Clinical Research Directory

Inclusion Criteria: * Postmenopausal (definition: No menses for 1 or more years or surgical menopause (bilateral oophorectomy). If there is a past history of hysterectomy, patient must be age 56 or older (95th percentile for age at menopause) or have laboratory evidence of menopause (ie. FSH \>30) * Meets criteria for recurrent urinary tract infections (UTIs) with 2 or more UTI in 6 months or 3 or more UTI in 1 year * May include patients who used vaginal estrogen previously if they have stopped use for 3 or more months prior to inclusion into study. * Patients must be recommended vaginal estrogen as part of normal clinical care for prevention of recurrent UTI Exclusion Criteria: * Current use of vaginal or oral estrogen products * Inability or refusal to use vaginal estrogen * Daily antibiotic use * Significant vaginal stenosis (eg. due to lichen sclerosis, radiation or obliterative prolapse surgery) that would prohibit use of a vaginal applicator (ie. genital hiatus \<1cm) * Inability to use vaginal applicator and without caregiver who can administer (eg. provider-managed pessary use, significant arthritis) * Frequent (1x weekly or more frequent) use of bladder instillations containing an antibiotic * Known hydronephrosis as a result of incomplete bladder emptying * Use of intermittent or indwelling urinary catheterization * Known bladder stones, mesh erosion into bladder, or foreign object in bladder * Unable to consent for self * Active treatment for an estrogen-dependent malignancy