In 2021, Karen, who asked that her last name not be used, was always running to the bathroom because of a burning sensation and the urge to urinate. 

It had been more than 30 years since she had a urinary tract infection (UTI), but Karen suspected that one was causing her frequent bathroom trips. She visited her gynecologist, but her urinary culture tested negative for infection. At the time, her doctor didn’t seem concerned by Karen’s discomfort. 

“I was on my own,” Karen, 65, of Pittsburgh, told CIDRAP News. “Doing my own research, I upped my water intake and began taking a supplement called D-mannose. They kept my symptoms at bay.” 

After Karen’s gynecologist retired, she visited a new one and described her symptoms. Following an exam, her doctor knew exactly what Karen was experiencing. 

“She told me I had vaginal atrophy, but it was completely reversible with the usage of vaginal estrogen,” Karen said. “She assured me it would also alleviate the UTI symptoms, which it, in fact, did.” 

Karen’s experience is not unique. Declining estrogen levels during perimenopause and menopause make it more likely for women to experience a UTI. A feeling of urgency, UTIs, vaginal atrophy, pain with sex, and vaginal dryness fall under what’s called the genitourinary syndrome of menopause (GSM), which affects 13% to 87% of women, according to a 2024 editorial in the Annals of Internal Medicine.