Urinary Tract Infection (UTI) and Menopause
The razor-sharp pain and burning of a urinary tract infection is often unbearable. While the urgency might send you running to the restroom, what’s even more troubling is that urinary tract infections have a tendency to be recurring.
Urinary tract infections are among the most common diseases, affecting over half of all women at some point in life and repeatedly in 25 percent of these. Menopausal women have an increased risk of recurrent urinary tract infections, which has been associated with low estrogen levels.
Infecting bacteria first come in contact with the inside of the urinary bladder. The bladder lumen is covered with epithelial cells, acting as a fence protecting the vulnerable tissue as well as producing antimicrobial peptides -- the body's self-made antibiotic. These peptides act as rapid front line soldiers fighting infecting microorganisms. By the early action of the antimicrobial peptides, the number of bacteria can be reduced before they have a chance to multiply. In the postmenopausal woman, however, the epithelium is fragile and often damaged with occasional gaps between cells, which in turn affect the ability to resist infection.
Some of the urinary symptoms that can be associated with menopause include:
* The urge to urinate often, or when the bladder is not full (termed urinary urgency).
* Discomfort or burning with urination.
* Leakage of urine with coughing, laughing, sneezing, or lifting heavy objects (termed stress incontinence).
* The need to urinate more frequently, including at night.
In one of the recent Swedish studies, the researchers treated post-menopausal women with estrogen for 14 days, and then analyzed cells excreted in the urine. They found that estrogen acts on the epithelium in a way that the gaps between the cells lining the bladder lumen are healed, i.e. estrogen is gluing them together. This makes it more difficult for bacteria to break this protecting shield and reach the underlying cells.
"During menopause, women have low levels of estrogen, and therefore also low levels of antimicrobial peptides as well as a damaged lining of the lumen in the urinary tract," says study leader Dr. Annelie Brauner at the Department of Microbiology, Tumor and Cell Biology of Karolinska Institutet. "This will give the bacteria opportunity to reach the underlying tissue, where they can hide and stay until they are triggered to cause a new infection. By treating postmenopausal women locally with estrogen the cells lining the bladder are strengthened and the body's own defense against infection is improved, making women better suited to fight infections."
Low estrogen levels have always been linked to recurrent infections, and the new study sought to identify exactly how estrogen might affect a woman's risk of recurrent urinary tract infections.
Risk Factors for UTI
Besides menopause as the substantial risk factor, there are other we would like to mention:
* Being sexually active. Sexually active women tend to have more UTIs than do women who aren't sexually active.
* Using certain types of birth control. Women who use diaphragms for birth control also may be at higher risk, as may women who use spermicidal agents.
* Having urinary tract abnormalities. Babies born with urinary tract abnormalities that don't allow urine to leave the body normally or cause urine to back up in the urethra have an increased risk of UTIs.
* Having blockages in the urinary tract. Kidney stones or an enlarged prostate can trap urine in the bladder and increase the risk of UTI.
* Having a suppressed immune system. Diabetes and other diseases that impair the immune system — the body's defense against germs — can increase the risk of UTIs.
* Using a catheter to urinate. People who can't urinate on their own and use a tube (catheter) to urinate have an increased risk of UTIs. This may include people who are hospitalized, people with neurological problems that make it difficult to control their ability to urinate and people who are paralyzed.
Natural Ways to Prevent UTI
For those who are prone to urinary infections, there are many natural ways to promote urinary health and help prevent infection.
Cranberry juice concentrate — the very bitter form of pure cranberry juice — and cranberry extract in capsule form, are excellent remedies to help fight infection and promote a healthy urinary system. Pure cranberry juice and cranberry extract coat the lining of the urinary tract and bladder to help flush out bad bacteria. It’s wise to avoid cranberry juice with added sugar, which may augment symptoms.
Sugar and white flour make the body more acidic — which enhances the growth of bacteria and causes inflammation. This not only makes the infection worse, but can exacerbate minor inflammation in the urinary tract and make urination more painful.
