HHS and American Urological Association Announce Landmark Collaboration to Advance Women’s Health

New Memorandum of Understanding Aims to Educate Clinicians and Women on Evidence-Based Local Estrogen Therapy for Postmenopausal Genitourinary Syndrome of Menopause and Recurrent Urinary Tract Infections

WASHINGTON, D.C. - March 12, 2026 - The U.S. Department of Health and Human Services (HHS), through its Office on Women's Health (OWH), today announced a formal Memorandum of Understanding (MOU) with the American Urological Association, the American Urological Education and Research, and the Urology Care Foundation (together, the AUA) to promote the appropriate and evidence-based use of local estrogen therapy in postmenopausal women, particularly those experiencing genitourinary syndrome of menopause (GSM) and recurrent urinary tract infections (UTIs).

The collaboration reflects a unified commitment by both institutions to improving women's health, preventing disease, and enhancing quality of life through safe and effective therapies. Together, HHS and the AUA will exchange information, develop educational resources, and work collaboratively to reach health care providers and women across the country.

"This collaboration represents an important step forward in addressing a significant and often undertreated women's health concern," said Dorothy A. Fink, M.D., Principal Deputy Assistant Secretary for Health and Director of the HHS Office on Women's Health. "Many postmenopausal women are not aware that local estrogen therapy is a safe and effective treatment for GSM and recurrent UTIs. By joining forces with the AUA, we can ensure that clinicians and patients alike have access to clear, evidence-based guidance."

Why This Matters: A Public Health Imperative

Postmenopausal estrogen decline causes predictable physiological changes - including thinning of the urogenital epithelium, loss of glycogen and protective lactobacillus flora, elevated pH, and increased susceptibility to bacterial colonization - that significantly raise the risk of recurrent UTIs, urosepsis, urinary urgency and frequency, pelvic pain, and sexual dysfunction.

Recurrent UTIs in postmenopausal women carry serious complications, including:

• Repeated antibiotic exposure and growing antimicrobial resistance
• Emergency department visits and hospitalization
• Life-threatening urosepsis
• Evidence demonstrates that local estrogen therapy restores urogenital tissue health, lowers pH, reestablishes protective flora, and significantly reduces recurrent UTIs, thereby lowering the risk of progression to systemic infection and sepsis. Reducing UTI frequency directly decreases morbidity, health care utilization, and potentially mortality.

Quality of Life and Sexual Health Benefits

Local estrogen therapy has been shown to:

• Strengthen urogenital tissue
• Improve lubrication and elasticity
• Reduce dyspareunia
• Improve sexual desire and enhance orgasmic satisfaction
• Decrease urinary urgency and frequency
• Reduce urinary incontinence
• Diminish chronic pelvic discomfort

MOU Objectives and Scope

Under the MOU, HHS and the AUA will collaborate over an anticipated period of up to five years. Key commitments include:

• HHS will increase clinician education and public awareness regarding GSM and local estrogen therapy
• The AUA will share expertise on the diagnosis and management of GSM and its impacts on women's health
• Both parties will jointly educate health care providers and women on the appropriate and evidence-based use of local estrogen therapy in postmenopausal women, and assess the impact of the initiative

The MOU is effective for an initial period of one year and may be extended by mutual agreement for up to five years. It may be terminated by either party upon 60-days written notice.

About the HHS Office on Women's Health: The HHS Office on Women's Health provides expert advice and consultation to the Secretary of HHS on scientific, legal, ethical, and policy issues related to women's health. OWH establishes short- and long-range goals within the Department and coordinates activities relating to disease prevention, health promotion, service delivery, research, and health care professional education for issues of particular concern to women throughout their lifespan.

About the American Urological Association: Founded in 1902, the American Urological Association is a premier urologic association providing invaluable support to the urologic community. Its mission is to promote the highest standards of urological clinical care through education, research, and the formulation of health care policy. The AUA has more than 24,000 members worldwide who have been transforming and improving urological care for over 100 years.