February 05, 2023
Most women associate menopause with mood swings and troublesome hot flashes, but many women also experience recurrent urinary tract infections (UTI) as another unwelcome side effect of the change of life. Although you may have had a UTI at some point in your life, as nearly half of all women have experienced a UTI at least once, menopause makes it much more likely for this type of infection to occur. Let’s explore why menopause makes you more vulnerable to chronic UTIs and what you can do to prevent them.
In trying to understand more about UTIs in women, it’s helpful to do a bit of anatomy review. (Don’t worry, there won’t be a test!) Here’s why women are more prone than men to develop a UTI. The bacteria that cause urinary infection enter your body through your urethra. This is the small tube that leads from your bladder out of your body and serves to carry urine away when you urinate.
Because this tube in women is so short, if bacteria get into the urethra, they can quickly multiply and spread upward into the bladder, causing a bladder infection. These bacteria can also move upward and infect your kidneys as well. Because the opening of your urethra is close to your vaginal and rectal openings, it’s in a place where bacteria are naturally present. Men have a much longer urethra that has to pass a long circuitous route from the male bladder and ultimately through the penis. Plus, the opening of the urethra onto the head of the penis is not located near the rectum. This much longer passageway and anatomical position makes it more difficult for bacteria to gain a foothold in men.
So why are postmenopausal women even more likely than younger women to get UTIs? Although younger women are more likely to get a UTI as the result of intercourse, when bacteria in the rectal and vaginal area can get transferred to the urethra, older women get infections mainly due to the effects of hormonal changes. After menopause, your levels of estrogen drop dramatically, and this drop has several negative effects. First of all, estrogen helps the “good” bacteria (called lactobacilli) that naturally occur in your vagina to flourish. These good bacteria help to lower the pH (a measure of acidity/alkalinity) in the vagina which controls bacteria that are likely to produce infection. So without estrogen’s protective effect, the infection causing bacteria can multiply and get out of hand.
There are other changes that come with menopause that also increase your risk of a UTI. These include a weakening of the musculature and tissues of the pelvic floor causing the pelvic organs to droop, thinning and dryness of vaginal tissue, and incomplete emptying of the bladder.
So what can you do to prevent postmenopausal UTIs from becoming a chronic problem?
A UTI is usually treated with a course of antibiotics to get the infection under control and clear the bacteria from your urinary system. Then the focus moves to preventing these episodes from recurring. Basic habits that you may already be implementing should be continued, such as wiping yourself from front to back to avoid spreading bacteria from the rectal area to the urethra, urinating after intercourse to flush bacteria from the urethra before they can get established, and taking showers rather than soaking in the bathtub. Staying well hydrated is important as well as a healthy diet.
You should also steer clear of harsh, drying soaps as well as feminine hygiene products like deodorants that are apt to further irritate already dry and sensitive skin. You may also want to speak with your physician about options for reducing the drying and thinning of vaginal tissues as well as help to get normal bacteria back in balance.
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