Oestrogen Does More Than You Might Think
Most of us associate oestrogen with our monthly periods, fertility, and common menopause symptoms such as hot flushes and night sweats.
However, oestrogen is also extremely important for keeping the bladder, urethra (the tube that carries urine from the bladder), and vaginal tissues healthy.
Oestrogen helps to:
- Support the lining of the bladder, urethra and vagina
- Maintain healthy blood flow to the area
- Keep tissues moist and flexible
- Support the body's natural defences against harmful bacteria
What Happens When Oestrogen Levels Fall?
At the beginning of perimenopause, and throughout the menopause transition, oestrogen levels gradually decline.
As this happens, the tissues of the bladder, vagina and urethra can become:
- Drier
- Less flexible
- More sensitive
These changes can make the tissues more vulnerable to irritation and bladder infections.
Lower oestrogen levels can also make it easier for harmful bacteria to gain a foothold, increasing the risk of cystitis and urinary tract infections.
But that's only part of the story.
The Link Between Oestrogen and Your Vaginal Microbiome
Most people have heard of the gut microbiome and the important role friendly bacteria play in digestive health.
However, we also have colonies of beneficial bacteria in the vagina.
When oestrogen levels are healthy, it helps beneficial bacteria known as lactobacilli thrive. These friendly bacteria help protect the vagina, urethra and bladder from infection. You can think of them as little guards and gatekeepers.
When oestrogen levels start to fall, the number of these beneficial bacteria can decrease too. This means there are fewer of these natural guards and gatekeepers protecting the area, making it easier for harmful bacteria to take hold and increasing the risk of cystitis and other urinary tract infections.
How Changes in Vaginal pH Can Increase Your Risk
Oestrogen also helps maintain the vagina's natural pH balance.
Although we often think of acidity as something negative, the vagina is naturally slightly acidic. This environment helps support beneficial bacteria and discourages harmful bacteria from growing.
As oestrogen levels decline, vaginal acidity can decrease as well. This creates an environment where unfriendly bacteria can flourish more easily.
These bacteria can move from the vagina into the urethra and then into the bladder, increasing the likelihood of cystitis and other urinary infections.
What Can Help?
The good news is that there are several simple things you can do to support your bladder and urinary tract health and help manage cystitis symptoms.
Stay Well Hydrated
One of the most important things you can do is drink plenty of water.
If your bladder and urethra are already sensitive, concentrated urine can become highly irritating. When you're not drinking enough water, urine becomes more concentrated and acidic, which may cause burning and discomfort when you go to the toilet.
A simple way to tell whether you're drinking enough water is to check your urine:
- Bright yellow or dark-coloured urine may indicate dehydration
- Strong-smelling urine can also be a sign that you need more fluids
Very often, drinking a large glass of water can help ease mild symptoms surprisingly quickly.
As a preventative measure, aim to drink plenty of plain water throughout the day.
It's also worth remembering that drinks such as tea and coffee don't count towards hydration in the same way and may irritate the bladder in some people.
Don't Hold Your Urine In
Try not to delay going to the toilet when you need to go.
Holding urine for long periods can place additional pressure on the bladder and may increase discomfort. It can also contribute to those occasional leaking moments that many women experience during menopause.
Go to the Toilet After Sexual Activity
It's also a good idea to empty your bladder after any sexual activity, as this can help reduce the risk of bacteria entering the urinary tract.
Be Careful with Intimate Hygiene Products
Avoid harsh soaps, shower gels and heavily fragranced products around the intimate area.
Instead, choose gentle, natural products where possible.
It's also best to avoid talcum powder and vaginal deodorants, as these can cause irritation for some women.
Watch Out for Bladder Irritants
Some foods and drinks may irritate the bladder or encourage the growth of unwanted bacteria, including:
- Coffee
- Alcohol
- Fizzy drinks
- Sugary foods
Reducing these where possible may help support bladder comfort.
Could Vaginal Oestrogen Help?
If you're experiencing significant vaginal dryness or recurrent urinary symptoms, it may be worth speaking to your doctor about whether vaginal oestrogen products could be suitable for you.
Taking a Sea Buckthorn oil supplement is another option many women find helpful. It is often used to support moisture in the vaginal tissues and may also help support the bladder and urethra.
Herbal Support for Cystitis Symptoms
For herbal support, you may wish to consider herbs such as Uva Ursi and Echinacea.
These herbs are found in A.Vogel Cystorelief Oral Drops and are traditionally used to help relieve symptoms of cystitis, including:
- Burning sensations
- Frequent urination
- Urgency to urinate
The drops are easy to carry with you and can be added to a small amount of water several times a day when needed.
A.Vogel Cystorelief Cystitis Uva-Ursi & Echinacea Oral Drops
- RELIEVE MINOR SYMPTOMS OF CYSTITIS: Traditional herbal medicinal product used to relieve minor urinary complaints associated with cystitis in women, such as burning sensation when urinating and frequent urination
- FRESH HERB TINCTURE: A combination of two herbs – Uva-ursi and Echinacea purpurea.
- HOW TO USE: Adults over the age of 18 take 15 drops 2 to 5 times daily, in a little water.
Antibiotics and Recurrent Infections
This is an important point to be aware of.
If you have a bladder infection, your doctor may prescribe antibiotics. These are often very effective at clearing the infection.
However, antibiotics can also affect the beneficial bacteria living in the vaginal area. This may leave some women more vulnerable to repeat infections in the future.
For this reason, some women choose to support their vaginal microbiome afterwards with a vaginal probiotic specifically designed for vaginal health rather than a standard digestive probiotic.
When Should You Speak to Your Doctor?
Cystitis symptoms can worsen quite quickly, and the longer an infection is left untreated, the more difficult it can become to clear.
If you develop symptoms that you think may be cystitis, it's important to get them checked by your doctor.
If tests show there is no infection present, you can then explore some of the self-help measures discussed above.
And remember, water really is the number one tip.
At the first sign of bladder discomfort, try drinking a large glass of water and continue to increase your water intake over the next 24 hours. In many cases, this can help settle mild irritation quickly.
However, you should seek medical advice promptly if you experience:
- Blood in your urine
- Significant pain
- Severe or debilitating symptoms
- Pelvic pain or discomfort
Many Women Experience This Too
Cystitis is incredibly common during perimenopause and menopause.
In fact, including myself, I don't think I've spoken to a single woman who has gone through perimenopause or menopause without experiencing at least one episode of cystitis or bladder irritation.
We know just how distressing and uncomfortable it can be.
If you've experienced cystitis during menopause, sharing your story may help reassure and support other women going through the same thing.
After all, sometimes hearing how someone else coped can make all the difference.
Other articles you might find helpful:
6 vaginal and urinary symptoms of menopause
Urinary incontinence in perimenopause and menopause – what you need to know
