UTIs in menopause

Genitourinary syndrome of Menopause

Menopause, and the menopausal transition, is a time where many women experience UTIs. This is grouped alongside a syndrome we refer to as genitourinary syndrome of menopause.

what is genitourinary syndrome of menopause (gsm)?

Genitourinary syndrome of menopause is very common and impacts 50-70% of postmenopausal women to varying degrees. It is defined as a chronic, progressive, vulvovaginal, sexual and lower urinary tract condition.

Symptoms might be predominantly

• genital

  • vaginal dryness and/or pain, prolapse

• sexual

  • pain with sex or bleeding after sex, decreased libido and/or arousal

• urinary

  • pain or urgency with urination, recurrent UTIs and/or incontinence

Considering how common this condition is, it is vastly under diagnosed. Women often see their symptoms as a normal feature of aging and don’t raise this complaint with their practitioners. Leaving far too many folks impacted without treatment.

Why does it occur?

Most of the symptoms can be attributed to a low-estrogen state that characterizes menopause. The decrease in estrogen causes anatomical changes in the genitourinary tract (meaning, genitals AND urinary system).

Without estrogen, we have decreased collagen, elasticity and blood flow in the tissues. The cells of the vaginal wall get dryer and thinner as well as change the way they store sugar - impacting the type of bacteria that live there and, ultimately, changing the pH.

Healthy bacteria produce antimicrobial compounds like lactic acid and hydrogen peroxide. UTIs are most commonly caused by sources of bacteria originating outside the urinary tract - the rectum or vagina - explaining how shifts in these bacteria with menopause can lead to increased risk of UTIs.

What can we do to prevent UTIs?

Many of the strategies we use to prevent recurrence of UTIs in menopausal women are similar to younger women in terms of supporting gut and vaginal microbes and using similar supplements. There is also good evidence for the use of topical estrogens for many of the symptoms of genitourinary syndrome of menopause - including preventing UTIs.

Depending on symptoms, pelvic floor muscle training (often alongside other therapies) can also make a drastic impact on symptoms and quality of life.

We have a lot of options to help support you feeling like your best self both in the peri-menopause period as well as post-menopause. Book a meet and greet with one of our naturopathic doctors to see if we are the right fit for you!