UTIs and Menopause: Taking Charge of Your Urinary Health
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In this article:
- The link between menopause and recurrent UTIs
- Effective treatment for menopause-related UTIs
- Comprehensive prevention methods for UTIs during menopause
The constant urge to pee. Burning pain when you expect relief. The dreaded signs of a urinary tract infection. If you’re a woman, you’ve probably experienced a urinary tract infection (UTI), but did you know that many women experience an increase in UTIs as they transition into peri- and post-menopause?
UTIs are extremely common, and they affect both premenopausal and postmenopausal women. However, the likelihood of developing UTIs increases with age, and menopausal women face unique challenges when it comes to fighting off these infections. While 10% of postmenopausal women experience at least one UTI in a single year, recurrent UTIs can affect up to 55% of women after menopause. A recurrent infection is when a person has at least two infections within six months or three or more in a year.
Understanding how UTIs and menopause are linked can empower you to take proactive steps to prevent and manage these uncomfortable infections.
What is a UTI?
Let’s start with the basics. A UTI is a common and often painful condition that occurs when harmful bacteria, most commonly E. coli, enters the urinary tract.
The urinary tract is made up of the bladder, urethra, ureters, and kidneys, and its main function is to eliminate waste and excess fluids from the body. When bacteria, usually from the genital or anal areas, find their way into the urethra, they can multiply and cause an infection.
Why does menopause increase your risk of developing a UTI?
In premenopausal women, UTIs often occur as acute infections, with E.coli bacteria as the cause. Chronic or recurrent UTIs, however, occur more often in postmenopausal women. In fact, recurrent UTIs increase from 26% in premenopausal women to a staggering 55% after menopause. This drastic shift emphasizes the importance of understanding how menopause impacts urinary health.
During perimenopause, estrogen levels fluctuate and decrease. The decline of estrogen impacts the ecosystem of microorganisms living in the urinary tract called the genitourinary microbiome. It also affects the health of the skin inside the bladder wall and the vaginal environment, making you more susceptible to bacterial infections.
The impact of menopause on the urogenital microbiome
Before menopause, the vagina is heavily colonized by "good" bacteria known as Lactobacillus. This helpful bacteria creates an acidic environment that fends off harmful bacteria, including those responsible for UTIs. However, as estrogen levels decline, the cells lining the vagina produce less glycogen—a sugar compound that nourishes Lactobacillus. Consequently, the protective flora in the vaginal environment diminishes, making it easier for infection-causing bacteria to establish a foothold.
Similarly to the vagina, declining estrogen levels during perimenopause can lead to modifications in the lining of the bladder, which can change the urogenital microbiome. This alteration in the microbiome weakens the bladder’s natural defenses against UTIs.
Vaginal, urethral, and bladder changes caused by menopause
As estrogen levels decline during peri- and post-menopause, changes occur in the vaginal walls, known as vaginal atrophy. This condition causes the vaginal walls to become thin, dry, and inflamed, making it easier for bacteria to enter and multiply. The urethra also changes, becoming thinner and shorter, increasing the ease with which bacteria can reach the urinary tract, raising the risk of UTIs.
Your bladder's response is notable too. It becomes less elastic, making it challenging to empty properly. Leftover urine in your bladder is a breeding ground for bacterial growth, leading to more frequent urinary tract infections.
Estrogen is essential for your bladder's health, helping maintain its inner lining. But during menopause, estrogen levels drop, and the bladder's inner lining becomes thin and weakened. With fewer protective cells and less shedding as a result of this atrophy, bacteria can build up inside the bladder, making it more prone to infection.
Another factor contributing to increased UTI risk during menopause is the atrophy of pelvic floor muscles. As estrogen levels decline, these muscles weaken, potentially leading to bladder prolapse—a condition known as cystocele. In cystocele, the bladder drops down, causing urine retention and an environment for bacteria to thrive.
Other risk factors for UTIs during menopause
While menopause itself is a significant risk factor for UTIs, several other factors can further increase your susceptibility to these infections. These include a history of UTIs, diabetes, urinary incontinence, and sexual intercourse, especially for postmenopausal women.
Our caring physicians at FemGevity can help you understand your menopause-related UTI symptoms and provide you with treatment options to help get you back to feeling like yourself again.
How can I get the right treatment for menopause-related UTIs?
