Estrogen Specifically Impacts Positive Bacteria
In the second part of the study, the researchers focused on the 34 women who were taking menopausal hormone therapy. These women had more of a particularly helpful species of bacteria, Lactobacillus, in their urine.
The findings in this study suggest that hormone therapy may encourage colonization of the urinary tract with potentially beneficial Lactobacillus species. This in turn may provide colonization resistance against infection, De Nisco explains.
These results add to existing research supporting the beneficial effects of estrogen on the urogenital microbiome and its possible impact in reducing the prevalence of chronic UTIs, Dr. Ellerkmann says.
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Reframing Your Physical Symptoms
Even with the possible solutions mentioned above, the changes in your reproductive and urinary organs at menopause can be frustrating. Sometimes, rather than a physical solution to these challenges, a shift in mindset might be the answer. If a person cannot change a situation in their life, sometimes they can change their emotional response to the situation. This is where reframing can help.
Cognitive reframing is a tool in which a situation does not change, but your reaction to the situation or your perspective on the situation does change. With menopausal symptoms, this may include looking not at the negatives of your situation, but the positives instead. Rather than focusing on your vaginal dryness and how it affects your sex life, perhaps focus on how you are free to have sex whenever you wish without the thought of birth control. If the cost of vaginal lubricants disturbs you, consider how much money you are saving on pads and tampons. There is also a freedom that comes with no longer needing to make sure you have these menstrual products on hand.
Reframing is not always easy to do, and sometimes you may need to “fake it until you make it.” Remember there are silver linings in nearly any situation.
Trying to create a sense of gratitude can also be helpful. Many people have found that keeping a gratitude journal is a good way to shift their frame of mind from the negative to the positive. Try to think of three positives in your life every day.
Utis And The Female Anatomy
Infection-causing bacteria typically gain entrance to your urinary tract through the urethra, that tiny tube-like structure that carries urine away from your bladder and out of the body. Once they gain a foothold in the urethra, bacteria can quickly multiply and spread upward into the bladder and other structures in your urinary system.
These structural differences help explain why women are much more likely to develop UTIs than men. Female anatomy and hormonal changes also play significant roles in recurrent postmenopausal UTIs.
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What Causes Urinary Tract Infection
The vast majority of urinary tract infections are caused by the bacteria Escherichia coli , which is usually found in the digestive system. However, other pathogens may cause a UTI. These include:
- Klebsiella pneumonia
- Enterococcus faecalis
- Staphylococcus saprophyticus
The bacteria may infect any part of the urinary tract bladder, urethra or kidneys. Depending on where the infection occurs, the UTIs are often known as:
- Cystitis infection of the bladder
- Urethritis infection of the urethra
- Pyelonephritis infection of the kidneys
The infection in urethra and bladder is usually not very serious and clears up with treatment. Similarly, ureters very rarely get infected. However, if a UTI reaches the kidneys, it may lead to kidney infections and a person may have to go to the hospital for treatment.
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Why Are Utis More Common During Menopause
UTIs are caused by growth of bacteria in the urinary tract. This includes the kidneys, ureters , bladder and urethra . Unfortunately, bacteria are amazing at getting into the urinary tract by travelling up the urethra from your genital area, especially thanks to the changes seen in this area of your body during your menopause journey. There are quite a few changes that, unfortunately, make getting a UTI more likely during menopause.
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Oestrogens For Preventing Recurrent Urinary Tract Infection In Postmenopausal Women
Recurrent urinary tract infection is defined as three episodes of urinary tract infection in the previous 12 months or two episodes in the last six months. In postmenopausal women the prevalence rate for having one episode of UTI in a given year varies from 8% to 10%. This increased risk is associated with a decrease in oestrogen levels. The use of oestrogens has been proposed as a preventive strategy. This review identified nine studies treated with oestrogens versus placebo, no treatment or antibiotics. Vaginal oestrogens reduced the number of UTIs when compared to placebo. All studies reported adverse events for the oestrogen treatment groups. These included breast tenderness, vaginal bleeding or spotting, vaginal discharge, vaginal irritation, burning and itching.
Based on only two studies comparing vaginal oestrogens to placebo, vaginal oestrogens reduced the number of UTIs in postmenopausal women with RUTI, however this varied according to the type of oestrogen used and the treatment duration.
Recurrent urinary tract infection is defined as three episodes of urinary tract infection in the previous 12 months or two episodes in the last six months. The main factors associated with RUTI in postmenopausal women are vesical prolapse, cystocoele, post-voidal residue and urinary incontinence, all associated with a decrease in oestrogen. The use of oestrogens to prevent RUTI has been proposed.
Risk Factor Of Treating Utis Without Antibiotics
Some research has found that about 25 to 40 percent of uncomplicated UTIs may wither away on their own. In other words, the bacteria from E.coli may flush out from the urinary tract without any medications. However, this usually happens in women with no other health issues, which can complicate things.
