A lesser known symptom of menopause, caused by the extreme decline in estrogen, is the increased risk for urinary tract infections (UTIs). The bladder becomes less elastic, triggering an inability to fully empty, therefore creating a breeding ground for bacteria to multiply. Additionally, the lack of estrogen makes the bladder lining and vaginal tissues more prone to bacterial adherence since there is less protection. These situations set the stage for developing UTIs.

According to Larrian Gillespie, retired urologist and author of the popular book, You Don’t Have to Live with Cystitis (HarperCollins), there are ways to control or prevent the recurrence of UTIs associated with menopause:

• Stay Hydrated: It is imperative to stay hydrated by drinking plenty of water which promotes regular urination. This flushes out bacteria from the urinary tract.
• Watch your back: Lower back stress that affects the lower muscles of the back can interfere with the flow of urine, which can lead to abnormal voiding (urination) and UTIs. When exercising, try to maintain good form while lifting weights or on exercise machines to avoid back injury. If you suspect a back problem may be contributing to your UTIs, ask your doctor to give you a “uroflow” exam to assess whether or not you are voiding efficiently.
• Strengthen your core: Often, a lazy bladder (unable to empty urine properly) occurs due to lower back problem, so consider doing exercises to help strengthen your back and stomach muscles. Ask your physician or fitness trainer about which exercises are beneficial to your abs and back.
• Respond to “nature’s call”: It’s always a good idea to urinate as soon as you feel the need in order to eliminate unwanted bacteria. While “holding it in” does not directly cause an infection, it can cause overdistension that can damage the lining of the bladder, making it more vulnerable to bacteria and over time, it may not contract or relax at will.
• Take a vitamin C supplement: Take about 1,000 milligrams of vitamin C throughout the day to help inhibit the growth of some bacteria by acidifying the urine.
• Lubricate: As estrogen declines, vaginal dryness increases.  Make sure to be properly lubricated during sexual activity (use a water-based vaginal lubricant) to decrease friction in the vagina/urethral areas.
• Take an antibacterial: If you are menopausal and prone to UTIs, Gillespie recommends taking Cystex® as a preventative, as it is the only OTC urinary tract medication that contains methenamine, an antibacterial agent that attacks bacteria and helps prevent it from adhering to the cell wall lining of the bladder. Cystex® can be taken before activities or situations that you believe have contributed to urinary tract infections, such as sexual intercourse. If you do develop a UTI, taking Cystex® until you can see the doctor will help keep the infection from progressing and also help with the pain.