Pink Prescriptions: Urinary Tract Infections


Do UTIs increase with menopause?
I never had a UTI in the past, but now that I am menopausal, I seem to get them often, is
there a connection?

Women may not want to hear this but the answer is yes; being menopausal does increase your risk of urinary tract infections. This can be due to a few different reasons and some women will be more at risk than others. After menopause, the lack of the hormone estrogen leads to changes in both the vagina and the urinary tract. The vaginal wall lining becomes thinner, the muscles become more relaxed and the vaginal pH changes.  Bacteria like enterobacteriaccae  (a main cause of UTI) overgrow as the presence of lactobacillus decreases.  You can think that “bad” bacteria out numbers your “good” bacteria in your vagina.  Another cause is when the vaginal walls become more relaxed the urethra (the tube leading from the bladder that empties the urine) comes in contact more with the vaginal bacteria.  The urethra itself also undergoes changes due to the lack of estrogen as it’s walls become thinner and less strong (this also leads to increased chances of urinary incontinence or leaking). Menopausal women with diabetes, cystocele (bladder drop), catheter use, urinary retention or poor diet/nutrition are at even more risk for UTI.

What can I do to avoid this since I can’t avoid menopause?
The good news is that there are some basic steps women can follow to help decrease their risk of getting a UTI!

• Ladies should always urinate when they have the urge and not “hold” their urine.
• Wipe front to back when urinating.
• Frequently wash the vaginal area well.
• Drink adequate amounts of water.
• Avoid diet choices high in caffeine, sugar or salt.

Women can have their doctor prescribe vaginal estrogen to help the vaginal walls and urethra stay strong and healthy. Women can take probiotics or use vaginal pH balance gels to help promote the growth of “good” bacteria.
-Tracy Blusewicz, M.D., F.A.C.O.G., Board Certified OB/GYN, Advanced Women’s Care

Is cranberry juice effective in preventing a UTI?
Cranberry juice or cranberry extract can be an effective and safe method for reducing the frequency of UTIs.  Cranberry as a preventative strategy is thought to work by inhibiting the adherence of pathogenic bacteria to the lining of the bladder. Though the exact component of cranberry has not been identified, nor the optimal dose or form of cranberry described, analysis of multiple trials suggests cranberry can reduce the incidence of recurrent UTIs by 35%.
-Manuel J. Perez, M.D., Board Certified Urologist, The Urology Group

What are the symptoms of UTIs?
The symptoms of a bladder infection generally are burning when you urinate, having to go suddenly or feeling like you need to go but only a little comes out (urgency). Another symptom is having to go again after you just went (frequency).  

UTI implies germs are the cause, but often women may have some or all of these symptoms without germs. That's why it is important to see your doctor when you have these symptoms and not be treated over the phone. A culture should be done to determine if a germ is involved. Many women are frustrated by "recurrent infections" and their failure to get better with antibiotics when the problem is not an infection (caused by germs) at all.
-Michael Staley, MD, FACS, Board Certified Urologist, Coastal Carolina Hospital

Does having sex increase UTIs?
In general, intercourse is not thought to be a direct cause, but rather a risk factor, for urinary tract infections. There is some increased risk if certain precautions are not taken. The urethral orifice, the vagina and rectum are all in close proximity to one another. Thus, during intercourse bacteria can be introduced from the rectum or the vagina into the urethra. Therefore, if one makes a point to go to the restroom each time after intercourse and wipes off their genitals, they shouldn't have an increased risk of urinary tract infections. There are certain conditions that make this risk higher and if a woman is having infections after intercourse frequently, she should contact her doctor for a more thorough look into the problem. Some women require antibiotics after intercourse but this is rare.
-Randall Royal, MD., Board Certified OB/GYN, Riverside Women's Care

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