Urinary tract infections (UTIs) are no laughing matter, but for many women entering their 40s and in (peri)menopause, they can become an all-too-familiar nuisance. In this article, we'll explore why UTIs are more common as we age and particularly in the menopausal phase of our life. We’ll also share some practical tips on what you can do to keep them at bay.
Why UTIs Are More Common in Midlife and Menopause
Throughout the lifetime of a woman, her body undergoes numerous hormonal fluctuations, a process that becomes particularly evident during the phase of reproductive aging known as perimenopause. One of the most significant physiological changes during this stage is the gradual reduction in estrogen levels.
This depletion of estrogen levels and subsequent low levels of Estrogen has a direct impact on the urinary tract and increases its susceptibility to infections. As your Estrogen levels stay low in postmenopause you will continue to be at an increased risk of developing UTIs for the remainder of your life. Interested to learn how exactly low levels of Estrogen makes you more susceptible to UTIs?
How Low Estrogen Levels Make
Low levels of Estrogen impact the body in very many different ways but there are four key implications that tend to contribute to the increased incidence of UTIs in women over the age of 40:
1. Thinning of the urinary tract lining: With lower estrogen levels, the lining of the urinary tract becomes thinner and more prone to irritation, making it easier for bacteria to enter and cause an infection.
2. Weakening of the pelvic floor muscles: Estrogen also plays a role in maintaining the strength of the pelvic floor muscles. When these muscles weaken, it can lead to incomplete emptying of the bladder, which in turn increases the risk of UTIs.
3. Changes in the vaginal environment: Estrogen helps maintain the acidic pH of the vagina, which keeps harmful bacteria in check. With declining estrogen levels, the vaginal environment becomes more alkaline, allowing bacteria like E. coli to thrive and potentially cause UTIs.
4. Urinary incontinence: it is very common for a woman to experience some type of urinary incontinence at some point in her life. This is particularly common after giving vaginal birth and during menopause (up to 52.3% of women) due to hormonal changes and weakened pelvic floor muscles. The number #1 solution women use to manage bladder leaks are thick pads and adult diapers, which, if not changed frequently, can create a breeding ground for bacteria. Urinary Incontinence is hugely underreported and many women are unaware of better and safer products existing in the market.
These four implications are key factors in making urinary tract infections (UTIs) more prevalent as women age.
A Local Asian Perspective
In the Asian context, particularly in India, discussions about menopause and particularly symptoms that have to do with urinary and vaginal health, are often considered taboo. As a result, many women may not be aware of the increased risk of UTIs during menopause, and they might not seek timely medical advice or treatment. Furthermore, some traditional practices or beliefs may indirectly contribute to a higher risk of UTIs. Some examples include:
1. Insufficient water intake: In some households, traditional beliefs may encourage limiting water intake to avoid frequent urination. However, not drinking enough water can lead to concentrated urine, which may increase the risk of UTIs.
2. Use of traditional remedies: Some women may rely on traditional herbal remedies either based on Ayurveda or TCM to treat UTIs, which may not be as effective as modern medical treatments. Delaying or avoiding proper medical care can lead to complications and recurrent UTIs.
3. Genital hygiene: Some traditional Indian practices involve the use of herbs or powders to cleanse the genitals. However, these substances may cause irritation or disrupt the natural balance of bacteria, leading to a higher risk of UTIs.
It is important to note that these practices and beliefs vary widely across different regions and communities in India and broader Asia. To reduce the risk of UTIs, it is essential to follow good hygiene practices whether you are menstruating or not, drink enough water, and seek appropriate medical care when necessary.
What You Can Do About UTIs During Menopause
While UTIs may be more common during menopause, there are several steps you can take to reduce your risk and maintain good urinary health. Here are some tips to help you prevent and manage UTIs during this stage of life:
1. Stay hydrated: Drinking plenty of water throughout the day can help flush bacteria from your urinary system and reduce the risk of UTIs. Aim for at least eight glasses of water daily.
2. Practice good hygiene: Wipe from front to back after using the toilet to prevent the spread of bacteria from the rectum to the urethra. Also, avoid using harsh soaps or feminine hygiene products, as they can irritate the sensitive tissues of the urinary tract.
3. Urinate frequently: Empty your bladder regularly, and don't hold it in for extended periods. Make sure to urinate before and after sexual activity to flush out any bacteria that may have entered the urethra.
4. Wear breathable underwear: Choose cotton underwear and avoid synthetic materials that can trap moisture and promote bacterial growth.
5. Consider topical estrogen therapy: If you're experiencing recurrent UTIs, talk to your doctor about using topical estrogen therapy in the form of a cream, tablet, or ring. This can help restore the natural balance of the vaginal environment and reduce the risk of UTIs. However, be sure to discuss any potential risks or side effects with your healthcare provider before starting this treatment.
6. Strengthen your pelvic floor muscles: Engage in regular pelvic floor exercises, like Kegels, to help strengthen your pelvic floor muscles and improve bladder control. Yoga, pilates, or consulting a pelvic floor physiotherapist can also be helpful in maintaining good pelvic health.
7. Avoid bladder irritants: Certain foods and beverages, such as caffeine, alcohol, and spicy foods, can irritate the bladder and increase the risk of UTIs. Experiment with reducing or eliminating these from your diet to see if it makes a difference in your urinary health.
8. Use probiotics: Probiotics, found in yogurt and other fermented foods, can help maintain a healthy balance of good bacteria in the vagina and may reduce the risk of UTIs. You can also consider taking probiotic supplements after consulting your doctor.
9. Maintain a healthy lifestyle: Eating a balanced diet, exercising regularly, and managing stress can all contribute to overall health and well-being, which can positively impact your urinary health during menopause.
10. Seek prompt medical attention: If you suspect you have a UTI, don't hesitate to consult your doctor. Early diagnosis and treatment with antibiotics can help prevent complications and more severe infections.
Key takeaway
While menopause and UTIs might not be the most glamorous topics, understanding their connection and taking practical steps to minimize the risk can significantly improve our quality of life during this transitional phase. Menopause is a natural phase of life, and while it may come with its share of challenges, including an increased risk of UTIs, being informed and proactive can make a significant difference. By following the tips outlined above and seeking appropriate medical advice, you can maintain good urinary health and sail through menopause with confidence and grace.
So, let's raise our glasses (of water, of course!) to a future where every woman has the knowledge, support, and resources she needs to face menopause and UTIs head-on, and emerge even stronger on the other side. Cheers to our health, ladies!
Sources
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Kim, J. M., Park, Y. J., & Norwitz, E. R. (2015). Urinary tract infections in pregnant women with bacterial vaginosis. American Journal of Reproductive Immunology, 73(2), 162-172.
Raz, R., Stamm, W. E. (1993). A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. New England Journal of Medicine, 329(11), 753-756.
Beerepoot, M. A., Geerlings, S. E., van Haarst, E. P., van Charante, N. M., & ter Riet, G. (2013). Nonantibiotic prophylaxis for recurrent urinary tract infections: a systematic review and meta-analysis of randomized controlled trials. Journal of Urology, 190(6), 1981-1989.
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