Why are premenopausal and menopausal women more likely to get a UTI? Oestrogen plays a crucial role in keeping the tissues of the vagina and urethra elastic and well-moisturised. During your 40s and 50s when levels start to drop, these tissues can become thinner, drier, and more prone to irritation, creating conditions that are conducive to developing urinary tract infections.
Drops in oestrogen also reduces the level of healthy bacteria that normally live in your vagina and bladder. Healthy bacteria help fight off infection-causing bacteria, meaning you are less able to prevent infections.
The standard treatment for urinary tract infections is a short course of antibiotics (NHS guidance), however, there are other research based treatments that can be effective.
Effective treatments
1. Creams/tablets: For post menopausal women, who have not had a period for a year, oestrogen creams or tablets can be very effective. These are placed internally, where they release small amounts of oestrogen into nearby tissues. It takes about 6 to 12 weeks to get full benefits. Over time, it’s estimated that vaginal oestrogen can reduce your risk of UTIs by more than 75 percent.
Vaginal oestrogen is only available on prescription, except the brand Gina (vaginal tablets) which has recently become available to buy from pharmacies.
Newson Health Menopause Society chair Dr Louise Newson said: ‘This is a certainly a step in the right direction that women will be able to buy this treatment to improve their localised symptoms.
‘It is known that the majority of menopausal women experience symptoms related to vaginal dryness and urinary symptoms yet only the minority receive treatment.
‘However, it is going to cost around £30 for one packet which will last around three months which clearly is expensive.'
2. Cranberry Extract: In 2023, researchers analysed all of the available research to assess whether cranberry products help reduce urinary tract infections (UTIs). This included 50 clinical studies involving 8,857 participants.They compared the effectiveness of cranberry products with placebo (a fake treatment) or no treatment at all.
For women with recurrent UTIs, cranberry juice or syrup may have little to no effect in preventing UTIs.
However, cranberry tablets or powders, which are more concentrated, may reduce the risk of UTIs. The ideal dosage isn't clear yet, but a daily dose of a high-strength capsule (at least 200 mg of cranberry extract) is likely more effective than drinking cranberry juice.
3. Probiotic: Although controversial, there is growing research regarding the use of probiotics, as treatment for UTIs. Specific probiotics increase the level of healthy bacteria that exist in the urinary tract, which protect against the harmful bacteria which cause UTIs. However, selecting the correct probiotic can be confusing, and research shows that only specific strains of healthy bacteria may help. Jarrow Formulas Femdophilus contains the well researched probiotic strains L. rhamnosus GR-1 and L. reuteri RC14.
References
Rahn DD, Carberry C, Sanses TV, Mamik MM, Ward RM, Meriwether KV, Olivera CK, Abed H, Balk EM, Murphy M; Society of Gynecologic Surgeons Systematic Review Group. Vaginal estrogen for genitourinary syndrome of menopause: a systematic review. Obstetrics Gynecology. 2014 Dec;124(6):1147-1156.
Cochrane review 2023 - Cranberries for preventing urinary tract infections (Review) Williams G, Stothart CI, Hahn D, Stephens JH, Craig JC, Hodson EM
Akgül T, Karakan T. The role of probiotics in women with recurrent urinary tract infections. Turk J Urol. 2018 Sep;44(5):377-383.
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