But, one may have some serious risks due to leaving a UTI untreated. The person can have pyelonephritis and sepsis, which is why it becomes very important for the patient to consult with the doctor and seek treatment for betterment if any suspicious symptoms arrive.
However, there is some risk factor that can make the infection more complicated
-
bacteria species are already resistant
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to conditions that affect the immune system and can have HIV, cardiac disease, or, at worst, cause lupus
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changes in the urinary tract or organs can help in swollen prostate or reduce the urine flow.
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How Do Probiotics Work In The Urinary Microbiome
Research has shown that Lactobacillus probiotic strain works in three different ways in your urinary system. One way is by producing lactic acid in the microbiome that helps fight and kill infection-causing bacteria and viral pathogens. Another way is the formation of protective epithelial colonies in the urinary tract lining that prevents any bacteria from settling and colonizing. The last way is by stimulating the immune response to kill any foreign microbe in the body .
You should keep in mind that chronic UTI should only be treated by using properly prescribed medicines by your doctor. Dont start supplements without prior knowledge of your condition and expect relief from chronic infections. Probiotics are good for preventing recurrent UTI and keeping you safe in the long term.
How To Manage Recurrent Utis In Postmenopausal Women
Although there is no clear-cut solution to the problem of recurrent UTIs in postmenopausal women, “various strategies can be employed that have found success,” write Wade Bushman, MD, PhD, and Brian V. Le, MD, MA.
Recurrent urinary tract infections in postmenopausal women can be a particularly challenging problem. We acknowledge there is no clear-cut solution to this vexing problem, but various strategies can be employed that have found success.
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Asymptomatic bacteriuria is common in postmenopausal women, and the incidence increases with age, diabetes, and sexual activity. There is a correlation of bacteriuria with risk for symptomatic UTI however, it is not recommended to treat asymptomatic bacteriuria, as it may paradoxically increase the risk of symptomatic UTI. The goal, then, is to treat as necessary but to avoid overtreatment.
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Next: Detailed history
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First, a detailed history must be taken to elicit symptoms, severity , frequency , microbiology , comorbidities, prior evaluations, treatments, and responses to date. Contributing conditions may be identified on physical examination, bimanual and vaginal exam, and post-void residual measurement.
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Next: Treatment of contributing factors
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Use Of Probiotics For The Prevention And Treatment Of Utis
Vaginal lactobacilli have protective roles: they are able to produce antimicrobial compounds such as lactic acid, hydrogen peroxide to produce a biosurfactant that inhibits the adhesion of uropathogens to surfaces and to stimulate non-specific innate immune system. Restoration of vaginal flora with lactobacilli using probiotics is an effective strategy to decrease the frequency of UTIs.
A recent study suggests that the administration of vaginal suppositories containing L. crispatus GAI 98332
Data Synthesis And Analysis
Outcomes measured in only one trial were reported narratively. Outcomes measured in more than one trial were synthesised quantitatively. We estimated between trial heterogeneity using the I2 statistic and used random effects meta-analyses to estimate pooled risk ratios and 95% CIs. We undertook sensitivity analyses to examine treatment effects according to study quality and assessed the impact of including data from a potentially eligible trial where the study author did not reply to our request for data on older participants.
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How Do Utis Affect Pregnancy
Changes in hormone levels during pregnancy raise your risk for UTIs. UTIs during pregnancy are more likely to spread to the kidneys.
If youre pregnant and have symptoms of a UTI, see your doctor or nurse right away. Your doctor will give you an antibiotic that is safe to take during pregnancy.
If left untreated, UTIs could lead to kidney infections and problems during pregnancy, including:
- Premature birth
Causes Of Utis In Menopause
UTIs are most common in women of childbearing age, but they can occur at any age. UTIs are more common in menopause because of changes in the urinary tract. The lining of the urethra and bladder changes, making it easier for bacteria to travel up the urethra and enter the bladder. The decreased production of estrogen during menopause also decreases the acidity of urine, making it more hospitable for bacteria. In addition, changes in sexual activity and kidney function can also contribute to UTIs in menopause
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At Least 50 Percent Of Women Will Experience A Uti In Their Lifetime
Editorial note: This article first appeared in the Womens Integrated Services in Health May 2015 newsletter.
Urinary tract infections account for eight million health care visits per year at the cost of $1.6 billion. Urinary tract infections account for fifteen percent of all patient prescriptions written. Unfortunately, women affected by recurrent urinary tract infections may attempt to cope with symptoms on their own instead of seeking treatment.
Recurrent urinary tract infection is a serious health condition that increases with age and peaks in menopausal women. The rate of urinary tract infections is 1 percent in young children and climbs to approximately 15 percent at age 60, and peaks at 25-50 percent after age 80. Whereas sexual activity and pregnancy are risk factors in younger women, vaginal thinning or vaginal atrophy, illness, and hospitalization are more important risk factors in menopausal women.
