Complete Guide to Menopause and UTIs - Stella

Menopause and UTI


Urinary tract infections (UTIs) are something most are all too familiar with, unfortunately. Menopause UTIs are inconvenient, painful and can make going out and about a challenge when all you are doing is assessing where the nearest loo is. During menopause, UTIs can ramp up and cause all sorts of grief.


A UTI is usually a bacterial infection that can happen anywhere in your urinary tract. They can show up with a multitude of symptoms.

You are more susceptible to UTIs during menopause due to:

  • Hormonal changes and declining levels of oestrogen
  • Skin thinning – making it easier for bacteria to grow
  • Reduced vaginal flora variety – it is easier for ‘bad bacteria’ to colonise
  • Sex – can drive ‘bad bacteria’ into your urethra and bladder

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  • Approximately 50-60% of women will develop a UTI in their lifetime
  • You are more likely to have menopause UTIs  if you also have a chronic condition such as diabetes
  • Having a urinary tract infection can also cause temporary urinary incontinence

Read more about the stages of menopause.


UTI symptoms depend on which part of the urinary tract is infected. 

Lower tract UTIs (the most common form) affect the urethra and bladder and symptoms can include:

  • Burning or pain sensation when you pee
  • Needing to pee suddenly and more often
  • When you pee, you’re not passing much urine
  • Pelvic pain or pain in your lower tummy
  • Pee that looks bloody or cloudy
  • Pee that has a stronger odour than what you’re used to

Upper tract UTIs mainly affect the kidneys. These are less common, but more serious and can be potentially life-threatening. Symptoms can include:

  • Pain and tenderness in your upper back and sides
  • Chills
  • Fever
  • Nausea
  • Vomiting


  • Toilet hygiene – wipe yourself from the front to the back
  • Go to the loo when you need to, don’t hold your pee in for ages
  • Pee after sex – this helps get rid of any bacteria
  • Keep hydrated


Make an appointment to see your doctor as soon as you feel those tell-tale signs of a UTI – don’t wait! Ask for an urgent appointment if you notice blood in your pee.


Your doctor may suggest:

  • A course of antibiotics
  • Single-dose antibiotic approach, where you take an antibiotic as soon as a trigger happens (such as having sex)
  • Daily low-dose antibiotic, if you have recurrent UTIs

NICE says that it is not possible to say whether a single-dose antibiotic or low-dose taken daily works any better.


According to NICE, one small study found that women taking D-mannose were less likely to have a UTI over six months. But it is difficult to give reliable figures on whether this treatment prevents UTIs.

Cranberry products

Some studies have shown a benefit, while others didn’t. NICE advises it is difficult to give reliable figures on if this treatment prevents UTIs.

Vaginal oestrogen

Your doctor can advise if this hormone treatment is suitable for you. You insert this as a cream into your vagina with an applicator.NICE says that out of 100 women using this treatment over 8 months, 45 women avoid getting a UTI because of this treatment, 15 people still get a UTI and 40 won’t get one but would not have done anyway.

As the figures are from studies taken across different women at different times, NICE says it is not possible to say whether this treatment reduces UTIs.


Fluctuations and an overall decrease in your oestrogen levels throughout the stages of menopause change the vulval tissue, making it more fragile and also changes the balance of bacteria in your vulva which increases the risk of a UTI.

Your pelvic floor muscles may also weaken, which make it harder to fully empty your bladder.

Some have other menopause symptoms, such as incontinence or vaginal discomfort.

Having a urinary tract infection can affect your quality of sleep and your enjoyment of sex.

A urinary tract infection can increase the risks of having recurrent or chronic UTIs or kidney infections. They can affect your overall quality of life.

Many types of urinary incontinence are temporary or improve with pelvic floor muscle programme.

It’s a good idea to have a chat with your doctor to see what types of medical and surgical treatment could be available to you.

The fear of going somewhere new where you do not know where the loos are can be overwhelming”


  • Al-Badr A, Al-Shaikh G. Recurrent Urinary Tract Infections Management in Women: A review. Sultan Qaboos Univ Med J. 2013;13(3):359-367. doi:10.12816/0003256
  • Foxman B. Epidemiology of urinary tract infections: incidence, morbidity, and economic costs. Am J Med. 2002;113:5–11S.
  • Gupta K, Hooton TM, Naber KG, Wullt B, Colgan R, Miller LG, et al. Infectious Diseases Society of America; European Society for Microbiology and Infectious Diseases. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: A 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Diseases. Clin Infect Dis. 2011;52:e103–20
  • Healthline: UTIs in Adults: Everything You Need to Know
  • Hu KK, Boyko EJ, Scholes D, et al. Risk Factors for Urinary Tract Infections in Postmenopausal Women. Arch Intern Med. 2004;164(9):989–993. doi:10.1001/archinte.164.9.989
  • Mody L, Juthani-Mehta M. Urinary tract infections in older women: a clinical review. JAMA. 2014;311(8):844-854. doi:10.1001/jama.2014.303
  • NHS: Urinary tract infections (UTIs)
  • NICE: Reducing the chance of recurrent urinary tract infection (UTI) in postmenopausal women
  • Raz R. Urinary tract infection in postmenopausal women. Korean J Urol. 2011;52(12):801-808. doi:10.4111/kju.2011.52.12.801
  • Renard J, Ballarini S, Mascarenhas T, et al. Recurrent Lower Urinary Tract Infections Have a Detrimental Effect on Patient Quality of Life: a Prospective, Observational Study [published online ahead of print, 2014 Dec 18]. Infect Dis Ther. 2014;4(1):125-135. doi:10.1007/s40121-014-0054-6
  • Scholes D, Hawn TR, Roberts PL, et al. Family history and risk of recurrent cystitis and pyelonephritis in women. J Urol. 2010;184(2):564–569.
  • Shao IH, Wu CC, Hsu HS, et al. The effect of nocturia on sleep quality and daytime function in patients with lower urinary tract symptoms: a cross-sectional study. Clin Interv Aging. 2016;11:879-885. Published 2016 Jun 29. doi:10.2147/CIA.S104634
  • Wagenlehner F, Wullt B, Ballarini S, Zingg D, Naber KG. Social and economic burden of recurrent urinary tract infections and quality of life: a patient web-based study (GESPRIT). Expert Rev Pharmacoecon Outcomes Res. 2018;18(1):107-117. doi:10.1080/14737167.2017.1359543


Is it normal to leak and pee a lot during menopause? Read more

Our complete guide to sex and UTIs during menopause. Read more

How to stem the flow of heavy periods. Read more

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