Estrogen is important in maintaining the health of the vagina, vulva and lower urinary tract (bladder and urethra). With menopause, the lack of estrogen results in weakening of the tissue supports to these structures and thinning of the protective tissue lining to these organs, which are important in preventing infection. Many women have worsening prolapse issues, which can prevent complete bladder emptying, and that static residual urine serves as a reservoir for bacteria to grow in. Likewise, the nerves of the bladder often function less well, so the symptoms that signal that an infection is starting may be blunted. With various medical issues that become more common as we get older, the immune system may also be weakened, allowing a bacterial colonization to blossom into a full blown infection. If you are having several UTIs a year, or a stubborn recurrent infection that isn't responding to routine antibiotic therapy, a more detailed evaluation with a gynecologist or urologist may be extremely beneficial.
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