UTIs and Menopause

Menopause is the transition all women go through when their menstrual cycle and their reproductive years end.

As we age, your ovaries will produce less estrogen and progesterone, we will notice many changes in our body and fertility declines.

The onset age for menopause varies, but the majority of women start experiencing symptoms in their mid-forties, going initially through a period of perimenopause which can be few months to few years.

Menopause is diagnosed when you have gone 12 months without a period and can happen in your 40-50s. The majority of women reach menopause when they are in their late 40s and early 50’s. The following symptoms are experienced by the majority of women:

  • Vaginal dryness
  • Hot flashes
  • Night sweats
  • Sleeping difficulties
  • Chronic UTIs and after sex UTIs
  • Hair thinning
  • Dry skin
  • Mood swings
  • Weight gain 
  • Slowed metabolism
  • Changes in the breasts
  • Reduced libido

The three reasons why UTIs are so frequent at Menopause:

  • Anatomical changes
  • Bacterial resistance
  • Hormonal changes

Anatomical changes following child delivery.

This is not something mentioned or discussed enough by healthcare practitioners, yet it applies to the overwhelming majority of women, that is women who delivered one or more babies.

Anatomically, the neck of the bladder is attached to the anterior wall of the vagina(1) . The reality of labour and delivery is that dilation and the passage of the baby through the birth canal stretches the tissues to the point where it causes a certain degree of damage resulting in bladder prolapse and urinary incontinence.

This is overwhelmingly common among up to 90% of women. A prolapsed bladder makes it very easy for the bacteria to enter through the urethra and settle in the bladder lining.

Bacterial resistance

Globally 80% of all the antibiotics are used in farming, and 20% in human healthcare resulting in antibiotics in our food and water supply, including tap water.

This caused the bacteria to mutate and develop defence mechanisms against antibiotics, resulting in infections that are resistant to the main classes of antibiotics. Today the World Health organisation estimates that 50% of infections do not respond to the standard treatment.

Hormonal changes

The decline in the hormone production affects the vaginal tissue that becomes thin and easily irritable, making it prone to infection. At the same time, the estrogen decline causes changes in the pH of the vagina, thus creating an environment where bad bacteria can grow.

Dr Gemma Newman GP “During menopause women are especially vulnerable and most at risk of suffering from on going frequent or chronic UTIs even if they receive hormone replacement therapy. Preventing recurring on going UTIs, avoiding long term antibiotic use and having a healthy urinary function is infinitely better for our own immunity, health and wellbeing, as well as our environment.

Despite the commonly held belief that estrogen treatments at menopause prevent urinary tract infections, a recent Cochrane review concluded that while local estrogen supplementation is not beneficial long term, systemic estrogen therapy is, in fact, detrimental, resulting in worsening UI rates, compared with placebo (2) . This clearly demonstrates the need for targeted, consistent UTI prevention in menopausal women, independently of any hormone replacement therapy‘ – says Dr Laura Mann, founder of Blue Green Health

A combined approach is needed to address the above factors in order to clear and prevent the serious effect UTIs have on the quality of life and prevent complications that can lead to kidney damage and sepsis(3) depression, social isolation and ultimately reducing the burden on the healthcare system.

“Women at menopause could benefit from antibacterial and anti-inflammatory, clinically researched plant extracts, like Boswellia, Turmeric, D-Mannose, Green Tea polyphenols and Pumpkin seed, that support our urinary tract and help avoid bladder symptoms and on going antibiotic courses. URALIX is a new UK manufactured vegetarian supplement which is a blend of this natural botanical products in combination, which has been specifically designed to improve urinary health.” Dr Gemma Newman MBBCH DRCOG DFSRH MRCGP

Lifestyle steps to prevent UTIs:

  • Drinking plenty of fluids
  • Strengthening the pelvic floor muscles
  • Emptying your bladder periodically
  • Avoiding long baths and douches
  • Reduced alcohol and fizzy drinks

In addition to these steps, taking URALIX daily for bladder health:

  • can prevent bacteria from settling in the bladder,
  • supports bladder function,
  • helps avoid the bladder symptoms caused by sexual activity
  • maintains a healthy urinary tract.

References

  1. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1472875/
  2. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7086391/
  3. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4756185/