Board Certified Urologist, Dr. Elizabeth Kavaler, Offers Tips on How to Avoid a UTI during Menopause

Menopause affects every woman and is usually associated with hot flashes, irritability, and difficulty sleeping. However, a lesser known issue in menopause is the increased risk of urinary tract infections (UTIs) due to a lack of estrogen.

“The decrease in estrogen causes the bladder to become less elastic, triggering an inability to empty the bladder completely,” says Elizabeth Kavaler, M.D., urologist and author of “A Seat on the Aisle, Please! The Essential Guide to Urinary Tract Problems in Women,” (Copernicus Books, 2006). “Ultimately, not being able to empty the bladder completely can create a breeding ground for bacteria to multiply, leaving menopausal women at risk for developing a UTI.”

Additionally, the amount of protective vaginal organisms, lactobacilli, which help prevent harmful bacteria from adhering to vaginal tissue and the urethra, decreases after menopause, as well.

Dr. Kavaler who is one of 500 female urologists in the United States specializing in female urinary tract issues, recommends these 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

• Respond to “nature’s call”: Urinate as soon as you feel the need to in order to eliminate unwanted bacteria

• Watch your back: Protect your back since 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

• 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

• 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 making sure you have an acid 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, Dr. Kavaler recommends taking Cystex® as a preventative, as it is the only over-the-counter 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, as well as a pain reliever

Visit www.cystex.com to view the new Cystex “Know Your Bladder Better” video series or connect with Dr. Kavaler directly by visiting the new interactive “Ask the Urologist” feature to submit an informational question about bladder health.

 We are really excited to share this information with you. Below is a list of the top questions we’ve received via our “Ask the Urologist” online feature.  If you have a question about UTIs that you’d like to see answered, visit the Cystex Know Your Bladder Better “Ask the Urologist” form page and send it in. Thank you for your support!

Q- I have Interstitial Cystitis. I need something that will help with frequency of urination, mostly at night, along with bladder pain, would Cystex work for that also?

A- Interstitial Cystitis can be difficult to treat but there are many different options to help relieve both the frequency of urination and the pelvic pain. Cystex may help relieve the symptoms, and it has many fewer side effects than many of the medications that are prescribed by physicians. It is certainly worth a try, and it is safe.

Q – I get a UTI almost every time I have intercourse. I’ve tried taking precautions, but nothing seems to work. I try to go to the bathroom afterwards, but that doesn’t always work and I usually don’t have to go. Will taking Cystex help to prevent an infection?

A – Many women have the same problem. The bacteria come from your own body, so your partner is not the source of the infections.

Cystex may help in prevention. If you feel you are prone to UTIs, speak to your physician about taking Cystex before activities that may irritate the urethral area, such as sexual activity. For more information about the connection between Sex and UTIs click here or visit the Cystex video library.

Q –Can you have sex with a UTI? Or would it harm you further if sexual intercourse was the cause of the UTI you already have?

A – You can have sex with a UTI without harming either yourself or your partner. If you are taking Cystex or an antibiotic to manage an infection, you can have sex as well. So, don’t let these infections interfere with your life, if you can help it.

Q – Why do I keep getting UTIs one after the other?  What gives?

A – Many women have the same problem. If you are prone to UTIs, you should discuss a uroflow exam (which measures the flow and force of your urine stream) with your physician. Ask your physician about going on a low dose of antibiotics every night for three month to completely get rid of the infection. Sometimes that will kick out the infection and give your immune system a boost. Also, talk to your doctor about taking Cystex as a preventative measure.

Q – Does Cystex effect the proficiency of my birth control?

A – Cystex will not affect the efficacy of your birth control pill. It is recommended that you talk with your physician about specific medications and their effect on contraception.

Q – Can Cystex be taken while pregnant or breastfeeding?

A –We do not encourage taking Cystex or any medication, either over-the-counter or prescription while you are pregnant or breastfeeding unless you absolutely need it and your doctor okays it.

Q – How long does it take for Cystex to start working?

