An orange and yellow paper cut out of a bladder on a light blue background

Can menopause cause
recurrent UTIs?

By Kathleen Morrison w/ Hormonally
May 15, 2024

For about half the global population, menopause is an inevitability. It signals that your body is transitioning out of producing and carrying children and into a new stage of life. Your ovaries stop releasing eggs and your periods stop, too, which in turn means that your body stops producing the levels of hormones needed to support a pregnancy. Changes in these hormone levels can result in a lot of the unpleasant side effects that many of us know to be associated with menopause, like hot flashes, irregular periods, mood changes, and recurrent UTIs. UTI and UTI symptoms can quickly become serious (not to mention painful!) so if you’re dealing with them, you need answers fast. Let’s dive in!

Why does menopause cause UTI symptoms?

Menopause can lead to Genitourinary Syndrome of Menopause, or GSM, a condition where the tissues of the vulva and vagina become thin, dry, and inflamed due to the decrease in your body’s production of estrogen. At first glance, this may not appear to be a serious problem, but thinner, dryer tissue is more prone to tearing and infection, and can lead to day-to-day discomfort from simple activities, like walking, sitting, and urinating. Additionally, this more irritated vaginal tissue often makes sex uncomfortable, if not outright painful. If you’re experiencing symptoms that include vaginal dryness, painful intercourse, and/or a urinary frequency or urgency, you may be dealing with GSM.

What is Genitourinary Syndrome of Menopause (GSM)?

Genitourinary Syndrome of Menopause is a term that describes various menopausal symptoms and signs, including not only genital symptoms (dryness, burning, and irritation), and sexual symptoms (lack of lubrication, discomfort or pain, and impaired function), but also urinary symptoms (urgency, dysuria, and recurrent urinary tract infections). These symptoms look different for everyone, and they may exacerbate each other. In the US, there are more than 34 recognized symptoms of menopause and 80% of women will experience some of them in their lifetime!

What is the impact of GSM?

Because there are so many different symptoms of menopause, it’s possible for the effects to touch all different parts of your life. The physical symptoms of GSM specifically can easily impact day-to-day activities, sexual relationships, and mental health, if they are not properly managed and treated. Recurrent UTIs can become a major source of both physical and emotional distress as a result of GSM, but Wisp and Hormonally have your back with convenient treatment options, prevention, and resources to help you navigate your menopause journey!

What treatments are there for GSM-related UTIs?

First, you should know that the most effective treatment for a UTI before, during, and after menopause is a round of antibiotics (always finish your full course!). Antibiotics will have you feeling better fast, but UTI symptoms can be painful, and in this case, prevention can be the best medicine. There are a few options you can explore with a provider for preventing UTIs if you’re peri or postmenopausal.

Vaginal estrogen

During the perimenopausal, menopausal and postmenopausal period, many women get relief from UTIs with vaginal estrogen creams, tablets, or rings. These are placed into your vagina, where they release small amounts of estrogen into nearby tissues to help combat vulvovaginal atrophy and rejuvenate dry and thinning tissue. Over time, it’s estimated that vaginal estrogen can reduce your risk of UTIs by more than 75%. Hormonal therapies have gotten a bad rap in the past where they’ve been linked to certain cancers, but recent research suggests that vaginal estrogen therapy is safe—researchers found that in vaginal estrogen therapy users compared with hormone replacement therapy nonusers, there was no evidence of a higher risk of breast cancer-specific mortality. The bottom line? Using vaginal estrogen to treat GSM symptoms is considered very safe and will not increase your risk of developing cancer!

Low-dose antibiotics

Your healthcare provider may prescribe a preventive dose of antibiotics for 6 months or more, or a single preventative dose right after having sex. This can be a highly effective strategy, but there is risk of creating bacteria resistant to antibiotics so it’s always best to consult with your doctor on the treatment that’s right for you.


If you’d like to explore a more natural route, D-Mannose is a natural supplement that is backed by research to help flush UTI-causing bacteria from your urinary tract to help prevent UTIs. Two different studies show that regular use of D-Mannose (in a dose of 1.5g or greater) can be as effective as antibiotics in the prevention of UTI recurrence.

Ready to learn more?

Hormonally is dedicated to making access to information on hormone health a more equitable experience for all! Use their Menopause Symptom Checker for more information about your menopause experience, or check out their Menopause resources.

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