There is one form of sugar that actually helps stop a urinary infection. D-Mannose, a supplement available in capsule and powder form, also coats the urinary tract lining and helps to flush out the bad bacteria. It’s also a low glycemic sugar which doesn't stay in the bloodstream and therefore doesn't raise blood sugar in the body.
A natural remedy for people with a current urinary tract infection is a combination blend of uva ursi, berberine, marshmallow root, bladder-wrack and celery seed. To prevent a urinary tract infection from happening in the first place, take a multistrain probiotic with 12 to 14 strains of beneficial bacteria. The probiotic should be kept refrigerated and should be purchased that way.
When buying any probiotics, vitamins or supplements, always purchase a brand that uses third-party testing to verify the purity and quality of their product.
Additionally, a daily herbal blend of cranberry concentrate, dandelion leaf extract and hibiscus flower extract can also be used to prevent a urinary tract infection.
The herbal remedies, probiotics and D-Mannose can be taken with an antibiotic to complement the treatment. It’s important to note that if you have a urinary tract infection, you must see your physician or health care provider. Urinary tract infections can lead to kidney infections if untreated and in some cases can lead to a life-threatening blood infection in the body.
The elderly are also more susceptible to urinary tract infections because of urinary incontinence and not being able to fully empty their bladder. It’s important to note that elderly individuals with a urinary tract infection often present with much different symptoms than a younger adult and may have confusion, fatigue, weakness, muscle aches and abdominal pain.
Typical symptoms of a urinary tract infection for younger adults include painful urination, urgency and frequent urination, and cloudy, dark or bloody urine. If you have a fever, back pain or pain in your side below the ribs, or any nausea or vomiting, that could indicate a kidney infection and medical treatment should be sought.
There are some simple steps to keep the urinary tract healthy. Drink water throughout the day to help flush out bacteria. To stay hydrated, drink the amount of water in ounces that is equivalent to half of your body weight. This means a man who weighs 180 pounds should drink 90 ounces of water. This does not apply to a person on a fluid restriction who must limit the amount of fluids they consume.
It’s best to avoid caffeine, which irritates the bladder, and alcohol, which acts as a diuretic and can increase urgency and frequency. Antihistamines found in cold and allergy medicines can cause urinary retention, which may lead to an infection.
While both males and females experience urinary tract infections, women are more susceptible because they have a smaller urethra, which makes it easier for bacteria to enter the urinary tract.
Women can prevent urinary tract infections by wearing 100-percent cotton underwear and wiping front to back to prevent bacteria from coming in contact with the urethra. Many women react to dyes in toilet paper and feminine products. There are unscented and unbleached toilet paper, sanitary napkins and pantyliners available to help avoid irritation. It’s also helpful to urinate before and after sexual intercourse to get rid of bacteria.
Menopausal women have a higher risk of developing urinary tract infections. When estrogen levels drop during menopause, the outermost layer of skin in the urethra and bladder begins to thin and loses its protective nature against infection. A health care provider can prescribe a bio-identical estrogen replacement therapy to replace estrogen in the body during menopause. A compounding pharmacist can then compound a bio-identical estrogen therapy that is tailored to the individual patient and replicates natural estrogen produced by the body. Bio-identical estrogen therapy is available in a cream, which is applied vaginally to target the affected area.
There are also natural lubricants available to help alleviate dryness and combat any bad bacteria or yeast that comes in contact with the urethra. Look for a lubricant with Calendula Flower, Pine Resin and Canadian Balsam Fir.
As we age, urinary incontinence can become another issue altogether. Luckily there are exercises called Kegels, which can be performed anytime, anywhere. Kegels strengthen your pelvic floor muscles that support the bladder and prevent leaking. While squeezing these muscles is beneficial, this should not be done during urination, which can lead to a urinary tract infection.
For women, a healthy urinary tract is important to overall health. Remember to take good care of yourself, drink plenty of water, and eat a balanced diet to give your body the nutrients it needs to prevent infection and maintain optimum health.
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