While antibiotics are commonly relied upon to manage UTIs, taking a more comprehensive approach to diagnosis and treatment can offer effective relief from UTIs during menopause. Getting the best treatment involves thorough testing to pinpoint the underlying cause of the infection, using antibiotics tailored to the specific type of infection, and implementing preventive strategies to prevent recurring infections.
Comprehensive UTI testing
When dealing with urinary tract infections during menopause, accurate diagnosis is essential for effective treatment and prevention. Here are some key tests to consider:
1. PCR UTI Testing: If you’re dealing with recurrent UTIs, it may be beneficial to undergo a PCR (Polymerase Chain Reaction) test. This advanced diagnostic tool can accurately detect the presence of UTI-causing microbes, even at low concentrations. Understanding the root cause of your infection will enable your healthcare provider to prescribe the most appropriate antibiotics from the outset, minimizing the risk of unnecessary rounds of treatment.
2. Vaginal Microbiome Analysis: The vaginal microbiome is crucial in maintaining a healthy urinary tract. Analyzing the vaginal microbiome can provide valuable insights into the balance of beneficial and harmful bacteria. By understanding the unique composition of your vaginal microbiome, you can work with your physician or wellness practitioner to develop tailored preventive strategies.
3. Overall Health Assessment: Recurrent UTIs can be linked to underlying health conditions such as endocrine disorders like diabetes. Therefore, it’s essential to undergo a full health assessment to rule out any underlying medical conditions that may contribute to UTI recurrence.
Taking a comprehensive approach to UTI diagnosis ensures that treatment and preventive measures are precisely targeted, minimizing the likelihood of recurrent infections and optimizing your long-term health.
Antibiotics for UTIs during menopause
When a UTI occurs, the primary course of action is typically a course of antibiotics prescribed by a healthcare provider. Antibiotics eliminate the harmful bacteria causing the infection, relieve the symptoms, and promote healing. For women with recurrent UTIs, doctors may recommend "prophylactic" antibiotics, meaning taking a dose of antibiotics every time sexual intercourse triggers UTIs.
However, prolonged use of antibiotics, especially for prophylaxis, has potential downsides. Overreliance on antibiotics contributes to the growing concern of antibiotic resistance in bacterial infections. Postmenopausal women may also have higher resistance rates to certain antibiotics.
What can I do to prevent UTIs during menopause?
While antibiotics are important for treating UTIs, there may be better long-term solutions, especially if you experience frequent infections. The good news is that there are proactive steps you can take to prevent UTIs during menopause and reduce your reliance on antibiotics.
Menopause Hormone Therapy (MHT)
Menopause hormone therapy is a highly effective treatment for managing genitourinary symptoms of menopause (GSM), which includes conditions that may predispose women to UTIs. FemGevity offers FDA-approved, plant-based bioidentical estradiol as part of MHT to supplement declining estrogen levels naturally.
Estradiol Vaginal Cream
Vaginal estrogen therapy is an option many menopausal women explore to combat the spread of bacteria and soothe hormonal-induced skin irritations. Studies show that vaginal estrogen is particularly effective in reducing recurrent UTIs compared to oral estrogen. This therapy involves using a topical cream, tablet, insert, or insertable ring that slowly administers a low dose of estrogen directly to the vagina.
FDA-Approved Vaginal Medications
Alongside vaginal estrogen therapy, FDA-approved vaginal medications containing DHEA (dehydroepiandrosterone) and ospemifene (a Selective Estrogen Receptor Modulator) work similarly to estrogen, enhancing the condition of vaginal tissue to prevent UTIs linked to vulvovaginal atrophy.
Probiotics
Probiotics are live microbe supplements that can help you restore and maintain a healthy vaginal microbiome. When choosing a probiotic, look for specific microbial strains, live organisms, adequate CFU count, and the option for vaginal insertion, tailoring it to your UTI prevention plan.
Smart lifestyle modifications
Incorporating lifestyle and hygiene changes into your daily routine can also significantly reduce the risk of UTIs during menopause. Here are some helpful tips:
- Urinate before and after sex
- Try not to strain when you pee. Stay relaxed and empty your bladder completely so no urine is left over.