A – It takes about 20 -30 minutes for the pill to start working once it is taken. Some people find that it takes a little longer.

Q – Do I still need to see a doctor if my UTI symptoms and pain have subsided since taking Cystex? Can the Cystex completely cure my infection?

A – Yes, it is important to see a doctor as soon as possible. Your healthcare provider will take a urine culture so that the proper course of antibiotic therapy may be prescribed to cure the UTI.

Please note that the new “Ask the Urologist” and Q&A with Dr. Kavaler on the Cystex Web site (www.cystex.com) or other sites associated with the Cystex Web site is for informational purposes only and should not be construed as a personal medical diagnosis or formal medical advice. If you have any health questions or concerns, we recommend that you seek medical advice from your physician.

Cystex “Know Your Bladder Better” Video Gives the Down Low on the Sex and UTI Connection

According to a study in the American Journal of Clinical Nutrition, frequent sexual intercourse (three or more times a week) is associated with a greater risk of UTI compared with less frequent intercourse (less than once a week).

“An increase in sexual activity can lead to urinary tract infections and is often referred to as honeymoon cystitis, however, you don’t just get cystitis on your honeymoon,” says Elizabeth Kavaler, M.D., urologist and author of A Seat on the Aisle, Please! The Essential Guide to Urinary Tract Problems in Women (Copernicus Books, 2006). Any boost in the romance department can put you more at risk for a UTI.

The increased genital friction can more easily introduce bacteria into the female urethra (leading to the bladder), which for some women who have issues with urinating properly, can increase the chance of getting a UTI.

If you think you have a UTI you need to see a physician for proper treatment, but until then there are some things that you can do to ease the pain and keep the infection under control. Dr. Kavaler suggests drinking a lot of water, emptying your bladder frequently, and taking Cystex, an over-the-counter medication that will not only take the pain of the infection away, but it will also slow the reproduction of the bacteria in the bladder until you can see a doctor.

Visit www.cystex.com to view the new Cystex “Know Your Bladder Better” video series, including a new video on honeymoon cystitis, or connect with Dr. Kavaler directly by visiting the new interactive “Ask the Urologist” feature to submit an informational question about bladder health

Please note that the new “Ask the Urologist” and Q&A with Dr. Kavaler on the Cystex Web site (www.cystex.com) or other sites associated with the Cystex Web site are for informational purposes only and should not be construed as a personal medical diagnosis or formal medical advice. If you have any health questions or concerns, we recommend that you seek medical advice from your physician.

In a 2008 survey conducted by Cystex® urinary relief tablets, 70% of women indicated they have walked out of a public restroom without using it because they felt it was “too dirty.”  However, if you squat when you urinate in a public restroom to avoid an infection from the toilet seat, you may actually be doing more harm then good.

According to Elizabeth Kavaler, M.D., urologist and author of “A Seat on the Aisle, Please! The Essential Guide to Urinary Tract Problems in Women,” (Copernicus Books, 2006), squatting over the seat can actually prevent the complete emptying of the bladder, which can lead to infection, especially in women who are prone to urinary tract infections(UTIs).

When you squat over the toilet seat, you keep your pelvic muscle contracted, which reduces your ability to empty your bladder completely, as you would be able to if you were sitting and relaxed. When the bladder doesn’t empty completely, the remaining urine can become a breeding-ground for bacteria, which may lead to a UTI. Prevent this by using a toilet seat cover when available or line the seat with toilet paper and take a seat. It’s important to note that you will not catch any infection, including STDs, from sitting on a public toilet seat.

Visit www.cystex.com to view the new Cystex “Know Your Bladder Better” video series or connect with Dr. Kavaler directly by visiting the new interactive “Ask the Urologist” feature to submit an informational question about bladder health.

Please note that the new “Ask the Urologist” and Q&A with Dr. Kavaler on the Cystex Web site (www.cystex.com) or other sites associated with the Cystex Web site are for informational purposes only and should not be construed as a personal medical diagnosis or formal medical advice. If you have any health questions or concerns, we recommend that you seek medical advice from your physician.

