Welcome to Menopause, Enjoy Your UTI

Urinary tract infections (UTIs) are one of the most common infections women will experience, but did you know that postmenopausal women are 55% more likely to develop a UTI?

Hormones play a key role in the prevalence of UTIs among this group of women. With age comes estrogen loss, which results in thinner tissue and weaker muscles in the urethra and vagina. Add in the lower levels of healthy bacteria from estrogen loss, and there’s a potential breeding ground for harmful bacteria to multiply. The female anatomy itself is another reason for the higher prevalence of UTIs in women. With a shorter urethra, bacteria have less distance to travel to reach the bladder.

About 20-36% of postmenopausal women will suffer with recurrent UTIs, which is two or more UTIs in a 6-month period or three or more in a year. Drug-resistant strains of UTIs are also on the rise and have been a concern for infectious disease experts for years. A 2022 World Health Organization report that included data from 87 countries found that more than 20% of UTIs were resistant to first and second-line antibiotics because of the presence of E-coli bacteria.

The good news is that women in the U.S. will soon have a new treatment option for UTIs. Pivmecillinam (Pivya) has been used in Europe for over 40 years and was FDA approved for use here in April. This oral antibiotic is 95% effective in treating UTIs and is recommended as a first-line option in many countries.

Symptoms of a UTI can include pain and a burning sensation during urination, urine that is cloudy or has a strong smell, and a frequent and constant need to urinate. More extreme cases include blood in the urine and back pain. Other risk factors include diabetes and urinary incontinence.

While some UTIs can’t be prevented, there are ways to help reduce the risk of developing an infection.

• Stay hydrated by drinking lots of water.
• Urinate before and after sexual activity.
• Shower instead of taking a bath.
• Wipe from front to back after using the restroom.
• Avoid the use of douches, sprays, or powders.

Pivmecillinam will be available in the U.S. in early 2025, and an intravenous form of the drug is also in development to be used in hospital settings for more serious cases. Cranberry juice or extract has long been used for the treatment or prevention of a UTI, but studies show no evidence to support the use of cranberries to treat or prevent an infection. It’s important to see a doctor immediately if you have symptoms of a UTI. Bacteria can spread quickly into other parts of the body if left untreated or if the current treatment is unsuccessful.