In today’s episode, Dr. Lisa and Dr. Toni talk about urinary tract infections and why they can rear their ugly head during perimenopause.

In this episode, we cover:

* Different symptoms and causes of urinary tract infections (UTIs)* Why you might have more as you transition into perimenopause and menopause* Other health issues that can mimic UTIs* The best way to test to see if you have a UTI* Strategies for preventing and treating them

Urinary tract infections or bladder infections are the most common reason why women are prescribed an antibiotic. 

Symptoms of urinary tract infections can include:

* Frequent urination* Urgency - you gotta go!* Painful burning urination* Cloudy urine* Blood in your urine or on your toilet paper* Cramps, aches, pressure in your lower abdomen* Fatigue, malaise, feeling unwell* More severe if: fever, chills, flank pain* This could mean the infection has traveled to your kidneys!

Genitourinary syndrome of menopause (GSM):

* As you transition into menopause, you can have lower levels of estrogen* Estrogen receptors throughout your lower genitourinary tract respond by thinning the vaginal and urinary tract lining, decreasing collagen, tissue elasticity and numbers of blood vessels* Symptoms can include: * vaginal dryness, irritation, itching, painful sex, diminished lubrication* recurrent urinary tract infections, painful urination, urinary frequency and urgency

Do you have a urinary tract infection? It’s important to see your doctor to rule out other issues that can cause similar symptoms like:

* Painful bladder syndrome or interstitial cystitis* A type of chronic pain syndrome with symptoms similar to UTI without infection* Sexually transmitted infections (STIs) like chlamydia, gonorrhea* Vulvovaginitis* Irritation from yeast infection in urethra

Testing for Urinary Tract Infections:

* urine dipstick - provides info about blood, white blood cells, blood in urine, doesn’t confirm or rule out bladder infection, but can raise or lower suspicion by looking at nitrate level, results affected by bladder pain medication phenazopyridine (turns pee orange)* urine culture - growing bacteria from urine, more definitive test, takes 1-2 days to get results* It’s important to know:* Up to 5% of perimenopausal women have bacteria without symptoms (up to 10-15% of postmenopausal women)* You might have a UTI but not enough bacteria for culture to show growth* Pregnant women and women with recurrent infections (4 or more infections a year) should have urine cultures done

What Causes UTIs in Women?

* Bacteria, such as: E.Coli (75% or more of cases); other: Klebsiella, Proteus, Staph saprophyticus shorter urethras, * Having a shorter urethra, whose opening is close to your vaginal tract and anus as compared to men* Wiping back to front: E.coli travels from your intestinal tract to your urinary tract* Having frequent intercourse, causing “Honeymoon cystitis” . Sex can irritate the urethra and bacteria from your vaginal tract can get into the urethra, resulting in a UTI* Not urinating after sex* Taking antibiotics for other infections, which disrupts your microbiome and kills off lactobacillus (your good bacteria)* Using oral contraceptives (the birth control pill): can double your risk of developing a UTI!* Hormonal imbalances, such as low estrogen* Dehydration* Genetics* Stress * Diabetes (poorly controlled)* Increased alcohol and sugar intake* Weak immunity * Irritation caused by: personal care products, synthetic fabric underwear or thongs, spermicides on condoms, * Bacterial biofilms: these are the protective layers that bacteria create around themse...