If you’re having difficulties `going with the flow,` you could possibly have a urinary tract infection (UTI). Since your urinary flow or `stream` can be the first indicator of possible medical issues, such as inflammation, it’s important to recognize any changes in your urine stream. A strong, steady, healthy urine flow naturally cleanses the urinary tract and surrounding area of unwanted bacteria each time you urinate. If something is inhibiting normal urination, bacteria can be trapped inside the urinary tract leading to a UTI.

According to Elizabeth Kavaler, M.D., urologist and author of A Seat on the Aisle, Please! The Essential Guide to Urinary Tract Problems in Women (Copernicus Books, 2006), there are ways to improve your urine flow strength:

• Stay Hydrated: Drinking plenty of water will increase the flow of urine and help flush out bacteria in the urinary tract.
• Take a “Uroflow” Test: If you suffer from recurrent UTIs or suspect you have a urinary blockage, ask your doctor for a “uroflow” test to assess whether or not you are voiding efficiently.
• Put Down the Heavy Purse: Carrying a heavy backpack, tote or large, filled-to-the-brim pocketbook, no matter how chic and gorgeous it is, can contribute to the development of lordosis (a painful condition that creates pressure on the nerves in the lower back). Back strain in the lower back muscles can actually interfere with urine flow, which can lead to abnormal voiding (urination) and increased presence of bacteria that doesn’t get flushed away…leading to risk for UTIs.

Urinary tract infections are not pleasant to experience. However, you’re not the only one suffering. UTIs are the second most common infection in the body accounting for more than eight million doctor’s visits a year.

So while not every UTI is avoidable, there are some ways to help prevent a UTI from taking hold:

1. Stay Hydrated: UTIs do not occur when bacteria gets into the bladder, they occur when it does not get out.  Drinking at least eight glasses of water per day promotes regular urination which helps flush out bacteria in one’s urinary tract.
2. Protect Your Back: Lower back stress can affect the flow of urine, which can lead to abnormal voiding (urination) and UTIs.  If you suspect a back problem may be contributing to your UTIs, ask your doctor for a “uroflow” exam to assess whether or not you are voiding effectively.
3. 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.
4. Avoid Feminine Hygiene Sprays and Scented Douches: They can irritate the urethra causing an inflammation that can promote urinary bacteria
5. Respond to “Nature’s Call”: Urinate as soon as you feel the need to 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.
6. Wear Cotton Undies: Opt for panties with a cotton crotch since cotton fabric allows moisture to escape while other fabrics trap moisture (which bacteria thrives on).
7. Wipe From Front to Back: After a bowel movement or voiding, wipe from front to back to prevent bacteria from the anus from entering the vagina or urethra.
8. Take Showers Instead of Baths: Avoid exposing your urethra to stagnant water which predisposes you to a urinary tract infection.
9. Proper Washing: Wash your genital area before and after sexual intercourse to help prevent transferring bacteria to the urethra or vaginal area which can create a breeding ground for a UTI.
10. Take an Antibacterial: Women who have recurrent UTIs might consider taking Cystex® as a preventative as it contains methenamine, an antibacterial agent that helps prevent bacteria from adhering to the walls of the urinary tract.  Cystex® can be taken before activities or situations that you believe have contributed to urinary tract infections. Speak to your physician.

For more information on UTIs and other useful tips on preventing one, Check out the Cystex Web site at www.cystex.com

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.

At last, you’ve arrived at your vacation destination only to be welcomed by a urinary tract infection (UTI). Although there’s never an ideal time to have a painful and annoying UTI, vacation time is at the top of the list, since its symptoms – painful urination and frequency – among others – is sure to put a damper on your fun in the sun.

