Vaginal Dryness and Urinary Tract Infections (UTIs)
Do you have vaginal or vulvar dryness, burning, decreased lubrication, or pain? You are not alone.
These symptoms are part of a process called Genitourinary Syndrome of Menopause (GSM). GSM occurs because of the natural decrease in estrogen in the vagina, vulva, and bladder that occurs with menopause. With declining estrogen, the vaginal tissue can become thinner and more easily irritated.
About 30 percent to 50 percent of postmenopausal women experience these symptoms. Unfortunately, though, women do not generally discuss these problems with their health care providers.
GSM also can cause urinary symptoms like pain with urination and recurrent urinary tract infections.
What are the symptoms of Genitourinary syndrome of menopause (GSM)?
- Vaginal dryness
- Vaginal burning
- Vaginal discharge
- Genital itching
- Burning with urination
- Urgency with urination
- Frequent urination
- Recurrent urinary tract infections
- Urinary incontinence
- Light bleeding after intercourse
- Discomfort with intercourse
- Decreased vaginal lubrication during sexual activity
- Shortening and tightening of the vaginal canal
Urinary Tract Infections
Recurrent Urinary Tract Infections are one of the most common symptoms of Genitourinary syndrome of menopause (GSM). A Urinary Tract Infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. E. coli, a type of bacteria that lives in the bowel and near the anus, causes most UTIs. UTI symptoms include pain, abdominal pain, mild fever, urinary urgency and frequency.
Many older women struggle with urinary tract infections and a big reason why is because their bladder walls can be invaded by several species of bacteria.
Researchers at University of Texas Southwestern (UTSW) in Dallas analyzed bacteria in bladder biopsies from 14 postmenopausal women with recurrent UTIs. The investigators found that in these patients, several species of bacteria can get inside the bladder's surface area.
Other factors believed to contribute to higher UTI rates in postmenopausal women include pelvic organ prolapse, diabetes, lack of estrogen, loss of Lactobacilli in the vagina, and higher levels of E. coli in tissues surrounding the urethra, according to the researchers.
What Causes UTIs
Urinary tract infections (UTIs) typically occur when bacteria enter the urinary tract through the urethra and begin to multiply in the bladder. Although the urinary system is designed to keep out bacteria, these defences sometimes fail. When that happens, bacteria may take hold and grow into a full-blown infection in the urinary tract.
For a lot of us, UTIs are caused by specific activities that cause bacteria to enter the urinary tract through the urethra. For example, this may occur when wiping your bottom or having sex, but often it’s not clear why it happens. However, UTIs aren’t always caused by specific activities. Sometimes, UTIs seem to come out of nowhere and once we get just one UTI, our likelihood of getting another increase.
Biofilm is a tool that UTI-causing bacteria use to hide from both your immune system and antibiotics, waiting for a good time to release and start a recurrent UTI. That’s why some UTIs seem to come out of nowhere, unlinked to specific activities.
Did you know?
- Recurrent UTIs are very common among women.
- UTIs account for 20% of all infections in women.
- 1 in 2 women will have at least one UTI in their lifetimes.
- After a UTI: 20-40% of women will have recurrences which can last for years on end.
- The risk of UTIs in women increase significantly after menopause.
- UTIs are one of the biggest reasons for missed work days among women.
Symptoms of Urinary Tract Infections:
The most common symptoms of a UTI are a frequent urge to urinate and a painful, burning sensation while urinating in young women. Older men and women may have abdominal pain and feel tired and weak. The urine may also be dark, cloudy, foul smelling or bloody. If these symptoms are accompanied by fever, back pain and nausea and vomiting, it may be a sign of a kidney infection.
If you have frequent UTIs, your doctor may make certain treatment recommendations, such as:
- Low dose antibiotics, initially for six months but sometimes longer.
- Self-diagnosis and treatment, if you stay in touch with your doctor.
- A single dose of antibiotic after sexual intercourse if your infections are related to sexual activity.
- Taking antibiotics for 1 or 2 days every time symptoms appear.
- Vaginal estrogen therapy if you’re postmenopausal.
- Using an at-home urine test kit when symptoms start.
When to see a doctor
Many postmenopausal women experience symptoms of "genitourinary syndrome of menopause (GSM) such as vaginal dryness and Recurrent Urinary Tract Infections (UTIs), however, few seek treatment. Women may be embarrassed to discuss their symptoms with their doctor and may resign themselves to living with these symptoms.
Make an appointment with your doctor if you have any unexplained vaginal spotting or bleeding, unusual discharge, burning, or soreness.
Also make an appointment to see your doctor if you experience painful intercourse that's not resolved by using a vaginal moisturizer or water-based lubricant.
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