ARE YOUR FREQUENT URINARY TRACT INFECTIONS RELATED TO YOUR ESTROGEN LEVELS?

27 Mar 2023

When women go through menopause they often expect things like hot flashes, weight gain and no periods. These are the common symptoms portrayed in our media, however, did you know with the changing hormones of menopause you may also experience things like:

– Low sex drive

– Vaginal dryness

– Insomnia

– Joint pain

– Fatigue

If this is you – we need to chat.

There is one other sneaky side effect of menopause, and that is an increased frequency of urinary tract infections (UTIs).

UTIs are amongst the most common bacterial infection in women, with an increase of incidence occurring after menopause and 20-30% of these women will experience a recurrence. The definition of recurring UTIs,, for the purpose of this discussion, is more than two episodes in the last six months or more than three episodes in the last 12 months.

There are risk factors to discuss with your doctors that may be contributing to the recurrence, such as frequent sexual intercourse, poor hygiene, use of spermicide or condoms and abnormal pelvic anatomy.

After menopause, our body’s natural estrogen level will decline – some more than others – which causes the above list of symptoms. With this change in estrogen, the vaginal and pelvic floor musculature weakens, blood flow to the tissue changes, and the vaginal pH increases. This change of pH leads to changes in the ecosystem of the vagina – meaning less good bacteria are able to flourish and more bad bacteria can take route and cause problems.

Long term, low-dose antibiotic treatment is often recommended to women who are experiencing frequent episodes. However, this method causes increased bacterial resistance and more problems in the future. Though effective, constant antibiotic use is masking the problem – it is not a solution.

Studies show that when using topical estrogen, applied to the labia, women had fewer recurrences of UTIs. This means less time spent on antibiotics and a healthier gut and immune system overall. Bringing estrogen levels into the higher menopausal range can allow for the vaginal pH to adjust back to 4-4.5, where lactobacillus bacteria are able to survive and fend off any bacteria being introduced on a day-to-day basis.

Another interesting area of research in terms of UTIs and postmenopausal women is low Vitamin D status. Researchers are finding proper Vitamin D levels enhance the immune cells present directly in the bladder walls – meaning a more direct and efficient immune response when bacteria are invading the tissue.

When it comes to treating UTIs and preventing their recurrence, it is important to:

– always ensure you are eating a diet low in simple sugars

– drink lots of water to clear out that bladder

– void your bladder and/or showering after sexual intercourse

– take a good quality probiotic that contains the strains L. Rhamnosus and L. fermentum

However, if you are doing all of the above and those pesky UTI symptoms keep resurfacing – it is time to look into your hormone levels!

If you are interested in finding out more about hormone health or bio-idential hormone treatment (BHRT), please give the clinic a call at 519-265-8035 or click the ‘Book Online’ tab above to book an appointment today.

In health,

Dr. Kelsey Duncan ND

References:

Beerepoot M., and Geerlings S. Non-antibiotic prophylaxis for urinary tract infections. Pathogens 2016; 5: 36.

Hickling D., and Nitti V. Management of recurrent urinary tract infections in healthy adult women. Rev. Urol. 2013; 15: 41-48.

Nseir W. et al. The association between serum level of vitamin D and recurrent urinary tract infections in premenopausal women. Int J. Infect. Dis. 2016; 2013: 1021-9712.

Pabich WL., Fihn S., Stamm W., Scholes D., Boyka E-J., and Gupta K. Prevalence and determinants of vaginal flora alterations in postmenopausal women. J. Infect. Dis. 2003; 188: 1054- 1058.

Raz R. Urinary tract infection in postmenopausal women: Review. Korean J. Urol. 2011; 52: 801-808.