Dr. Betty MurrayHelping Women Navigate Menopause | Speaker, Author, and Advocate for Women's Health Over 40

Insurance Denies Vaginal Estrogen? Here’s Why That’s a Problem

27 Aug 2026 · 1 min

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In this video Dr. Betty Murray explains that genitourinary syndrome of menopause (GSM) affects a large proportion of menopausal women and is vastly undertreated. Although clinical guidelines now recommend vaginal estrogen for all women—regardless of age, breast cancer history, or other factors—to prevent vaginal atrophy, urinary tract infections (UTIs), and the downstream risk of sepsis and death, many insurers, including Medicare, refuse to cover it. Dr. Murray argues that this denial stems from a gendered assumption that vaginal estrogen is only needed for sexual activity, leading to a systemic neglect of women’s health and unnecessary suffering.

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When we look at genital syndrome of menopause, it affects a large share of menopausal women and it's undertreated partly because some women can't or won't use vaginal estrogen. A significant portion of the problem here is because conventional medicine, despite the standard of care recommendations that have now outlined that vaginal estrogen should be given to all women regardless of age, regardless of history, including breast cancer treatment, To protect against the genital urinary syndrome of menopause. Still to this day, insurance companies do not pay for it. Medicare does not pay for it. They don't pay for it to help reduce vaginal atrophy and UTI risk, which can cause sepsis and death, leading cause of, of infectious death in women who are older. It's because we look at it and they're like, you know what? Women only need that to have sex. And guess what? They'll probably have sex even if it hurts, cuz we don't care.