The Dr Louise Newson Podcast 35 - How vaginal hormones can transform the health of women
Nov 25, 2025
Dr. Rachel Rubin, a urologist and sexual medicine specialist, sheds light on how hormonal changes negatively impact women's urinary and vaginal health. She emphasizes the prevalence of recurrent UTIs and advocates for vaginal hormone therapies as a vital preventive measure. The discussion touches on the significant evidence supporting vaginal estrogen's safety and efficacy, the overlooked role of androgens, and the barriers preventing proper hormone therapy access. Informed patients and clinicians can transform approaches to menopause care and enhance quality of life.
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Perfect Candidate Denied Hormone Therapy
- Rachel Rubin described a 'picture perfect' patient denied systemic HRT by an uninformed doctor.
- The patient remained stuck between conflicting advice and uncertain whom to trust.
Menopause Causes Lasting Genitourinary Harm
- Genitourinary symptoms from menopause are common and driven by low oestrogen and testosterone.
- These symptoms include urinary frequency, urgency, leakage and increased UTI risk, and worsen with age.
Use Vaginal Hormones To Prevent UTIs
- Offer vaginal hormones as prevention, not just antibiotics for UTIs.
- Vaginal estrogen or DHEA reduces recurrent UTIs and improves urinary symptoms and should be considered lifelong.