Because of the FDA’s black-box warning for estrogen products, menopausal women spent years unable to get relief from the potentially deadly but often preventable effects of recurrent urinary tract infections. And despite growing evidence supporting safety and efficacy, as well as the lifting of the warning, a lingering stigma is still keeping women from life-saving care.
For years, major medical groups have recommended a low dose of vaginal estrogen to help prevent recurrent urinary tract infections in menopausal women. But a “misinterpretation” in 2002 of a landmark research study by the Women’s Health Initiative prompted the FDA to “slap its strongest warning” on all estrogen products, said USA Today.
The study suggested that some forms of hormone therapy that included estrogen and progesterone could “increase the risks of cardiovascular problems, breast cancer, endometrial cancer and possibly dementia,” said Harvard Medical School. But low-dose vaginal estrogen was never studied in the associated trial. Last November, the FDA lifted the black-box warning.
Vaginal estrogen has been shown to be an effective treatment for menopausal women with frequent UTIs. In a recent study of recurrent UTSs published in the Urology Journal, “women 55 and older who were prescribed vaginal estrogen were about half as likely to be hospitalized with a UTI as those who were not,” said USA Today. Their recorded rates of sepsis and death were “roughly one-fifth as high.”
Despite that evidence, treatment “still isn’t widespread” because of the continuing stigma, said USA Today. And unlike “widely prescribed” menopause hormone therapy, vaginal estrogen also suffers from a “public relations problem,” said The Center for Infectious Disease Research and Policy, with “few women knowing what it is.”
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