Consider Adding Some Cranberry To Your Diet
Research supports the benefit ofcompounds found in cranberries, known as proanthocyanidins , for reducing the risk of getting a UTI. If given a chance, bacteria that enter the urinary tract will attach themselves to the inside surface of the bladder wall.
Studies have shown that it takes36 mg ofproanthocyanidins to help fend off bacteria from sticking to your bladder wall before they have a chance to hang around and cause an infection. You can get this level of PACs in 8-10 oz of 27% cranberry juice, 1 ½ cups of fresh cranberries, ½ cup of cranberry sauce, and 1 ounce of sweetened dried cranberries.
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Causes Of Urinary Tract Infections
UTIs are usually caused by bacteria from poo entering the urinary tract.
The bacteria enter through the tube that carries pee out of the body .
Women have a shorter urethra than men. This means bacteria are more likely to reach the bladder or kidneys and cause an infection.
Things that increase the risk of bacteria getting into the bladder include:
Bladder Health For Older Adults
Everyone uses their bladder many times each day, but they may not know what to do to keep their bladder healthy.
Located in the lower abdomen, the bladder is a hollow organ, much like a balloon, that stores urine. It is part of the urinary system, which also includes the kidneys, ureters, and urethra. Urine contains wastes and extra fluid left over after the body takes what it needs from what we eat and drink.
As you get older, the bladder changes. The elastic bladder tissue may toughen and become less stretchy. A less stretchy bladder cannot hold as much urine as before and might make you go to the bathroom more often. The bladder wall and pelvic floor muscles may weaken, making it harder to empty the bladder fully and causing urine to leak.
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Why Uti Symptoms Persist After Antibiotics
The pain or residual discomfort in the bladder can linger long after the bacteria is cleared by the antibiotics. The reason for this is because the damaged lining of the bladder must regenerate because of all the inflammation. Inflammation is the immune response that releases white blood cells that try to clear the bacteria. When the infection is severe, biofilms can form that prevent the immune response from working right and the antibiotics may not penetrate the biofilms very well. Biofilms are a conglomeration of bacteria, cells, and sugars that create a surface slime. They are responsible for treatment failures, especially in the immunocompromised and are a continual source of resistant bacteria.
Because the bladder gets no rest since you must continue to urinate, the bladder wall muscle contracts and triggers the nerves to fireand that is painful. Of course, the residual pain could be an incomplete treatment or a recurrent infection, possibly due to antibiotic resistance.
Like any infection or trauma, the tissue takes time to heal and the nerves take time to settle down. Until then, you may continue to experience discomfort. The key is to keep well hydrated. Dont avoid fluids for fear of pain when urinating because that keeps the bacteria concentration high and they will continue to multiply until killed or washed out of the body with urination.
Senior Toileting Tips For Preventing Uti
A senior could be having problems emptying their bladder. If possible, when they urinate in the toilet, count to thirty once they have finished and then encourage him to give it another push. In potty-training my disabled son, an autism specialist told me that after the initial urge is gone, the brain can stop/reduce the message that they still needed to go. I know Ive tried it myself and I am always amazed at how much Ill go again after the count. Sorry if thats TMI! Lastly, if they are wearing adult diapers, you may need to be changing them more frequently since they are bacteria sponges. Rainmom
Encourage/help older folks get to the toilet at least every 2 hours. Sometimes, older folks dont feel thirsty, sometimes they forget to drink, but sometimes, they are afraid of urinary accidents and avoid drinking enough fluids. Its very important to keep going to the bathroom to empty that bladder. MomDaughterRN
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Are There Herbal Remedies To Help Me
It is possible to take herbal remedies to support home measures while easing your symptoms of a bladder infection. Uva-ursi, also known as bearberry, is a small plant found in Europe, and has flowers of similar shape to a bladder. However, it is for more than this coincidence that Uva-ursi is used to relieve the symptoms of a bladder infection. It is thought to have antiseptic properties and promotes excretion of bacteria in the urine.
However, if you are looking for a herbal solution to support you throughout the stages of the menopause, and all the associated side-effects, then soy isoflavones which mimic the effect of oestrogen in the body can help to reduce unwanted symptoms. These can be found in herbal remedies, such as A.Vogelâs Menopause Support.
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When Should You See A Doctor
As soon as you feel UTI symptoms, its important to see your doctor quickly, especially if you:
- Could be pregnant
- Have any kidney conditions
- Have underlying medical conditions which can make you more vulnerable to infection
Less commonly, UTIs can spread upwards into the kidneys, an infection known as pyelonephritis which sometimes needs hospital treatment. Call your doctor for an urgent appointment if you have:
- Pain in your back or sides
- Nausea or vomiting
- High temperatures with shivering
- Feeling generally unwell along with other signs of a UTI
See your doctor if you see any blood in your urine, as this can be a sign of underlying health conditions. This can range in appearance from a pinkish tinge to bright red urine, or even clots of blood. If you arent sure , check with your doctor anyway.
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