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Postmenopausal women are at greater risk for multiple health issues, such as hip fractures and urinary tract infections (UTIs), due to estrogen loss.
Vaginal estrogen is used to prevent recurrent UTIs, but a new study suggests its use may be associated with perioperative hip fracture complications, like UTIs. Results of the study will be presented at the 2026 Annual Meeting of The Menopause Society in San Diego Oct. 20–24, 2026.
Low estrogen levels after menopause cause the tissues of the vagina and urethra to become thin, dry and fragile (vaginal atrophy). Thinning tissues and reduced elasticity make it easier for harmful bacteria to enter the urethra and travel to the bladder, leading to an increase in UTIs.
Vaginal estrogen is an effective treatment option to help prevent recurrent UTIs in postmenopausal and perimenopausal women by rebuilding and thickening the epithelial lining of the vagina and urethra and helping to restore a healthy vaginal microbiome. However, its role in the perioperative setting has not been investigated.
A new study involving 375 postmenopausal women with hip fractures was designed to analyze vaginal estrogen use and its association with perioperative hip fracture complications, including perioperative UTIs. 8% (n=33) reported perioperative use of vaginal estrogen. A majority—32 of the 33—had been using vaginal estrogen for at least six weeks before surgery. Nearly 26% of the total (n=94) experienced at least one perioperative UTI, and 28 experienced a preoperative UTI.
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