One out of every two women in menopause is living with chronic UTI’s.

A chronic UTI is defined as 3+ UTIs in a single year. According to a 2019 study in the Journal of Molecular Biology, 55% of women in menopause will experience chronic, recurring UTIs.

How Menopause Contributes to Chronic UTIs

While menopause itself does not directly cause chronic UTIs, there are several factors associated with menopause that may increase the risk of UTIs in women. Here are some reasons:

  1. Hormonal Changes: During menopause, there is a decline in estrogen levels. Estrogen helps maintain the health of the urogenital tract, including the bladder and urethra. The decrease in estrogen can lead to changes in the urinary tract, making it more susceptible to infections.
  2. Changes in Vaginal pH: Estrogen plays a role in maintaining the acidic environment of the vagina, which helps prevent the growth of harmful bacteria. As estrogen levels decrease, the pH of the vagina may become less acidic, creating a more favorable environment for bacteria, including those that can cause UTIs.
  3. Thinning of Urethral Tissues: The decline in estrogen can result in the thinning of tissues in the urethra and bladder. Weakened tissues may be more prone to infections.
  4. Altered Vaginal Microbiome: Menopause can influence the composition of the vaginal microbiome. Changes in the balance of bacteria in the genital area may contribute to an increased risk of UTIs. Specifically, a decrease in Lactobacillus, which is a “good” bacteria which keeps out “bad” bacteria.
  5. Urinary Incontinence: Menopausal women may experience urinary incontinence, which can increase the likelihood of bacteria entering the urethra and causing infections.

Managing Chronic UTIs in Menopause Involves Dual Treatment

As you can see, the changes caused by menopause indicate that you will need to manage both the urinary tract and the vaginal canal to break the chronic UTI cycle.

1. Urinary Tract Therapeutics: D-Mannose and Cranberry

D-Mannose Powder To Clear UTI Symptoms

A natural supplement called D-Mannose has been proven to clear the symptoms of a UTI faster and more completely.  It is a powder that is extracted from fruits and produces glucose, the healthy sugar our body makes.

The UTI-causing bacteria are attracted to the D-Mannose sugar molecules, so they let go of the bladder lining and bind to these molecules which are then quickly washed out with the urine.

It is effective against the E. Coli and Klebsiella pneumoniae, representing 80% of all bacteria.  Unlike antibiotics, it does not harm the good bacteria, and it does not have the digestive and vaginal side-effects.

High-Powered Cranberry Extract  To Protect Against New UTIs

All of the latest scientific research confirms that cranberry does not help alleviate UTI symptoms; BUT at certain levels of concentration, it keeps new infections away.

Cranberry’s role is to coat the bladder so that any new bacteria will not be able to adhere to the slippery surface it creates.  Only cranberry products which show a daily dose of  “36 mg PAC” on the label will prevent new UTIs.  PAC stands for proanthocyanidins, which are the phenols which make cranberry work.  Read more about how cranberry works here.  So once UTI symptoms are no longer present, or urine test strips show negative UTI results, you can take a daily dose of cranberry to stay UTI-free.

2. Vaginal Therapeutics: Estrogen and Probiotics

Menopause gradually causes a loss of both the estrogen hormone and the “good” Lactobacilli in the vagina that help stave off UTIs.

Estrogen To Protect Against UTI Bacteria

A 2020 article in “Urology” provides a detailed case study and findings regarding the use of estrogen therapy to address these imbalances in estrogen and Lactobacilli.

As estrogen is depleted, the vaginal wall becomes dried out and infectious bacteria settle in its crevices, forming colonies and contributing to both vaginal and urinary tract problems.   These alterations allow a more hospitable environment for bacterial growth and increase the risk of UTI.  The application of estrogen (delivered either via ring or cream) has been clinically proven to be another way to defend against UTIs.

There are several brands of estrogen cream that are recommended by doctors.  Estrace cream or Estradiol vaginal gel, insert, and ring are most frequently recommended.

Probiotics To Replenish Lost Lactobacillus

Lactobacillus is the most frequently isolated microorganism from the healthy human vagina (this includes four strains: Lactobacillus crispatus, Lactobacillus gasseri, Lactobacillus iners, and Lactobacillus jensenii). These vaginal lactobacilli have been touted to prevent the invasion of bacteria by keeping their population in check.  Probiotics are a way to manage the right balance of vaginal flora.

There are many ways to administer probiotics and an overwhelming number of probiotic strains.  While taking  oral probiotics for vaginal balance will work, research shows that using probiotic suppositories is much more effective.  In this 2021 article the conclusion was as follows: “Vaginal suppositories containing the GAI 98322 strain of Lactobacillus crispatus effectively prevent episodes of recurrent cystitis (UTIs), both during administration and for at least 1 year after administration.