UTIs during menopause & why they keep coming back



Menopause Advisor
@EileenDurward
Ask Eileen


24 June 2019

Today's topic

Today on A.Vogel Talks Menopause, I'm going to be talking about urinary tract infections and why they keep coming back in the menopause.

Why recurring urinary tract infections are common during menopause

Now, why are urinary tract infections so common in the menopause? And why can we get in the position where they just keep coming back and we can't seem to get rid of them?

One of the main problems here is that the menopause can affect the production of mucus in the vagina. Mucus in the vagina helps to sustain our friendly bacteria there and these are very different to the friendly bacteria that live in our digestive tract.

One of the things that these friendly bacteria do in the vagina is that they police the whole vaginal area and that includes the opening of the urethra which is the tube that leads up to the bladder.

So, if the production of mucus in the vagina decreases, this can have a marked negative impact on the level of friendly bacteria in the vagina and that can leave you much more vulnerable to picking up bladder infections. That's just a really simple thing that can happen to an awful lot of us.

The problem then, is that cystitis is horrible. It's so uncomfortable and it's very, very painful. When we go to the doctors, normally we get prescribed antibiotics. The main problem with antibiotics is that they, very often, kill off the friendly bacteria, so they can then decrease the level of the friendly bacteria in the vagina even further.

And that will leave you even more vulnerable to repeat infections and, at that point, it just becomes a vicious cycle. You end up getting an infection, you take the antibiotics, you have less friendly bacteria, you get another infection and so on. This, for some women, has lasted for months, and months, and months. When it gets too bad, they then end up in the hospital.

How to prevent recurring UTIs during menopause?

So, what can you do to prevent this? There are actually some very simple and easy things that you can just incorporate into your daily life that can be of benefit in this situation.

Drink plenty of water

First one, guess what? It's water, loads and loads of water.

The bladder is kind of known as one of the mucous membranes and it can start to dry out a little bit. The lining of the bladder can then end up becoming thinner. It can also become much more sensitive to the type of urine that's being stored in the bladder. So, if you are dehydrated and your bladder is starting to get very sensitive, then your urine will become very acidic. It will become very concentrated and that is going to irritate your bladder even further.

It's also going to make your bladder more prone to succumbing to the types of bacterial infections that cause cystitis. So, keeping your bladder flushed with water on a daily basis is really, really important here. And it's one of the main things that will help in this situation.

Don't allow you bladder to be full for long periods

The second thing here is don't let your bladder get overly full and don't hold on because it may have got to the point where your urine is starting to irritate the bladder, and if you keep a hold of that for an hour or two, then it's just going to make everything worse.

So, if possible, and I know there are those of you in jobs where you can't just run to the toilet every five minutes, but if you can, the minute you feel that you need to go to the toilet, then go because that, again, is going to keep the bladder free of any kind of acidic urine.

Avoid irritating feminine products

You need to avoid feminine products. We do know that vagina's smell can get stronger during the menopause and so women will tend to use vaginal deodorants. Don't use things like harsh soaps and shower washes that are absolutely full of chemicals because these are going to dry out and irritate the opening to the bladder even further.

And the weaker that is, then again, the more likely the bacteria are going to be able to get into the bladder.

Your underwear is important

Are you using cotton underwear? What kind of soaps and fabric conditioners are you using on your underwear? That, again, can irritate the whole vaginal area and make things more prone to these bacterial infections.

Don't wear thongs in the menopause. I have actually written a blog about this. I know it sounds a bit weird but there'll be a link here, and I'll go into that in a lot more detail. But here, all that's happening is, if you're wearing thongs, then the actual strip part is held right up tight between your back passage, the vagina, and the opening to the bladder, and bacteria can use that part of the thong to travel all the way down. This, again, can be a contributory factor for bladder infections and also vaginal infections as well.

Wipe from front to back

If you're moving your bowels, always remember to wipe from the front to the back. Again, you don't want any bowel bacteria ending up in the vagina or ending up in the bladder either.

Balance your hormones

You can look at balancing your hormones here. So, if it's appropriate, you could look at our Menopause Support.

This is known to help get your oestrogen levels up gently so that might have a knock-on effect on supporting your friendly bacteria in the vagina and also helping to keep your bladder nice and healthy as well.

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Exercise your pelvic floor muscles

Look at things like pelvic floor exercises and Pilates. These can be absolutely great for strengthening the bladder and keeping it in tip-top condition.

If you go for Pilates instruction, they can teach you very specific exercises that will keep your bladder nice and strong and also help to maintain your pelvic floor muscles which is really important as you go through, and after, the menopause as well.

Cranberries can help

You can try cranberry juice. This is a nice one for flushing out the nasty bacteria in the bladder.

The only thing here is, don't have it sweetened because sugary foods, sugary drinks can help to feed those bacteria. So, you know, again, no sugar in the cranberry juice and try and cut down on sugar and other sweeteners in your diet as much as possible. That can sometimes help to lessen the likelihood of bladder infections.

A herbal helper

We also have a licensed product called Uva-ursi and Echinacea which is traditionally used for bladder infections such as cystitis. Because it's not an antibiotic, it's not going to end up affecting the level of friendly bacteria in the vagina, so you're going to miss out on that step that's possibly going to lead to all these repeat infections.

A vaginal probiotic

The other thing to do is maintain the friendly bacteria in your vagina, so look for a vaginal probiotic. It's important to go with one specifically for the vagina because, as I've mentioned before, the level of friendly bacteria in the vagina are very different to digestive ones.

There is a company in the UK called OptiBac, which do one specifically for the vagina and it's called 'OptiBac For women.' So, again, well worth taking if you're in this cycle of urinary tract infections.

When do you need to see your doctor?

If you are getting pain, if you are getting blood in your urine, if you're getting a temperature, if it's getting to the point where you can't cope with the pain, it really is important to go and check with your doctor.

We know that antibiotics can be part of the problem, but sometimes you need the antibiotics just to get rid of the first infection. But you need to then look at sustaining the friendly bacteria in the vagina and all these other things afterwards, just to avoid this becoming one of these vicious cycles.

Hope you found this one helpful. If any of you out there have any other tips that are going to help in this area then we would love to hear from you.

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Did you know?

You won’t get the menopause the minute you turn 50! The average starting age is actually between 45 and 55 and it can often depend on a number of factors including hereditary, weight and health, however every single woman will have an individual menopause.

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