Amazing Over 40 – Q & A!

Exciting news!  At Amazing Over 40, we are here to educate, empower and encourage you to be amazing at any age….40, 50, 60 and beyond!  So, you asked…and we listened!  Starting today, we will have a monthly blog devoted to the most frequently asked questions submitted by our Facebook and email followers. Names will ALWAYS be confidential- so feel free to answer your questions, get some answers, and in the process, you’ll be helping other women get the answers they may be looking for too! 

This week’s question is a great one!

DP: I started menopause at 49 I'm now 54 I am still fighting through so many menopause symptoms and one of them is uti after uti I've probably had about 40 uti's in 5 years it is so very frustrating I take d mannose and cranberry but I still get them any ideas please?

Urinary tract infections (UTI’s) are very common in women, with over ½ of all women experiencing a UTI at least once in her lifetime.  After menopause, the vaginal pH increases (less acidic) leading to greater growth of bacteria that can act as bladder pathogens (things causing infection).

The usual symptoms of UTI are pain with urination, increased frequency of urination, urgency to void and possible red-tinge in urine (indicating possible blood).  

The first thing to understand is to inquire with DP whether her doctor actually checked a urine culture to make sure that she truly has been having UTI’s.  Many women in their 40s, 50s, and 60s experience pain with urination but this may not necessarily be due to a bacterial infection in the bladder.  Other causes include interstitial cystitis, irritation of the urethra due to intercourse, a sexually transmitted infection, pelvic prolapse or bladder sensitivity due to spicy foods and caffeine.  As you can see, it is very important that you have a medical evaluation to determine the exact cause of your symptoms.

If DP’s doctor has documented that she truly has been experiencing recurrent UTI’s with positive urine cultures showing bacteria, one of the leading causes is sex.  Yes, sex can increase the risk of bacteria coming from the vagina (and possibly) rectum to enter the urethra (the tube that allows urine to flow out of your body).  Once bacteria enter the urethra, they can migrate upward into the bladder, which leads to a UTI.  Left untreated, this may lead to an infection of the kidneys, known as pyelonephritis, which may require intravenous antibiotics and possible hospitalization.

Ways to decrease this from happening:

1. Always empty your bladder immediately after sex.  This allows the urethra to be “flushed out” of bacteria, so they don’t enter the bladder.
2. Wipe from front to back after a bowel movement to prevent spreading of bacteria.
3. Avoid harsh soaps or feminine hygiene products that can irritate the urethra and remove the healthy bacteria (Lactobacilli) from the vagina.
4. Take D-mannose – this inhibits the bacteria from adhering to the bladder wall, making a UTI less likely.
5. Take a cranberry extract or pure unsweetened cranberry juice, which decreases the risk of UTI by making the bladder more acidic.
6. Use vaginal estrogen in cream or suppository form to strengthen the urethra, bladder and vaginal tissues and restore the vaginal pH to healthy level.
7. Use a post-coital antibiotic – your doctor can recommend the best dose/type.  Because resistance to antibiotics can occur over time, I tend to use this as my last resort – but it may be necessary in certain cases.

If none of the above should work for DP, I would refer her to a urologist who would further evaluate the reason for her recurring UTIs.

Looking forward to next month’s most frequently asked question!

In health and happiness!

Dr. Diana