Frequent UTIs and Menopause - What Can You Do?

4 minute read

By: Alloy Staff|Last updated: April 16, 2024|Medically reviewed by: Sharon Malone
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Are you running to the bathroom all of the time, having pain with urination, and experiencing pelvic pain? Do you recognize these tell-tale signs of a urinary tract infection (UTI) and wonder why you’ve been having more infections ever since you started transitioning into menopause? You are not alone. 

The natural changes that are happening to your body as it prepares to enter and finally reach menopause predispose you to develop UTIs. Thankfully, there are effective ways of preventing and treating menopausal UTIs.

How Do UTIs Happen?

Urinary tract infections are very common. 50% of women will develop at least one UTI in their lifetime. A UTI occurs when bacteria has entered the urinary tract, usually through the urethra, and has begun to multiply in the bladder. Symptoms of UTIs include the following:

  • Urinary frequency and urgency

  • Burning with urination

  • Urine that is cloudy, blood-tinged, and/or strong-smelling

  • Pelvic or abdominal pain

If the infection persists, you may develop a fever and lower back pain, indicating that your kidneys may be infected.

You may be wondering where the infecting bacteria comes from and how it enters your urethra. We all have bacteria that live in our genital and anal areas. This is completely normal. This bacteria can enter your urethra during sex or when you wipe yourself after using the bathroom (especially if you are wiping from back to front, which is not recommended), which can lead to UTIs. 

Why Are Menopausal Women More Prone to UTIs? Genitourinary Syndrome of Menopause

As you transition into menopause, your body’s estrogen levels fluctuate and eventually decrease. These hormonal changes affect your urinary tract, vaginal tract, and vulva in ways that can make you prone to developing UTIs. These physical changes and the symptoms associated with them are known as the Genitourinary Syndrome of Menopause (GSM).

Declining Estrogen Levels and Genitourinary Syndrome of Menopause

As your body’s estrogen levels fluctuate and trend downward, the tissues of your urinary tract become thinner, less hydrated, and less elastic. 50% of menopausal women suffer from GSM and experience symptoms such as vaginal dryness, vaginal and vulvar itching, vaginal tightness, sexual symptoms, and urinary discomfort.

Menopausal Symptoms that Increase Your Risk of UTIs

GSM leaves you vulnerable to UTIs. Changes in the bacterial flora of your vagina, changes in vaginal pH, and the breakdown of natural mucosal barriers that prevent infection are all thought to play a role. Knowing how the physiological changes associated with GSM affect your UTI risk will help you understand the ways in which you can lower this risk and prevent painful UTI symptoms from developing.

Thinning and Dryness of Vaginial Tissue

As your vaginal tissues become thinner and drier, they become fragile and susceptible to micro-tears and lacerations. Furthermore, your declining estrogen levels are causing changes in the bacterial makeup of your vagina, also known as the urogenital microbiome. Together, these changes make you more susceptible to bacterial infections.

Changes to Your Bladder

Along with your vaginal tissue, the tissues of your bladder and urethra (the duct that carries urine out of your body from your bladder) are also changing in response to declining estrogen. Your bladder becomes less elastic and has a decreased capacity, which can make it difficult for your body to hold as much urine as it did previously. You may experience urinary incontinence in which urine will leak from your bladder. 

Paradoxically, because your bladder is less elastic, when you do urinate, you may actually have difficulty emptying your bladder, leaving residual urine. This leftover urine in your bladder is a fertile field for bacterial growth, leading to more frequent urinary tract infections.

Urine is typically sterile and flows in one direction — out of your body. When your bladder is overloaded or retaining urine and the flow is hindered, that urine is more easily contaminated by bacteria, which leads to UTIs.

Alloy can help you understand your menopause-related UTI symptoms, provide you with treatment options that will help prevent them from reoccurring, and get you back to feeling like yourself.   

Prescription Antibiotics from Your Healthcare Provider

If you are experiencing the symptoms of a UTI, you should call your physician. Most physicians will treat UTIs with antibiotics that can be called directly into the pharmacy without an in-person visit. If you have had multiple UTIs or if you are not sure if what you are experiencing is a UTI, an in-person visit where you can be evaluated for other causes and can leave a urine sample may be the best option. Typically, you will need to take an antibiotic for 1 to 3 days, and you should experience significant improvement of your symptoms within 24 hours.

