Urinary tract infections (UTIs) might sound like a inconvenience—but let’s not downplay how painful they can be and they can lead to something more serious if it spread upward toward the kidney. UTIs are a common cause of delirium (temporary confusion) which increases risk of falls and potential injury (particularly in osteoporotic women).
Frequennt UTIs are common after menopause, with many women experiencing recurrent/ chronic UTIs (defined as more than three in a year, or more than 2 in 6 months).
Why do UTIs become more common in perimenopause/menopause?
The microbiome of the vagina changes as a result of decreased estrogen levels, resulting in less “good bacteria”. With fewer protective bacteria present, it is easier for infection causing bacteria to enter the urethra and bladder and cause a UTI. Other estrogen related vaginal changes (dryness, thinning and reduction of elasticity) can lead to incomplete bladder emptying which increases infection risk.
What can be done?
Treatment of uncomplicated UTIs is the same regardless of age (antibiotics). However, if you are experiencing recurrent UTIs it is important to discuss preventative management with your doctor. This may include:
- Vaginal oestrogen cream, pessaries or tablets
- MHT may be appropriate if also experiencing other symptoms of menopause
- Prophylactic antibiotics
