Women of any age are more prone to urinary tract infections (UTIs) than their male counterparts. However, the risks appear to increase as a woman ages. Her body changes as she grows older, and hormones are often the culprit of those changes. Studies show that 10 percent or more of females over the age of 65 have reported experiencing a UTI within the last year. In women over 85, the odds increase to 30 percent.
What causes a UTI?
The culprit that takes credit for most urinary tract infections is a bacterium known as E. coli. Though it finds its home in the intestines of a healthy human, and usually causes no issues, there can be trouble when it makes its way into the urinary tract. This can occur in several ways.
It may be disturbing to know that E. coli (present in feces) can get into the urinary tract during sexual encounters. This is more likely to happen if the participants are not careful to cleanse themselves between anal and vaginal sex. Cleanliness is by far the best defense when it comes to bacteria.
E. coli can also reach the urethra from water backsplash during urination or defecation. Females should also be careful to wipe from front to back, as the urethra is very close to the rectum.
What is a UTI?
A urinary tract infection is a bacterial infection that can be found in the urethra, bladder, kidneys, and ureters. It is often confined to the urethra and bladder, making it simple to combat with a short round of antibiotics.
These infections can be painful, and if allowed to reach the kidneys they can be debilitating. If left to grow for a significant amount of time, the UTI can make a hospital stay inevitable. In some cases, the infection can cause an altered mental state, especially in older adults.
However, in general, a UTI is easily eradicated by a round of antibiotics. Lab tests and the patients’ medical history will determine which antibiotic is necessary, and for how long it should be taken.
Menopause risks for UTIs
What is different in menopausal women that puts them at greater risk for a urinary tract infection? It is the hormonal changes in the female body that cause higher incidents of infection. There are physical changes accompanying the hormonal ones that contribute to the risk of UTIs.
- Thinning of the vaginal tissue/inflammation of vaginal walls
- Pelvic organ prolapses
- Trouble emptying the bladder completely
- Lower estrogen levels
After menopause, a female loses much of her estrogen supply. This hormone change alters the bacteria in the vagina. Since the female’s genital function is so closely related to the functioning of her urinary system, lack of estrogen contributes to urinary tract infections.
Estrogen plays a heavy role in urinary tract health. Menopause takes its protection from the female body. The vagina contains several types of bacteria. These bacteria can live together without a problem using the guidance of estrogen. Estrogen lets the good bacteria (lactobacillus) grow. Lactobacillus produces an acid that fights the bad bacteria, including E. coli. Without it the bacteria have a tendency to run rampant.
The bladder contains natural antimicrobial substances and estrogen is the catalyst that encourages their growth. The urinary tract becomes stronger as the gaps between the cells that line the bladder are closed. Though some shedding of the top layers of cells in the bladder is necessary, too much shedding can lead to bacteria getting access to deeper tissue. Estrogen keeps too many cells from shedding.
A lack of estrogen may also bring forth vaginal atrophy, the thinning and inflammation of the vaginal walls.
Incontinence and menopause
Incontinence often leads to urinary tract infections. It is good to note that more than forty percent of women in menopause suffer from incontinence, thus adding another layer to their UTI issues. The weakening of the pelvic floor is the large contributor to mobility and displacement of the urethra when a woman exerts herself physically. At such moments, women can leak urine.
Estrogen plays a part in stimulating the blood flow in a woman’s pelvic region. Extra blood flow increases muscle strength and aids in holding the bladder closed. During menopause the loss of estrogen contributes to what is known as stress incontinence. Movement, laughter, or sneezing will bring on leakage.
Damp underwear due to incontinence, or soiled absorbent pads used to contain the leakage, are the perfect conditions for bacterial growth. Use cotton underwear and change absorbent pads often to reduce the risk of UTIs.
Symptoms of a UTI
Most women will show the classic symptoms of a urinary tract infection. These are easily detectable.
- Frequent urge to urinate, often with little results
- Burning sensation while urinating
- Cloudy, white, pink, red, or dark urine
- Offensive odor
- Pelvic pain
However, older women, especially those with conditions such as Alzheimer's, may not show these typical symptoms. They, and their caretakers, must watch for atypical symptoms that may be misdiagnosed as another disease or infection.
- Urinary retention
- More frequent falls
- A decrease in mobility
- A lessening of appetite
Prevention: How to avoid urinary tract infections?
The usual prevention methods used at any age can help. However, an older female may need to add other forms of prevention. The following is a list of preventative measures.
- Drink lots of fluids, mostly water
- Wipe from front to back
- Empty the bladder often
- Take showers instead of baths
For older females, add these precautions:
- Don’t strain, but remain seated in a comfortable position until bladder is completely emptied every time you urinate
- Urinate immediately after intercourse. The flow will wash most bacteria away.
- Using estrogen creams, gels, rings, or suppositories may be of help to restore balance of normal bacteria
- Take preventive antibiotics after sex or continuously at a low dose
There is no way to promise a woman that she will never suffer from a UTI. However, precautions and regular doctor’s visits will lessen the odds. Cleanliness is the best defense as with most infections.
Should a woman find herself suffering from UTIs, whether before or after menopause, a quick exam by her physician, and several days of antibiotics will soon ease the pain. Never allow the infection to go untreated. It will only lead to complications and dire consequences to your overall health.