…..Postmenopausal women are at an increased risk for urinary tract infections (UTIs) because of a decrease in their estrogen levels. This lower hormone state is associated with specific physical and physiologic changes that increase this risk:
- Thinning of the mucosa of the vulva (vaginal tissue)
- Changing of the normal bacteria that usually inhabit the vagina, especially a decrease in lactobacillus colonization
- An increase in the pH of the vagina
- Vaginal colonization of E. coli.
…..There have been multiple studies which have found a decrease in these UTIs with the use of estrogen intravaginal creams. There are many variations on the types of estrogen used and many commercial products available.
…..If you are in the menopausal time of your life and suffer from recurrent UTIs, ask your medical professional about the possible use of a vaginal estrogen preparation.
…..In my practice, urinary tract infections are among the most common problems that I see. It is estimated that 60 to 70% of all women will experience a UTI in their lifetime and that half will have a first time infection by the time they are 35.
…..Most women know they have a “bladder infection” because of the symptoms they experience. These symptoms include:
- Pain with urination
- Increased urgency to urinate, with many times passage of just a few drops of urine
- Increased frequency of urination
- Pain, pressure, and/or fullness in the lower abdomen
…..If the infection of the urinary tract system has risen above the bladder and into the kidney, the symptoms change. The patient appears to be sicker with more severe symptoms, which include:
- Tender flank pain over the area of the kidneys
- Fever and chills
- Nausea and vomiting
…..Although the diagnosis of a UTI is usually made by a patient’s complaints, dipstick urine tests are commonly used to help confirm the diagnosis. These tests look for certain markers in the urine that point to a UTI. Dipstick urine tests are not totally conclusive.
…..The standard to confirm a UTI is the urine culture and sensitivity test at the laboratory. This test will diagnose the bacteria causing the infection, and it will also provide the susceptibility of the bacteria to certain antibiotics. The disadvantage of this test is the cost and the 48 hours it takes to get back the information.
…..There are many risk factors in pre-menopausal women for a UTI. A few of these are:
- Frequent or recent sexual activity
- Past history of a UTI
- Increased number of vaginal deliveries