Have no fear and listen up! The Cystex Experts are here with a few tips to help minimize your risk of getting a UTI while you’re away and guide you through this common infection, should you get one:

• When packing your bikini and sunscreen, make sure to also pack vitamin C, which  helps acidify the urine and inhibit the growth of some UTI-causing bacteria. Take 1,000 mg. daily while on vacation.
• In between sipping frozen cocktails on the beach, make sure to drink plenty of water and limit your consumption of alcohol to keep from becoming dehydrated. Eight glasses of water a day isn’t necessary for everyone: the amount of water you need depends on what makes you feel comfortable, your level of activity, your diet and the climate. On average, 32 ounces of fluid a day is enough to remove bacteria out of the bladder. Also, urinate regularly and empty your bladder completely (each time) to eliminate any unwanted bacteria.
• Unfortunately, while you’re away from home, you’ll have to use public restrooms more frequently than you might like,   so before you leave home, check out The Bathroom Diaries at Cystex.com, which rates and reviews public restrooms, including hours of availability, details about cleanliness, and safety from a personal perspective. If you follow this advice and still get a UTI while you’re away, try Cystex®, the over-the-counter urinary pain relief and prevention product that will help with the pain of a UTI and also slow the progression of the infection with an extra ingredient –  methenamine — that helps stop bacteria from adhering to the walls of the urinary tract. (Other UTI products sold over-the-counter do not have this bacteria-fighting ingredient,) When used as a preventative treatment, Cystex® should be taken before any situation or activity that might cause the infection. Always follow the instructions on the package.

Ultra high heeled shoes may be sexy, but did you know that they may not only be bad for your feet, but bad for your bladder? If you regularly wear high heels and also are experiencing UTIs, you might want to consider blaming your stilettos, says our expert, Larrian Gillespie, a retired urogynecologist and author of the book, You Don’t Have to Live with Cystitis, The Groundbreaking Guide to the Prevention and Cure of One of Women’s Most Stubborn Ailments (Quill, An Imprint of HarperCollins Publishers)..

She says that wearing high-heeled shoes that are too high for your hip and leg structure can cause your torso to tilt forward, which forces your hips and spine out of alignment. If this occurs often, you could develop a “swayback,” also known as lordosis, which is a painful condition that creates pressure on the nerves in the lower back.

Okay, so how does this cause an infection in your bladder? Well, Gillespie says that this pressure contributes to “inefficient urination,” which is the precursor for urinary tract infections.

This is how it works: The back contains many fine nerves, which can become strained by lifting/carrying heavy items, exercising, wearing high heels, from altered position, etc. The discs in the lower back can also become damaged, compressing the nerves and signaling the bladder to empty – even when it isn’t full. The injuries also can disrupt or inhibit urine flow, which causes bacteria to become trapped in the bladder causing a UTI. And, as you may have read on this blog or seen elsewhere on Cystex.com, good urine flow is necessary for flushing all the “bad” bacteria out of the bladder.

High heels aren’t the only culprit of lower back problems. Back strain can also be caused by overexerting yourself while exercising. (no, this is not a good reason to stop exercising!) Just make sure to use proper workout techniques by participating in aerobic activities that give you a natural, fluid motion, such as walking, and use weight machines instead of free weights – and ask someone to show you the proper way to use the equipment. If you currently suffer from back injuries, try swimming, which creates the least pressure on the injured area.

Also, lighten the load you carry around. Carrying a heavy backpack, tote or large, filled-to-the-brim pocketbook, no matter how chic and gorgeous it is, can contribute to the development of lordosis. (According to Time magazine’s special Style issue in 2007, the average weight of a woman’s purse was 5.2 pounds.) So ligten the load by getting rid of that hard-covered novel you keep saying you’re going to read on your lunch hour (but don’t) and only carry what you need to help avoid unnecessary back strain.

If you are prone to lower back problems and find you continue to get recurring UTIs help is out there. Make an appointment with your doctor and in the meantime, try Cystex®, which is an over-the-counter urinary medication that not only helps with the pain of a UTI, it also contains the natural antiseptic methenamine that helps stop bacteria from adhering to the wall of the urinary tract, thereby helping to prevent the infection from occurring in the first place. For more information, visit www.Cystex.com.

Cystex was recommended for women who have recurrent UTIs in the June/July issue of Health Wise Magazine. The article recommends Cystex as part of a healthy routine to prevent UTIs.