I'll never forget going to my urologist with a uti, and mentioning that I thought it might be cycling related, and he wrote 'Terry Liberator' on a prescription pad and it worked wonders. That was a long time ago, and I have since graduated to a butterfly, but yes, a saddle with a cut-out can help. You mentioned being peri-menopausal. I am too, and use an vaginal estrogen cream that also helps a lot. I know it makes a difference for my cycling, cuz once I didn't bother to carry it on a tour, and I was really sore until I got back to my base where I stored it. Also, be sure to use a chamois cream (I like chamois butter) since your tissues get thinner an dryer as you age.