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Urinary Health
recurrent UTI prevention

Urinary tract infections (UTIs) are the most common bacterial infection in women. When bacteria enter the urethra and then the bladder, this can cause an infection. UTIs can be a chronic problem, especially for postmenopausal women.

In this article, we discuss the reasons why postmenopausal women are at an increased risk for UTIs. Then, we share some strategies for recurrent UTI prevention after menopause.

Menopause and UTIs

There are a number of reasons why recurrent UTIs become a problem after menopause.  First of all, after menopause, your estrogen levels decline. This lack of estrogen may change vaginal pH which increases the risk of UTIs.

Some postmenopausal women also experience episodes of urinary incontinence or loss of bladder control.  With urinary incontinence, you may experience leaks due to sudden pressure on the bladder (like a cough or sneeze), or a sudden urge to urinate that you can’t control.  As a result, you may not drink enough fluids due to the worry of having an accident. Low fluid intake can increase the risk of UTIs.

If you have a UTI, always follow the treatment advice of your healthcare professional. And remember, the only way to get rid of a current UTI is to take antibiotics. However, if you are postmenopausal and experiencing chronic UTIs, consider the following strategies for recurrent UTI prevention.

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Drink enough fluids … and timing can help.

Although nowadays it’s hard to find someone who isn’t drinking from a water bottle all day long, some women restrict fluid intake due to incontinence. Inadequate fluid consumption can lead to UTIs for some women.

Adequate fluid intake may work in several ways for recurrent UTI prevention. First, it may dilute urine which studies show helps manage the growth of bacteria leading to an infection in the first place.  Second, it increases urination which in turn helps to flush bacteria out of the bladder and urethra.

The Institute of Medicine recommends having 91 ounces of with 20 percent coming from foods and 80 percent, or 72 ounces, coming from all beverages (including coffee!). Of course, people who exercise need more water, and the recommendation is to drink one cup before you begin exercising and one cup of water for every 15 minutes of exercise.

There are a number of strategies for drinking adequate fluids without concern for not being able to get to a bathroom in time. One thing you can do is to divide up your fluid intake throughout the day. Also, drink fluids when you know you will be close to a bathroom.

It would be great to get through an outing or even the whole night without several trips to the bathroom. Although this varies according to the individual, many people report that restricting fluids 2 hours before going on an outing can greatly reduce your need to find a bathroom urgently while you are out.

You can also follow this guideline at bedtime, and many people report that they stop drinking any fluids within 3 hours of bedtime to reduce nighttime trips to the bathroom. If you find you get thirsty before bed allow yourself a few sips of water at bedtime.

Strengthen pelvic floor muscles.

If you decide to drink more fluids, you will want to improve support for your bladder and urethra as much as possible. They are supported by several sets of muscles. Your pelvic floor muscles are at the core of supporting your bladder and urethra. You can strengthen these muscles to help avoid stress urinary incontinence (SUI).

Women with SUI leak urine during physical effort like lifting heavy weights or even during coughing, sneezing or laughing. If this is you, you’re in good company since it’s estimated that 20 million women in the U.S. experience SUI.

Although there are other causes of SUI, including pelvic organ prolapse, certain medications, and pelvic pain, most women can benefit from strengthening the pelvic floor muscles. One way to strengthen your pelvic floor muscles is to do Kegel exercises. These exercises are specifically designed to strengthen your pelvic floor muscles.

Kegel Exercise Guidelines from the National Institute of Diabetes and Digestive and Kidney Diseases

The first step in effectively doing Kegel exercises is to find the right muscles. Try one of the following ways to find the right muscles to squeeze.

  • Imagine that you are trying to stop passing gas. Squeeze the muscles you would use. If you sense a “pulling” feeling, you are squeezing the right muscles for pelvic exercises.
  • Lie down and put your finger inside your vagina. Squeeze as if you were trying to stop urine from coming out. If you feel tightness on your finger, you are squeezing the right pelvic muscles.

Do these exercises 3 times a day for 5 minutes at a time. And don’t be tempted to overdo these exercises. Overdoing it can lead to straining to urinate or having a bowel movement. Try not to engage other muscles while doing these exercises, focus only on the muscles you are working. Be patient though since you may not see improvement in bladder control for 3 to 6 weeks.

Consider cranberry for recurrent UTI prevention.

Research supports the benefit of compounds found in cranberries, known as proanthocyanidins (PACs), for reducing the risk of getting a UTI. If given the chance, bacteria that enter the urinary tract will attach themselves to the inside surface of the bladder wall.

Taking a daily cranberry supplement with 36 mg of proanthocyanidins (PACs) can help fend off bacteria from sticking to your bladder wall before they have a chance to hang around and cause an infection.

There is a fair amount of research that suggests that cranberry helps prevent UTIs. A 2012 meta-analysis of 13 cranberry trials found that overall, cranberry decreased the risk of UTIs by 38%. This study also looked at how effective cranberry was in specific groups. In adults with recurrent UTIs, cranberry reduced the risk of infection by 47%. In females, cranberry reduced the risk of UTIs by 51%, and in children, cranberry reduced the risk 67%.

2017 review and meta-analysis also found that cranberry products reduced UTIs in people prone to having them.  In this study, cranberry decreased UTI recurrence by 33%.

In short, cranberry PACs can prevent the bacteria from sticking to the bladder wall, and they won’t hang around long enough to cause an infection.

Key takeaways.

Once you have a UTI, you may be more prone to have another. Therefore, it is worthwhile to do as much as you can to prevent them from recurring. If you’re postmenopausal, speak to your healthcare professional about ways to increase vaginal pH, since it naturally declines with the decline of estrogen.

If you experience incontinence, strengthening your pelvic floor muscles can be a first step toward allowing you to drink adequate fluids to help stave off a UTI. Taking a high-quality cranberry supplement made from whole cranberries that supplies 36 mg PAC or drinking cranberry juice daily can be an effective way to decrease your chance of having another infection.

Always remember to tell your healthcare professional about any new supplements you start taking.


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