- Use silicone-based lubricants
- Wipe from front to back
- Stay hydrated
- Explore dietary supplements, including D-mannose, cranberry extract, and vitamin D3
Living UTI-free during menopause
Empowering yourself to take control of your urinary health can help you embrace this transformative phase of your life with fewer disruptive symptoms. Remember, discussing tailored prevention strategies with your healthcare provider is crucial for optimizing UTI prevention and your overall health during menopause. At FemGevity, we can help you get the right treatment to help prevent UTIs from holding you back during menopause and beyond.
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The 27 Main Symptoms of Hormone Depletion
Navigating the Many Symptoms of Hormone Depletion Around Perimenopause and Menopause: What to Expect and How to Manage Them
Menopause and perimenopause are significant life transitions that affect women both physically and emotionally as hormone levels begin to fluctuate and decline. Many women may enter perimenopause as early as their 30s without realizing it, only becoming aware when symptoms have persisted for a long time and become difficult to manage. While these hormonal changes are natural, the variety of symptoms they bring can feel overwhelming, often leaving women struggling to maintain balance and well-being. Below, we’ll explore some of the most common symptoms of perimenopause and menopause, along with insights into how to manage them effectively.
1. Hot Flashes
Hot flashes, also known as vasomotor symptoms, are perhaps the most well-known symptom of menopause, affecting up to 80% of women. These sudden surges of heat, often accompanied by sweating and flushed skin, can be uncomfortable and disruptive to daily life. While the intensity and frequency of hot flashes vary from woman to woman, they often begin during perimenopause and may persist for several years after menopause. Managing hot flashes can involve lifestyle changes like avoiding triggers (such as spicy foods or alcohol) and dressing in layers to help cool down quickly.
2. Vaginal Dryness
As estrogen levels decline, the vaginal tissues may become thinner, less elastic, and drier, leading to discomfort or pain during intercourse. This can affect intimacy and lead to emotional distress. Vaginal moisturizers, lubricants, or estrogen therapy can help alleviate these symptoms and restore comfort.
3. Mood Swings
Fluctuating hormone levels, particularly estrogen and progesterone, can lead to mood swings during menopause. Many women experience heightened irritability, anxiety, or even depression during this time. These emotional changes can intensify the response to everyday stress, leaving women feeling out of balance. Understanding the cause behind these shifts can be helpful, and seeking support from therapy or hormone therapy may provide relief.
4. Insomnia
Insomnia is another common symptom of menopause, often creeping in gradually until it becomes overwhelming. The classic 3 a.m. wake-ups and restless nights can leave women feeling unrefreshed and fatigued during the day. Lack of sleep further amplifies stress and emotional challenges, so addressing sleep hygiene and seeking help through relaxation techniques or medication can be crucial for managing insomnia.
5. Headaches
Headaches can worsen during menopause due to fluctuations in hormone levels, especially estrogen. For women who have experienced migraines or tension headaches, these hormonal shifts can intensify pain. Finding ways to reduce stress, staying hydrated, and seeking appropriate pain management can help alleviate these headaches.
6. Hormonal Weight Gain
Weight gain, particularly around the midsection, is common during menopause as metabolism slows and hormone levels shift. This weight gain often comes with bloating and water retention, making women feel puffy and uncomfortable. A balanced diet, regular exercise, and managing stress can help mitigate some of these changes, though the body may naturally hold more fat around the abdomen.
7. Easily Stressed
Many women find that their stress tolerance decreases during menopause. Hormonal changes can make small challenges feel more overwhelming, leading to frustration, irritability, and short tempers. Finding healthy outlets for stress, such as meditation, exercise, or time outdoors, can help manage these feelings.
8. Depression & Anxiety
The physical and emotional changes of menopause can negatively affect self-image and self-esteem. Hormonal fluctuations can disrupt sleep and brain chemistry, triggering new onset anxiety or depression, or worsening pre-existing mental health conditions. Addressing mental health is crucial during this transition, and seeking professional support may be necessary for managing these changes.
9. Brain Fog and Memory Issues
As estrogen levels drop, brain fog and memory difficulties, such as trouble recalling names or finding the right words, can become more common. Poor sleep only exacerbates this cognitive decline, making focus and clarity harder to maintain. Managing sleep issues and reducing stress may help mitigate these effects.
