UTIs, Incontinence and Menopause – More of a Connection than You Might Realize

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Welcome to Life Without Leaks, a podcast by the National Association for Continence. NAFC is America’s leading advocate for people with bladder and bowel conditions, with resources, connections to doctors, and a welcoming community of patients, physicians, and caregivers. All available at nafc.org. 

Do you have pain or burning when you pee? If so, you might have a urinary tract infection, commonly known as a UTI. They’re remarkably common. About 50% of women will develop one in their lifetime, and they get even more common as women get older and go through menopause. There are even some women who end up having chronic UTIs that seem to be triggered by the slightest dietary or hormonal changes.

If you’re one of the 50% unlucky enough to come down with a UTI, you know, firsthand that they can be far from pleasant. The discomfort, pain, inconvenience, and long-term effects can be anything from mildly disruptive to downright debilitating. And even though a UTI may seem like an isolated condition, it’s not. UTIs and incontinence often go hand in hand.

So what exactly is a UTI? It’s. A UTI is an inflammation in the bladder or urinary tract that’s caused by the presence of harmful bacteria. This can often be treated with antibiotics and it’s important that you don’t let your UTI go unchecked because they can become serious. If a UTI spreads to the kidneys or bloodstream, for example, it can cause sepsis, which is genuinely life-threatening. That’s why it’s important to always treat your UTIs as soon as possible.

UTIs usually start when the passageway between the bladder and the urethra – that’s the tube that passes urine outside the body – opens up, allowing harmful bacteria to enter into the bladder.

Symptoms include pain or burning while urinating, frequent urination, the urgent need to urinate right now, the feeling that you need to urinate despite having an empty bladder, urine that looks cloudy, bloody urine and pressure or cramping in the groin or lower abdomen. You may not have all of these symptoms, and there’s even a chance that you don’t show any at all.

There are a number of factors that can increase your risk of developing a UTI, like previous UTIs, infrequent voiding, which allows bacteria to grow for a longer time in the bladder. Incomplete voiding, which leaves an excess amount of urine in the bladder. Personal hygiene, since improper personal care can result in contamination that increases the risk of bacteria forming. Sexual activity, the use of spermicide, which changes vaginal flora and can allow bacteria to form. Genetics. Menopause, since the lack of estrogen can make bacteria more likely to form. Diabetes, because persistent high blood sugar levels cause immunosuppression that increases your chance of coming down with a UTI. And a weakened immune system.

One other big factor is being a woman. Women’s urethras are much shorter than men’s and they’re closer to the rectum too, which makes it easier for dangerous bacteria to enter the urinary tract.

And a woman’s anatomy is only part of it. As women get older, they go through menopause, which as we’ve mentioned, also increases risk. You see, following menopause estrogen levels drop, impacting the elasticity and moisture of vaginal and urethral tissues. This can lead to thinning, dryness, and irritation, all of which can predispose you to developing a UTI.

As estrogen levels drop, vaginal pH climbs, making it less acidic, and this creates a breeding ground for bacteria like e. Coli to get out of control. In addition to pH, the urethral muscles get weaker. That tight one-way valve which holds urine in becomes looser, making it less of a one-way street, so it becomes easier for the bacteria to travel into the bladder. Take all that together and voila, more UTIs.

So what’s this about a connection between UTIs and incontinence? Recurrent urinary tract infections have been linked in particular to urge incontinence. That’s the type of incontinence where you feel like you have to go now, whether or not you have leaks.

The reason for this is that when you have frequent UTIs, your bladder mucosa is weakened, which means that the bladder lining and nerves are not as strong as they might otherwise be. That can lead to incontinence. Sufferers find themselves going through a cycle where they get UTIs, then incontinence, then UTIs, then incontinence, over and over again.

Not only can UTIs lead to urge continence, but postmenopausal women with incontinence are at an increased risk of UTIs. That’s because weaker pelvic floor muscles, including that valve we’ve been talking about, can lead to a looser urethral opening and increased susceptibility to infection.

It’s a pretty strong relationship too. Research shows that patients with urinary incontinence are three times more likely to have UTIs, and on average they have 1.6 UTIs per year. On top of that, according to one study, patients with urinary incontinence are 63% more likely to slip and fall during the night, as well.

So what can you do about it? While UTIs can be dealt with through the use of over-the-counter medications or antibiotics, it can be painful and tiring to constantly deal with. Better to do what you can to prevent UTIs in the first place. Here are a few suggestions worth considering.

Stay hydrated. You might think that cutting back on liquids is a good idea, but it can actually be counterproductive. Instead, increasing water intake can help flush out bacteria and reduce your UTI risk. Urinate after sex. Emptying the bladder following sexual activity can help expel bacteria that may have entered the urethra.

Take cranberry supplements. Cranberry supplements are believed to contain compounds that prevent bacteria from lingering in the urinary tract, potentially reducing UTI occurrences. And try pelvic floor strengthening exercises. These can enhance urethral support and reduce the likelihood of urinary leakage.

In fact, treating your incontinence through pelvic floor muscle training and other measures can have remarkable results when it comes to UTI management. One study found that 82% of women experienced a resolution of their recurring UTIs once they address their incontinence.

For more information on UTIs, menopause, and all the different ways that you can work to strengthen your pelvic floor, visit us online at NAFC.org.

Life Without Leaks has been brought to you by the National Association for Continence. Our music is Rainbows by Kevin McLeod. More information about NAFC is available online at nafc.org.