When is vaginal oestrogen therapy recommended for recurrent urinary tract infections?

After menopause, lower oestrogen can make the vaginal entrance and nearby urinary tissues thinner, drier, and more easily irritated. These changes may alter the local protective environment and make urinary symptoms or repeated infections more likely. Vaginal oestrogen delivers a small amount of hormone locally as a cream, tablet, gel, or ring, depending on the product and clinical advice. It is different from whole-body hormone therapy, and it is prescribed after reviewing your symptoms, health history, and medicines.

Arrange a review if infections keep returning after menopause, especially if you also have vaginal dryness, burning, discomfort with sex, urinary urgency, or repeated irritation. A clinician may confirm that episodes are urinary infections and discuss whether local oestrogen fits your situation. Use it exactly as prescribed; improvement in tissue symptoms can take time. Mention unexplained vaginal bleeding, a history of hormone-sensitive cancer, blood clots, liver disease, or medicines you take before starting treatment.

Seek prompt medical care for fever, chills, pain in the side or back, vomiting, feeling faint, or worsening illness with urinary symptoms, because these can signal an infection needing urgent assessment. Contact a clinician about blood in the urine, new vaginal bleeding, or symptoms that do not settle. Vaginal oestrogen is preventive support and does not replace assessment or treatment of an active infection.

Ask whether your previous episodes were confirmed infections, whether low-oestrogen tissue changes are present, which local formulation suits you, and what symptoms should be reported. Also ask how to use it, when to review progress, and whether your personal medical history changes the recommendation.