empower them. This information could change your life.

Mel Robbins is the author of The Let Them Theory and host of The Mel Robbins Podcast.