Menopause and UTIs: How They’re Linked and Ways to Lower Risk

Yes, menopause increases the risk of UTIs or urinary tract infections.

As the body naturally transitions through perimenopause, menopause, and postmenopause, falling estrogen levels weaken the urinary tract’s natural defenses. 

Vaginal and urethral tissues become thinner and drier, pelvic muscles lose strength, and the balance of protective bacteria shifts — all of which create conditions where bacteria can easily grow and cause UTIs. 

Let’s learn about the connection between menopause and UTIs and some practical steps to lower your risk of infection. 

Let’s Unpack:

• Why Are UTIs Common After Menopause?

• How Does Estrogen Decline During Menopause?

• How Does a Drop in the Hormone Estrogen Increase UTI Risk?

• What Are the Symptoms of UTI in Menopausal Women?

• How to Diagnose and Treat UTIs in Menopausal Women

• Self-Care and Lifestyle Tips to Prevent UTIs During Menopause

Why Are UTIs Common After Menopause?

UTIs are more common after menopause because falling estrogen levels weaken the urinary tract’s natural defenses. 

This hormonal shift affects bladder muscles, vaginal and urethral tissues, and the balance of healthy bacteria — all of which normally help protect against infection. 

Menopause itself is a natural and gradual process that includes perimenopause, menopause, and postmenopause. Throughout this time, estrogen levels steadily decline.

How Does Estrogen Decline During Menopause?

During the menopausal transition, your ovaries stop producing significant amounts of estradiol (E2) — the most potent form of estrogen during the reproductive years.

Estrone (E1), a weaker estrogen produced mainly in fatty tissue (adipose tissue), becomes the primary circulating form. Although the body can convert some estrone to estradiol, overall estrogen levels remain much lower during menopause. 

These hormonal changes increase your UTI risk and can also trigger menopause symptoms such as hot flashes, night sweats, and mood changes.

How Does a Drop in the Hormone Estrogen Increase UTI Risk?

Lower estrogen levels trigger several changes that can make UTIs more likely:

1. Weak Bladder and Pelvic Muscles

Estrogen normally helps maintain the strength of your pelvic muscles and supports good blood flow. 

When it dips during menopause, your pelvic muscles, including those that support the bladder and urethra, can weaken. This can lead to accidental leaks during activities that put pressure on the bladder or urethra, such as exercise, coughing, or even laughing.

Incontinence pads or briefs can support you during accidental bladder leaks. However, excess moisture can create conditions that allow bacteria to grow and cause infections. 

Want an extra layer of protection with incontinence care?
Using a hygiene shield, such as UraGuard®, with an incontinence product can reduce your exposure to harmful bacteria. 

UraGuard® sits directly over your urethra, creating a physical barrier that blocks the entry of infection-causing bacteria, reducing your risk of getting a UTI. 

It’s light, comfortable, discreet, and fits easily inside your incontinence diaper or brief.

Support your urinary hygiene during menopause with UraGuard® — try it today!

Note: UraGuard® is for use with incontinence briefs and diapers; not for sanitary pads or tampons.

2. Thinning and Dryness of Vaginal and Urethral Tissues

Estrogen keeps the lining of the vagina and urethra thick, elastic, and well-lubricated. 

When estrogen levels are low, these tissues become thinner, drier, and more delicate — a condition known as vaginal atrophy. This can make your genital area more prone to irritation and infection.

3. Loss of Healthy Bacteria

Estrogen promotes the growth of protective “good” bacteria — mainly Lactobacillus — in the vagina and urinary tract. 

Before menopause, the vaginal walls release glycogen, a form of glucose, which Lactobacilli ferment into lactic acid. This acidic environment helps stop less-friendly bacteria and other pathogens from taking hold.

When estrogen levels decline with menopause, glycogen levels in the vaginal tissue drop. With less glycogen to feed on, Lactobacilli numbers fall, and the vaginal pH becomes less acidic. 

This shift makes it easier for infection-causing bacteria to thrive and cause recurrent UTIs. 

4. Pelvic Organ Prolapse (POP)

Pelvic organ prolapse is the sagging of pelvic organs, such as the bladder, uterus, or rectum, into or through the vaginal canal due to weakened pelvic floor muscles. 

This can make emptying your bladder difficult and create conditions for bacteria to grow and cause UTIs.

What Are the Symptoms of UTI in Menopausal Women?