10. Fatigue
Menopausal fatigue is more than just being tired—it’s a persistent, overwhelming feeling of exhaustion that doesn’t go away with rest. This fatigue can severely affect daily activities, social interactions, and overall well-being. To combat fatigue, women may need to focus on improving sleep quality, managing stress, and adopting healthy eating and exercise habits.
11. Anger & Rage
Hormonal fluctuations can ignite intense anger or rage, often over minor frustrations that wouldn’t normally cause such a reaction. These emotional outbursts can take women by surprise and may strain relationships. Recognizing that these feelings are tied to hormonal changes can help with self-compassion and finding strategies to manage emotional responses.
12. Bloating
Bloating becomes more common during menopause, as hormone shifts affect digestion and increase water retention. This can leave women feeling uncomfortably full and swollen. Dietary changes and drinking plenty of water can help reduce bloating and digestive discomfort.
13. Skin and Hair Problems
Declining estrogen levels can affect the skin and hair, leading to dryness, thinning, and changes in texture. These visible signs of aging can impact self-esteem. Moisturizing regularly, using sunscreen, and eating nutrient-rich foods can help support healthier skin and hair during menopause.
14. Painful Sex
Vaginal dryness and thinning tissues often lead to discomfort or pain during intercourse, making intimacy challenging. Many women feel frustrated and disconnected from their bodies during this time, but vaginal lubricants, moisturizers, and medical treatments can help alleviate these symptoms and improve comfort.
15. Decreased Libido
Lower hormone levels may lead to a drop in libido, leaving women feeling less interested in intimacy. This change can be unexpected and may cause feelings of disconnection in relationships. Open communication and exploring different ways to maintain intimacy can help couples navigate this shift.
16. Hair Thinning
Hair thinning becomes more apparent as hormonal changes affect hair growth and strength. For many women, hair is closely tied to identity, and thinning hair can significantly impact self-esteem. Managing hair health through good nutrition, stress reduction, and targeted treatments can help slow down hair loss.
17. Joint Pain
Joint pain and stiffness can become more frequent during menopause due to decreased estrogen levels. Regular physical activity, stretching, and joint supplements may help reduce the discomfort associated with these changes.
18. Apathy
Feelings of apathy or emotional flatness may creep in during menopause, making everyday tasks feel burdensome. Hormonal changes dull the excitement and motivation, leaving women feeling disconnected from things that once brought joy.
19. Changes in Body Odor
Hormonal shifts can alter body odor during menopause, causing some women to feel self-conscious about changes in their scent. This unexpected symptom may require adjustments to hygiene routines or seeking advice from healthcare providers.
20. Decreased Muscle Mass
The loss of muscle mass during menopause can make women feel weaker and less resilient. Regular strength training, along with a protein-rich diet, can help counteract muscle loss and maintain physical fitness.
21. Digestive Issues
Hormonal fluctuations can disrupt digestion, leading to constipation, gas, and bloating. Dietary adjustments, probiotics, and regular exercise can help manage these digestive symptoms.
22. Osteoporosis Risk
With the decline in estrogen, women face an increased risk of osteoporosis, as bone density decreases, leading to a higher chance of fractures. Regular weight-bearing exercise, calcium, and vitamin D supplements can help protect bone health.
23. Gums and Oral Health
Hormonal changes during menopause can affect oral health, making gums more sensitive and increasing the risk of gum disease. Maintaining good dental hygiene and scheduling regular checkups can help prevent these issues.
24. Frozen Shoulder
Frozen shoulder, characterized by pain and stiffness, can develop during menopause, limiting movement and causing discomfort. Physical therapy and targeted exercises can help relieve symptoms and restore mobility.
25. Numbness & Tingling
Some women experience numbness or tingling sensations in their hands or feet due to hormonal fluctuations during menopause. While often harmless, persistent symptoms should be evaluated by a healthcare provider.
26. Heart Palpitations
Heart palpitations—sudden feelings of a racing or irregular heartbeat—can be alarming during menopause. These are often linked to hormone changes but should be monitored, especially if they become frequent or concerning.
27. Night Sweats
Night sweats, a common symptom of menopause, can disrupt sleep and leave women feeling exhausted. Dressing in breathable fabrics, using cooling bed sheets, and maintaining a cool sleeping environment can help manage night sweats and improve sleep quality.
