Why UTIs Keep Coming Back During Menopause (And What You Can Do)
Recurrent urinary tract infections (UTIs) can be a common occurrence during perimenopause and menopause—but why? Menopause expert Jessica Bell walks through the causes of UTIs during this phase of life and what you can do about it.
Transcript:
Jamie Forward:
UTIs are more common in menopause. So, can you talk a little bit about why UTIs occur more frequently during that time?
Jessica Bell:
As we go through this midlife transition, perimenopause and menopause, we will all experience tissue changes at the level of the vagina, the vulva, the urethra, the vestibule. These are all detailed, different anatomies of the pelvis, of the pelvic health. So, when estrogen declines, there are pH changes that occur inside of the bladder that can create a space for bacteria to kind of overgrow. So, I’ll have to describe this mechanism in a few different ways.
So, first of all, nearly all of us will experience estrogen decline at the tissue level, and that happens no matter how much – sometimes people think I would say, “Gosh, well, if you’re using it, if you’re making sure that there’s good blood flow to that area, maybe with stimulation, those kind of things, that the estrogen changes won’t happen.”
That is definitely a misnomer. So, estrogen changes happen without our control. They happen to all of us. And at the urethra, the tissue can become very stiff and rigid and actually allow bacteria to enter more easily. And then when bacteria enters and it’s in the bladder there, there are pH changes in the bladder that allow an overgrowth of that bacteria to occur.
So, that is how urinary tract infections can become more prevalent and common as we go through that midlife transition. Some of us might know grandmas, aunties, some of the ladies that are a bit older than us are landing in urgent cares, emergency departments, sometimes hospitalized with these infections, and there’s also a misnomer there that it just has to do with maybe toileting or bathroom habits, those kinds of things, but that’s actually not the primary driver or the primary cause.
It is the low hormone effect that is the consistent experience that they’re having that contributes to those urinary tract infections and hospitalizations. And honestly, that’s a really big deal, and it doesn’t have to be that way. We can practice prevention in that area and not just be reactive. I always say, it’s a silly thing.
We know that these hormonal changes contribute to these urinary tract infections, and oftentimes we’re waiting until they occur or until they become recurrent, and then we give people the treatment that would have prevented that all along. So, I sometimes use the analogy, we brush our teeth so we don’t get cavities in the future, and we can actually start the treatment now to prevent those urinary tract infections in the future, or for some people, pain with intimacy, with themselves or others as well.
Jamie Forward:
Okay. And just to touch on this while we’re on the subject of UTIs, what about cranberry juice, cranberry pills, probiotics? Is that helpful?
Jessica Bell:
Yeah, good question. So, our data shows that drinking cranberry juice is not helpful for preventing urinary tract infections. Some of my patients still do that, and they’re like, “It works for me.” I never negate a person’s experience, you know? So, but our data shows that pushing cranberry does not help that. There is now a derivative, there is a medication that a person can use.
It’s a different mechanism, though, that can be a tool in the toolbox for UTI prevention. And that’s also one of the ways that I describe it sometimes as well. I mean, it’s not only treating the low hormone effect.
There are other pieces to that recurrent UTI puzzle, but that is a huge one, and one that I would say we can kind of control a little bit as well, or prevent.