UTIs in older women can appear in ways that aren’t always obvious:

• Instead of the usual burning sensation, pain, or cloudy urine, a UTI might appear as new or worsening leaks, confusion, forgetfulness, or unusual tiredness.
  

• Some women may experience loss of appetite, difficulty breathing, or lower blood pressure. 

• Sometimes, just a feeling of being “not quite yourself” can be an early sign. 

These changes can also affect mental health, leading to increased anxiety, stress, or insomnia.

If you experience a high fever (101°F or higher) or notice blood in your urine, seek medical attention immediately.

Important: Menopause and UTI symptoms can sometimes overlap, and you may have a hard time telling them apart. For instance, menopausal women may experience painful urination due to vaginal atrophy. The thinning of vaginal tissue can cause discomfort while peeing, even in the absence of a urinary infection.

How to Diagnose and Treat UTIs in Menopausal Women

Diagnosing a Urinary Tract Infection

To find out if you have a urinary tract infection, doctors may recommend:

• A urine test to check for signs of infection, like bacteria or white blood cells.

• A urine culture to determine the bacteria causing the infection, so you get the proper antibiotic treatment.

• An ultrasound or CT scan if your urinary symptoms don’t improve or if there’s bleeding.

Treating a UTI

For treatment, doctors may suggest:

• Vaginal estrogen creams, tablets, or rings to help restore estrogen levels and lower your risk of chronic UTIs. They work by improving blood flow, thickening vaginal tissues, and reducing vaginal dryness, strengthening the body’s natural barrier against infection.
  
  Note: Vaginal estrogen may not be suitable for everyone, especially if you have a history of heart attack or stroke, or if you or a family member has had blood clots or breast cancer. Talk with your doctor to determine if it’s safe for you.

• Antibiotics (oral tablets such as Nitrofurantoin or Keflex) to clear the infection. Most people start to notice relief with antibiotics within a couple of days.

• Low-dose antibiotic treatment for several months to prevent recurrent UTIs.

• Hormone Replacement Therapy (HRT), which contains estrogen, if your bladder problems are linked to tissue changes from menopause. By improving the health of the bladder, urethra, and vaginal tissues, hormone therapy can help reduce chronic UTIs.

Important: Over-the-counter pain relief medication or topical analgesic gels can provide temporary relief from urinary symptoms and discomfort, but they do not treat the underlying infection. Instead of self-medication, consult your doctor if you notice any symptoms.  

Self-Care and Lifestyle Tips to Prevent UTIs During Menopause

UTIs can be a real bother during menopause, especially if you’re also managing urinary incontinence. However, a few simple changes in your daily routine can help support urinary tract health, keep you more comfortable, and reduce irritation.

If you wear incontinence diapers or briefs, pairing them with a hygiene shield like UraGuard® gives you extra protection and peace of mind.

Here’s why women prefer UraGuard®:

• It’s lab-tested to block bacteria and protect your skin.

• It shields the delicate area around the urethra, where most bacteria sneak in.

• It’s soft, light, and flexible, so you’ll hardly notice it’s there.

• And best of all, it’s slim and discreet, so no one else will notice either. 

Along with using UraGuard®, here are some easy self-care tips to help lower UTI risk during menopause:

• Stay hydrated: Drinking plenty of water helps flush bacteria from your bladder. It also reduces vaginal dryness and irritation.
  

• Wipe the right way: After using the bathroom, gently wipe from front to back. This keeps bacteria from the anal area away from the urethra and vagina.
  

• Go gentle with cleansing: Skip perfumed soaps, sprays, or harsh cleansers down there. These can upset the natural balance of your vagina and cause irritation. 
  

• Wear breathable fabrics: Cozy cotton undies and loose clothes can help you stay dry and comfortable, giving bacteria less chance to grow.
  

• Support your overall health: Engaging in regular physical activity, even if it’s light movement, and eating well can keep your immune system strong and boost physical and mental health.

Navigate Menopause and UTIs with Confidence

Menopause is a natural transition, but it can also be complex — and dealing with urinary tract infections adds another layer of frustration.

The good news is that small, consistent habits, such as staying hydrated and choosing the right hygiene products, can help support your urinary health and keep you more comfortable.

If you’re dealing with incontinence, UraGuard® can offer extra peace of mind. It forms a barrier over the urethra, where most bacteria enter, reducing your chances of getting a UTI. 

Try UraGuard® today to help protect against incontinence-related UTIs.