How to Prevent UTIs During Menopause

Knowing that menopausal women are prone to UTIs, it is natural that you will want to do everything you can to avoid getting infected. There are several steps you can take to improve your chances of staying healthy and UTI-free.

Menopause Hormone Therapy with Alloy

Menopause Hormone Treatment (MHT) is generally considered an effective treatment option for GSM-related changes and symptoms. At Alloy, MHT consists of FDA-approved, plant-based, bioidentical estradiol, which will supplement your body’s naturally declining estrogen levels. 

Estradiol Vaginal Cream

Research has shown that estradiol vaginal creams significantly reduce the number of recurrent UTIs in postmenopausal women. Topical estrogens restore vaginal pH and hydrate the vaginal walls, thus reversing the thinning and drying effects of your body’s decreased estrogen production. Estrogen creams are absorbed directly into the area of application and do not lead to increased levels of estrogen in your bloodstream. Remember, estrogen therapy is for prevention of urinary tract infections. If you have an active urinary tract infection, antibiotics are required. Not all urinary discomfort is due to infection. Pain with urination, urgency, and frequency that are chronic are more likely to be due to GSM.

Estradiol Pill or Patch

Estradiol pills or patches can be used for healthy women who do not smoke, have normal blood pressure, and have no history of heart disease, liver disease or blood clots. Systemic via estradiol pills or patches will increase the estrogen levels circulating in your bloodstream and will, therefore, not only treat GSM but will also help you with other menopausal symptoms, including hot flashes and sleep disturbances.

Estradiol Spray (Evamist®)

In addition to pills and patches, Estradiol Spray, or Evamist, presents a straightforward approach to managing GSM and reducing the risk of UTIs in menopausal women. This FDA-approved, transdermal spray delivers bioidentical estradiol directly through the skin, offering an effective way to supplement the body's declining estrogen levels without the need for oral intake or skin application.

Evamist is specifically designed for ease of use, providing a precise dose of estrogen with a simple spray on the forearm. This method ensures a consistent absorption of estrogen into the bloodstream, which can help maintain the health of the urinary tract and reduce the susceptibility to infections by supporting the tissues in the urinary and genital tracts.

Estradiol Gel

Estradiol Gel offers a unique approach for postmenopausal women dealing with frequent UTIs. Applied topically, this gel delivers estradiol directly to the body, helping maintain the health of the urogenital tract. 

By addressing the estrogen deficiency that often accompanies menopause, estradiol gel can help restore the natural balance of the vaginal flora and urogenital tissue, potentially reducing the risk of UTIs. Its localized effect focuses on the genital area, providing a targeted strategy to support urogenital health without significantly affecting systemic hormone levels.

Wipe from Front to Back

After having a bowel movement or urinating, always wipe from front to back. This will help reduce the spread of bacteria that can cause infection to your urethra after using the bathroom.

Drinking Cranberry Juice

The research into the effectiveness of drinking cranberry juice or taking cranberry extracts as a means of reducing the frequency of recurrent UTIs is mixed. But, you may know people who swear by it! There are currently ongoing clinical trials looking at the impact of cranberry juice consumption on the vaginal microbiome of post-menopausal women. Since we do know that drinking cranberry juice is safe and inexpensive and that it may be effective in preventing UTIs, you may consider giving this a try.

Take Showers Instead of Baths and Avoiding Fragranced Soaps

Other recommendations for preventing recurrent UTIs include taking showers rather than baths and avoiding the use of scented soaps. Warm bath water is thought to be conducive to bacterial growth, and scented soaps may alter the vaginal environment and make you more susceptible to UTIs. 

If You Are Suffering from Frequent UTIs as a Result of Menopause Symptoms, Alloy Can Help

If you are suffering from frequent UTIs as a result of menopause, Alloy can help you find relief. Start by taking an assessment. We will evaluate your answers and make treatment recommendations tailored to your needs.


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