A new study of 375 postmenopausal women found an association between vaginal estrogen use and perioperative urinary tract infections in hip fracture patients.

A study involving 375 postmenopausal women with hip fractures indicates that vaginal estrogen use is associated with an increased risk of perioperative urinary tract infections (UTIs). The findings are scheduled to be presented at the 2026 Annual Meeting of The Menopause Society in San Diego. Researchers noted that while vaginal estrogen is typically used to prevent recurrent UTIs, its effectiveness in the perioperative setting for this specific patient population remains unclear.

Study Findings and Methodology

The study analyzed 375 postmenopausal women, 8.8% of whom reported using vaginal estrogen perioperatively. Among the total study population, nearly 26% experienced at least one perioperative UTI. While vaginal estrogen use was associated with higher odds of perioperative UTIs in adjusted models, it was not significantly linked to other complications such as emergency department visits, hospital readmissions, or mortality within one year of surgery.

Context of Estrogen Use

Researchers observed that vaginal estrogen use was most common among women who already had a history of recurrent UTIs. Dr. Jocelyn Wittstein of Duke Health, the study's lead author, suggested that the lack of observed UTI reduction might be due to noncompliance or the fact that the treatment is primarily utilized by patients already at higher risk for infections. Further research is recommended to evaluate different delivery methods, such as creams, tablets, or rings.