Written by Dr. Alyssa Dweck, MS, MD, FACOG, Chief Medical Officer
You likely know the feeling of a urinary tract infection (UTI) all too well. Urgency, frequency and burning with urination are the hallmark symptoms of a UTI, and if you have had one you know it’s not fun. The symptoms can start gradually or come on suddenly, sending you running to the pharmacy or the gynecologist for evaluation and treatment. Left unchecked and untreated, a simple UTI can lead to a kidney infection or worse, hospitalization for sepsis.
UTIs are common, with more than 60% of women experiencing one in their lifetime. It’s also common for women to experience more than one UTI — many report recurrent infections. Familiar risk factors include poor bathroom hygiene habits, holding in urine for prolonged periods or sitting around in a wet bathing suit and even sexual activity. But there’s a lesser known factor that can lead to UTIs, and it’s tied to a natural event that all women will experience.
Can Menopause Cause Recurrent UTIs?
Declining estrogen levels during menopause can lead to more delicate and less elastic vaginal and vulvar tissue. This is a chronic and progressive issue. The changes experienced are broad; so much so that the term “genitourinary syndrome of menopause” (GSM) is now used to more broadly describe genital changes and related symptoms of dryness, pain during intercourse, irritation and bladder discomfort that can accompany menopause. Quite simply, the tissue around the urethra (where you urinate from) is not spared from this hormonal change. The periureteral tissue becomes prone to micro-abrasions (little cuts) during intercourse, allowing bacteria to migrate to the bladder. UTIs are more common during menopause for this reason in addition to changes in the vaginal microbiome, which can also occur during this time.
How to Prevent UTIs in Menopause
Always urinate before and after sex, especially if you are already prone to UTIs. The urinary stream can mechanically cleanse bacteria from the urethral opening, minimizing infection risk.
Consider a concentrated cranberry supplement if you have had recurrent infections. Proanthocyanins or PAC, a component found in cranberries, is theorized to make the bladder more slippery to E. Coli, a common UTI causing bacteria. Incorporating a probiotic supplement might also help. Some studies have shown that using probiotics to balance the vaginal microbiome may help to prevent the reoccurrence of some genitourinary infections; but more research is needed.1
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Supplements aside, be sure to hydrate well and urinate regularly. Holding the urine in for a prolonged duration might increase the risk of infection. Get out of wet workout gear or bathing suits in a timely manner too. Bacteria love to proliferate in moist, dark environments.
Managing vaginal dryness can also help to prevent UTIs in menopause. Regular use of a vaginal moisturizer will help to keep the genital tissue more elastic and supple and less prone to abrasion during intercourse. Bonafide’s Revaree® is made with a super moisturizer known as hyaluronic acid, a naturally occurring molecule in the body that can retain up to 1000x its weight in moisture, making it an effective, hormone-free option for relief. A good lubricant, used on demand during sex, can also help.
Remember, vaginal changes due to menopause can be chronic and progressive if not managed proactively, and UTIs are most definitely related. The good news? In most cases they are preventable with simple measures!