Why Do I Keep Getting UTIs?: When Vaginal Health Meets Hormonal Change

By Dr. Beverly Huang ND

"Anna", 53, had always been healthy. But over the past year, she found herself on a frustrating—and painful—merry-go-round: recurrent urinary tract infections.

“I’d just finish one round of antibiotics and feel another UTI coming on a week later. I started dreading going to the bathroom.”

It wasn’t just the discomfort. It was the mental toll: always worrying about the next flare-up, missing work, and avoiding intimacy with her partner out of fear of triggering another infection.

She’d been to the doctor multiple times. The usual tests were done. More antibiotics. Sometimes a suggestion to “drink more water.”

But no one asked the most important question:
What’s happening to Anna’s estrogen?

The Hormone–Urinary Connection

As women transition into menopause, declining estrogen levels affect more than hot flashes and mood. Estrogen plays a critical role in the health of vaginal and urinary tissues. When it drops:

• The vaginal wall thins and becomes drier

• The urinary tract becomes more vulnerable to bacteria

• The microbiome in the vagina changes, reducing protective flora

• pH levels rise, increasing infection risk

Anna wasn’t just unlucky. Her body was telling her she needed hormonal support.

The Solution: Restore the Foundation

Together, we created a plan that addressed the root cause—not just the symptoms.

• Topical vaginal estrogen to restore tissue integrity and rebalance the vaginal ecosystem
• Targeted probiotics to support a healthy urinary and vaginal microbiome
• Hydration, D-mannose, and lifestyle strategies to reduce irritation and support urinary health
• Stress and immune support, since cortisol and inflammation can also play a role

“I was nervous about using estrogen at first,” Anna said. “But within weeks, I felt a difference. I wasn’t afraid to leave the house or plan a trip.”

“The biggest shift? I felt like I could trust my body again.”

UTIs Aren’t Just a Bladder Issue

Recurrent UTIs in menopause are often a sign of genitourinary syndrome of menopause (GSM)—a condition that affects nearly half of postmenopausal women but is rarely talked about.

This is not just about peeing more or drinking cranberry juice. It’s about restoring hormonal and tissue health from the inside out.