Vaginal estrogen is highly effective and safe for reducing recurrent UTIs in women with low estrogen states by lowering vaginal pH through increased lactobacilli conversion of glycogen.

“So vaginal estrogen, meaning estrogen that's applied in the vagina either through a cream, a suppository, or a ring, is highly effective in reducing the occurrence of recurrent UTIs. And this is because when you have low estrogen, the pH in the vagina goes up and the pH in the vagina goes up because there's less conversion of glycogen to lactobacilli, and then those lactobacilli are preventative for UTIs. So essentially, you want to reduce the pH back to its normal acidic pH. And vaginal estrogen is very effective at doing that.”