The Effects of Estrogen on Menopausal UTIs

About the Author: Mache Seibel, MD is a leader in women's health and menopause. He is editor of My Menopause Magazine and Menopause Breakthrough Action Plan. Download his Free EBook: Changes During the Change: What to Expect and What to Do About It. His latest book, The Estrogen Window, is due from Rodale in April 2016.

Sponsored by: URISTAT®

First it was vaginal dryness, then it was uncomfortable sex, and now it's urinary tract infections (UTIs). Are you wondering what is happening to your vagina during peri-menopause and menopause? It can be challenging to make sense of all the changes until you realize that they all have at least one thing in common: lower estrogen levels. Lower estrogen levels really define menopause and it leads to the symptoms so many women experience. Here's why.

Women's reproductive tracts and urinary tracts are very sensitive to estrogen, so as a woman transitions from her reproductive years into peri-menopause and menopause, less estrogen is available to those tissues, which causes the symptoms of peri-menopause and menopause. When estrogen is abundant during the reproductive years, the end of the urethra—the tiny tube that carries urine out of the bladder—typically is level with the tissues of the upper vagina and is protected from infection. As menopause approaches and estrogen levels become lower, the upper vagina tissues shorten and narrow and pull back from the tip of the urethra. That leaves the tip of the urethra exposed to more bacteria and at a higher risk for infection. This is a major difference in the risk of UTIs between menopausal and non-menopausal women.

If you are going through peri-menopause or menopause and are experiencing UTIs, it’s best to talk with your healthcare provider about what approach is best for you. If left untreated, a UTI can lead to serious consequences. I've seen many of my older patients develop UTIs that become a silent cause of sepsis or a total body infection. Over half of women will have a UTI in their lifetime, and about 25-30 percent of those women will be under 55 years old. For women 55 years old or older, the chance of developing a recurring UTI increases. More than half of those women will get another UTI within 6-12 months.

If you do have a UTI and are waiting to see your health care provider for treatment, you can alleviate the UTI pain with an over-the-counter urinary pain reliever like URISTAT® Pain Relief Tablets. This option provides fast and temporary relief for UTI symptoms including pain, burning, frequency of urination and urgency.

Despite a greater risk of developing a UTI during menopause due to lower estrogen levels, there are ways to lower the chance of getting one. Here are my top six ways to lower your risk of UTIs during peri-menopause and menopause:

1. Take low-dose estrogen. If your healthcare provider feels it is safe for you and you are comfortable taking medication, low-dose estrogen is a very effective way to help prevent recurring UTIs. Local estrogen in the form of a tablet, cream or vaginal ring all work. When estrogen is applied locally (directly to the reproductive or outer vaginal tissues), it mostly stays in the vaginal area. Some forms do get into the blood stream, so discuss this with your healthcare provider. A study found that for women with recurring UTIs, both local estrogen and chronic antibiotics reduced UTIs per year by roughly half. Additionally, local estrogen also improved women’s vaginal dryness and painful sex without contributing to antibiotic resistance. That's why estrogen is my first line choice in preventing UTIs during menopause.
2. Control or correct other medical conditions. Women with diabetes or who have a sensitive bladder issue, such as difficulty emptying their bladder, are at an increased risk of UTIs. Controlling blood sugar if you have diabetes or correcting bladder problems can help lower the risk of UTIs.
3. Take antibiotics, but don’t rely on them. Staying on antibiotics such as nitrofurantoin can be effective, but it can also lead to bacterial resistance. For that reason this approach is becoming less popular today.
4. Take probiotics twice daily. Instead of trying to kill "bad bacteria," some studies investigate putting "good bacteria" into the pelvic organs to recreate balance. Taking medication with lactobacillus, a type of good bacteria, twice daily is helpful. The higher the concentration of lactobacillus, the better. Compare labels and get the option with the most lactobacillus or "good" bacteria” in it.
5. Make small changes to your daily life. While some of my tips require you to visit a health care provider, there are steps you can take on your own to lower your risk of developing a UTI during peri-menopause or menopause, including staying hydrated by drinking plenty of water, wiping front to back when you use the bathroom, avoiding irritating feminine products like douches, powders and deodorant sprays, and wearing cotton underwear to keep the area dry.
6. Use the bathroom regularly. “Holding it” is never good. Not only is it uncomfortable, but it can also make it easier for bacteria to multiply in your urinary tract. Urinating after sex can also prevent bacteria from moving into the urethra.

More About URISTAT®

URISTAT® Pain Relief Tablets contain phenazopyridine HCl, which is the #1 doctor recommended OTC ingredient for fast, temporary relief of UTI pain. If you already have an antibiotic for treatment, you can still take these tablets in the meantime to relieve pain before the infection is gone completely.

While waiting to see your doctor, you can also perform a test in the privacy of your home to see if you really do have a UTI by using the URISTAT® UTI Test Strip. The test is included in the URISTAT® Relief PAK™, which also includes 12 URISTAT® Pain Relief Tablets.

If your self-test reads that you do have a UTI, it is important to share those test results with your health care provider. In order to prescribe an effective antibiotic, he or she may need to go through an in-office test with you. If your self-test results are negative, it is still a good idea to talk to your health care provider for his or her opinion. Let your doctor know that you have taken URISTAT® Pain Relief Tablets too.

Although URISTAT® can help identify UTIs and relieve UTI pain, it is important to know that it does not cure the infection.

Visit Uristat.com to learn more about UTIs and URISTAT® products, and to download a $1 off coupon.

Sources:

Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection. Medscape. http://www.medscape.com/medline/abstract/21498386