UTIs After Menopause: How to prevent them?

While most individuals associate menopause with hot flashes and night sweats, many do not realize frequent UTIs are part of the below-the-belt menopause syndrome officially known as Genitourinary Syndrome of Menopause. Estrogen plays a crucial role in maintaining your bladder health and preventing UTIs. When your estrogen levels drop in menopause, your vaginal tissues become dry, thin, and less elastic, the muscles in your urethra weaken and the amount of good protective bacteria in your bladder decreases. These changes lower your body’s natural ability to fight bladder infections, increasing your risk of UTIs in menopause.   We spoke with Dr. Barbra Hanna, CEO and Co-founder of MyMenopauseRx about this crucial topic for women in all stages of menopause.

To Prevent UTIs In Menopause, You Must Determine If You Have a UTI.

 Since menopause and UTIs can both bring about urinary frequency and urgency, painful urination is the most tell-tale sign of a UTI in menopause. Obtaining an accurate UTI diagnosis is crucial for determining the correct treatment. Urine testing is recommended when your UTI symptoms arise.  If your urine testing is negative, taking antibiotics unnecessarily can increase your risk of developing antibiotic resistance.

For testing and infection confirmation, either a urine culture or PCR test is recommended. PCR urine testing is quick and easy to perform with a home test kit. A home test kit allows you to skip the trip to the lab or in-person doctor’s office required for a culture, speeding up your time to obtain an accurate diagnosis. Unlike urine cultures which take 3 days to determine if you have an infection, results from PCR testing are available in about 24 hours. Quick results ensure you get the right treatment for your symptoms. At MyMenopauseRx, we recommend you keep a MYUTI “Just in case” PCR urine test kit on hand for when those sudden UTI symptoms arise. Once your UTI is treated, we suggest you follow the following strategies to prevent another.

 “At MyMenopauseRx and for years in my gynecology practice treating UTIs, I saw menopausal women stuck in the cycle of UTIs bouncing from urgent care to their doctor's office, feeling frustrated with the lack of answers as to why they were recurring.  Utilizing advanced testing can be a powerful tool to rule in or out infection and then get on a treatment plan to resolve symptoms, whether that is antibiotics or vaginal estrogen.”

Dr. Barbra Hanna, DO, FACOG, MSCP

 Prevention of UTIs in menopause is simple.

 Most menopause gynecologists recommend using vaginal estrogen to prevent menopause UTIs. Vaginal estradiol is a form of menopausal hormone therapy that is applied directly in the vagina to restore your vaginal and bladder health.  Estradiol is a bioidentical form of estrogen, made from plants. FDA-approved estradiol is available in the form of vaginal creams, tablets, inserts, and rings. Vaginal estradiol creams and tablets are both generic and a prescription for either one is covered by almost all health insurance plans.

 Vaginal estradiol is safe for almost every woman to use in perimenopause and menopause. Treatment is meant to stay below the belt with very little absorbed into your bloodstream. Vaginal estradiol takes about 6-12 weeks to become effective and can decrease your risk of a menopausal UTI by about 75%. The doctors at MyMenopauseRx can help you decide what vaginal estradiol treatment is best for you and then send you a prescription to your local or mail-order pharmacy. Treatment is lifelong - once you stop using vaginal estrogen, your symptoms, and frequent UTIs will return.

 Some women find supplementing their diet with cranberry or D-mannose daily can help prevent UTIs. However, vaginal estrogen restores your bladder health and is more effective for the prevention of menopausal UTIs. 

UTI Prevention Is Key

 Now that you understand how menopause increases your risk of UTIs, it is time to take action to prevent those sudden painful infections. We recommend discussing your UTI care with a menopause-trained gynecologist or health clinician like those at MyMenopauseRx, good news is they also take most major insurance companies, to determine your personalized prevention strategies.

Taking care of your health during menopause is essential for maintaining your overall well-being and enjoying this new chapter of life. Stay informed, stay proactive, and remember that help is available to navigate these changes smoothly.