Managing Menopause Symptoms
Menopause is a challenging time for many women, but understanding these symptoms and finding ways to manage them can lead to a smoother transition. Seeking support from healthcare professionals, exploring hormone therapy, and making lifestyle changes can all contribute to improving quality of life during menopause. Remember, every woman’s experience is unique, and it’s important to find the right strategies that work for you.
What is Bi-est bioidentical hormone cream?
Bi-est hormone cream, also known as"bi-est cream," is a type of hormone therapy that can be used to help balance hormones for those experiencing menopause symptoms. It's a combination of bioidentical estrogen and bioidentical estriol.
Bi-est 80/20 refers to a specific ratio of the three estrogen hormones found in Biest hormone replacement therapy. The"80/20" refers to the ratio of estradiol to estriol. In this specific ratio, 80% of the hormone mixture is estradiol and 20% is estriol. This ratio is commonly prescribed because estradiol is the most potent of the three estrogens and is responsible for many of the beneficial effects of estrogenre placement therapy, while estriol is a weaker estrogen that is believed to have fewer side effects. This ratio is commonly prescribed to alleviate symptoms of menopause and to help prevent bone loss. However, it's important to note that it's always best to consult with a healthcare professional before starting any hormone replacement therapy.
During menopause, our bodies go through changes that can lead to symptoms like hot flashes, night sweats, and mood swings. Bi-est hormone cream can help by providing the body with the hormones it needs to balance out these changes.
The great thing about bi-est cream is that it's made with bioidentical hormones, which means they're chemically identical to the hormones produced by our bodies. This makes them safer to use and less likely to cause side effects than traditional hormone replacement therapy.
The estrogen component in bi-est cream can help reduce hot flashes and night sweats, as well as improve vaginal dryness and bone health. The progesterone component helps to balance the effects of estrogen and can also help with mood swings and sleep disturbances.
Many women have found bi-est cream to be very helpful in managing their menopause symptoms and enjoying a better quality of life. It's important to note that everyone is different and what works for one person may not work for another. It's always best to consult with your healthcare provider to determine if bi-est cream is right for you.
It's also important to mention that bi-estcream should not be used as a form of birth control. It's also not recommended for women who have had breast cancer or are at high risk of breast cancer.
Bi-est hormone cream can be a helpful tool for managing menopause symptoms. It's made with bioidentical hormones that are chemically identical to the hormones produced by our bodies, making them safer to use and less likely to cause side effects. If you're experiencing menopause symptoms, consult with your healthcare provider to determine if bi-est cream is right for you. Remember, every person is different and what works for one person may not work for another. But, with the right treatment, you can feel like yourself again and enjoy a better quality of life during this new chapter of your life
Bio-identical Hormones vs Hormone Replacement Therapy (HRT)
First off, let's start by saying that bio-identical hormone therapy is a type of hormone replacement therapy (HRT). They can be considered on in the same. Very often when the general population is speaking of HRT they are referring to synthetic hormones or hormones that are made by drug companies vs bio-identical hormones which are most commonly made by compounding pharmacies in small batches. In this article when we refer to bio-identical hormones we are talking about compounded hormones and when we speak on HRT we are referring to synthetic drug company hormones.
Hormone replacement therapy (HRT) and bioidentical hormone therapy (BHT) are both treatment options for women experiencing symptoms of menopause, such as hot flashes, vaginal dryness, and sleep disturbances.
HRT typically refers to the use of synthetic hormones, such as conjugated equine estrogens (CEE) and medroxyprogesterone acetate (MPA), which are chemically identical or similar to the hormones produced by the human body.
BHT, on the other hand, uses hormones that are identical to the hormones produced by the human body, such as estradiol and progesterone. These hormones are typically derived from natural sources, such as plants, and are formulated to be chemically identical to the hormones produced by the human body.
One of the main differences between HRT and BHT is that HRT is FDA-approved, while BHT is not. This means that HRT has undergone clinical trials and has been found to be safe and effective for its intended use, while BHT has not undergone the same level of testing.
Another difference between HRT and BHT is that HRT is typically prescribed in a "one-size-fits-all" dosage, while BHT is often customized to the individual patient's needs based on their hormone levels and symptoms. This means that HRT may not be as effective for some women as BHT, which is tailored to their specific hormone levels and symptoms.
Your FemGevity healthcare provider will discuss the best treatment options for your individual needs, and to weigh the benefits and risks of any treatment options.
