Menopause Masterclass: Recurrent UTIs and the Genitourinary Syndrome of Menopause (GSM)

Genitourinary syndrome of menopause (GSM) is the most undertreated condition of midlife — and one of the easiest to treat. In this solo episode, Dr. Mary Claire Haver breaks down the symptoms most women never connect to their hormones: vaginal dryness, painful sex, urinary urgency, getting up at night to pee, delayed orgasm, and recurrent UTIs — infections that, in older women, can lead to sepsis, falls, and hospitalization. Affecting 50–80% of postmenopausal women (and effectively all of us if we live long enough), GSM can also strike at any low-estrogen stage of life, from postpartum to breastfeeding.

Dr. Haver shares her own story of missing the diagnosis in herself, then walks through exactly how to treat it: why vaginal estrogen — not lubricants — is now the frontline treatment, how the FDA’s November 2025 removal of the black box warning changes the conversation, how to apply it (“treat the whole neighborhood, not just the block”), and the options beyond estrogen, from vaginal DHEA to pelvic floor PT. It’s never too late to start — and you never have to just live with this.

Books:
The New Perimenopause:https://thepauselife.com/pages/the-new-perimenopause-book
The New Menopause:https://www.amazon.com/dp/B0CKBZ4K1Z

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