Urinary Tract Infection (UTI) is an infection caused by bacteria that enter through the urethra and multiply in the bladder or kidneys. Some of the common causes include dehydration, poor hygiene, a weakened immune system, high blood sugar, and more. Women are at a greater risk of the condition, with the risk increasing with age, particularly during the menopausal stages.
A bigger concern is recurrent UTI, which refers to an infection that occurs two or more times within six months, or three or more within a year.
In an interaction with the OnlyMyHealth team, Dr Kavitha G Pujar, Consultant - Obstetrician, Gynaecologist and Infertility Specialist, Motherhood Hospitals, HRBR Layout, Bengaluru, discusses whether recurrent UTIs can be a sign of perimenopause, which is the natural transition before menopause. This is marked by declining oestrogen and progesterone, irregular periods, and fluctuating hormonal symptoms like hot flashes, mood swings, and sleep problems.
Also Read: Top Medical Reasons Behind Heavy Periods With Clots In Women Over 40
Are UTIs More Prevalent During Perimenopause?
A global analysis of health data from 1990 to 2021 found that UTIs are rising in women, but in different ways before and after menopause. A recent study published in the International Journal of Women's Health reported UTI cases increased more quickly in premenopausal women, especially during the COVID-19 pandemic, while deaths from UTIs grew faster in postmenopausal women.
Looking ahead, researchers predict that by 2044 there could be more than 25 crore cases in premenopausal and around 16.5 crore in postmenopausal women, with the steepest climbs in women aged 30–34 and 50–54.
According to Dr Pujar, during perimenopause, there is a decrease in the amount of oestrogen produced in the body, which is tied to an increase in the prevalence of UTIs. “With a dip in oestrogen, the external genitalia and the bladder become thin and dry, losing their protective cover. Reduced levels of 'good' bacteria and the thinning of the vagina's acid protective layer cause bacteria to spread and risk infection,” she explains.
A Regular UTI Vs Perimenopausal Issue: Differences
UTIs occur due to inflammation of the bladder and urethra, which manifests in the form of burning during urination and developing cloudy and oftentimes foul-smelling urine, along with an increased urge to urinate.
"If these conditions arise recurrently, or the cause is undiagnosed, with symptoms of discomfort, dryness, or the refraining of intercourse, then we return to the concept of hormonal changes during perimenopause. A medical checkup can help determine the distinction," shares Dr Pujar.
Also Read: Perimenopause: Supplements Women Should Start Adding To Their Diet
How To Prevent Recurrent UTI
While there is no way to completely prevent hormonal fluctuations during perimenopause or later stages, there are certain hygiene habits that you can adopt to reduce UTI risk:
- Adequate hydration
- Timely urination, along with urination post coitus
- Front-to-back wiping
- Avoiding the use of restrictive garments
- Avoiding the use of douching or strong descaling agents
- Avoiding the use of underwear made from synthetic
Remember, constipation, uncontrolled hyperglycaemia, and the absence of hydration in vaginal tissues also contribute to the recurring cycles of infection.
When To See A Doctor For A UTI?
“Women should see a doctor if symptoms do not improve within a day or two, or if fever, pain in the back or side, blood in the urine, or very frequent infections develop,” Dr Pujar recommends.
She concludes, “Women with diabetes or kidney disease should take special care and get earlier tests. It is a doctor who can determine if it is simply an infection or if hormone changes have to be acted upon.”