Welcome back Readers of NeurogenicBladder.me!  Our blogging platform was undergoing an overhaul and we were down for a few days.  This post will be a combined effort of Trudy and Julia, since Trudy needed some additional background research on this topic.

Please note that this particular entry will be specific to those of you who are entering or are already Post-Menopausal.

Because Trudy frequently gets back to back bladder infections due to her neurogenic bladder, her doctor recommended she try a vaginal estrogen cream.  Women who reach menopause may start to experience symptoms of vaginal dryness, itching burning or pain due to the lack of estrogen in their system.  Because systemic estrogen in this group of women is linked to an increased risk of breast and/or endometrial cancer, a low-dose locally-applied cream was developed to help with these symptoms.

The use of it has been shown to help:

  • Maintain the muscle tone and the vaginal and urethra
  • Reduce dryness and irritation and pain during intercourse
  • Reduce urinary tract infections or a tendency toward infection
  • Reduce incontinence (urinary frequency and urgency) by effect on vessels of urethra

The dosage is low so that the amount of hormone that will end up in my blood stream is minuscule.

Within a short time of starting therapy, the thin vaginal tissue thickens enough that the estrogen stays in the vagina instead of getting absorbed into the bloodstream. If you measure blood estrogen levels in a woman who routinely uses vaginal estrogen, her levels would be no higher than the normal post-menopausal range. That’s great news for the woman who is concerned about using estrogen or who has breast cancer. That’s also why there is no time limit on using vaginal estrogen. Women in their 80s can still enjoy intercourse. The real challenge is finding the partner who is still  “good to go.”

From Sandpaper Sex, Despite Lubricant, by Lauren Streicher

Read her blog entry

Vagina and Urinary TractEstrogen

When estrogen levels are low, as in menopause, the vagina can become drier and the vaginal walls thinner, making sex painful.

Additionally, the lining of the urethra, the tube that brings urine from the bladder to the outside of the body, thins. A small number of women may experience an increase in urinary tract infections (UTIs) that can be improved with the use of vaginal estrogen therapy.

Article by JoAnn Manson MD

I buy my topical estrogen online with a prescription.  It comes in a tube and since I have had so many bladder infections lately my doctor has suggested that I use frequently.  I apply it with a squirt to my finger after a shower to my external vaginal/urethral area.   I use it at bed time for the most absorption effect. 

Since it would not be a good idea to expose my husband to estrogen I keep my application of the cream and marital joys completely separate.  But, although I have been using the cream regularly I have not seen any real effect on the number of urinary tract infections that I get.

The use of topic estrogen is obviously regularly attributed as a treatment for UTIs in postmenopausal women  – but does it really work?  A 2001 study by Brown J.S., et al. PubMed Article of oral hormone therapy did not find that urinary tract infections were reduced.  There is a notable lack of evidence that estrogen replacement therapy or local estrogen creams actually do decrease UTI, but more studies are needed to determine if there are a group of post-menopausal women who do benefit by a reduction of UTI from estrogen cream.

If you are aware of new data about the benefits of this cream specifically for reducing Urinary  Tract Infections or have personally experienced benefits, won't you leave a comment for us?

Until next time . . . 

Trudy and Julia