If you’ve started getting more urinary tract infections after menopause, it’s not just coincidence. In fact, about 20 per cent of post-menopausal women will experience a UTI annually compared with 11 per cent in other age groups.
For many women, this sudden and unwelcome change comes out of nowhere—and most aren’t warned it might happen.
Despite these statistics, 82 per cent of Canadian women don’t realize that menopause makes recurrent UTIs more likely. And while we trust our doctors, only 27 per cent of family physicians proactively discuss menopause with their patients.
That means most women are left in the dark—unless they speak up. And here’s the crucial part: untreated or mistreated recurrent UTI’s can seriously affect your comfort, health, and quality of life.
The good news? New therapies are being developed just for post‑menopausal bodies—treatments that work with the changes happening now, not just mask them.
Why Recurrent UTI’s Surge After Menopause
There’s a reason women get more urinary tract infections post-menopause —and it starts with estrogen, the levels of which drop significantly post menopause.
This hormonal shift doesn’t just affect your periods or your sleep—it also changes the tissues around your vagina and urethra. These tissues become thinner, drier, and more fragile, a condition often referred to as genitourinary syndrome of menopause (or GSM). When these protective tissues break down, bacteria have a much easier time moving up the urinary tract and causing infections.
But it’s not just about thinner skin. Estrogen also plays an important role in maintaining a healthy balance of bacteria in the vaginal area. It supports the growth of good bacteria, especially lactobacilli, which help keep the area’s pH low and hostile to infection-causing bacteria.
When estrogen disappears, so do these protective bacteria—leaving more room for harmful ones to grow. On top of that, the physical changes to the urinary tract, including weakened muscles around the urethra, make it even easier for bacteria to enter the bladder.
The Trouble with Too Many Antibiotics
If you’ve had more than one UTI, you may have been offered another round of antibiotics—or even a low-dose prescription to prevent the next one (called an antibiotic prophylaxis). But over time, repeated antibiotic use can lead to antibiotic resistance, making future infections harder to treat.
The most common UTI culprit, E. coli, is becoming more resistant to medications like trimethoprim–sulfamethoxazole and ciprofloxacin, especially in older women. In some cases, resistance rates climb as high as 30 per cent.
Antibiotics can also disrupt the balance of good bacteria in the gut and vagina, which play a key role in preventing infections. For some women, this leads to more frequent infections—not fewer.
And sometimes, what feels like a UTI isn’t a UTI at all. Vaginal dryness and tissue thinning after menopause (also known as genitourinary syndrome of menopause) can cause similar symptoms, which can lead to inaccurate diagnoses and over-prescription of antibiotics.
Smarter, Safer Strategies for Preventing Recurrent UTI’s After Menopause
If you’re stuck in this frustrating cycle, there’s good news. Newer treatments are helping post-menopausal women prevent recurrent UTI’s by supporting the body’s natural defences—without relying solely on prescriptions. Discuss the best approach with your healthcare provider, who can refer you to a urogynecologist if needed.
🩺 Medical Options
Vaginal Estrogen
One of the most effective treatments for post-menopausal recurrent UTI’s. It rebuilds thinning tissues, lowers vaginal pH, and restores protective bacteria.
➡ What to know: Available as a cream, tablet, or vaginal ring.
➡ Why it matters: Studies limited but are showing a decrease in UTI recurrence.
➡ Backed by: Canadian Urological Association and major OB-GYN guidelines.
Prasterone (Vaginal DHEA)
This hormone-based treatment helps relieve dryness and thinning in the vaginal tissues and is prescribed in Canada specifically to treat postmenopausal vulvovaginal atrophy (VVA). Early studies suggest it may cut UTI rates—especially in women with diabetes.
➡ Status: Promising, but still under review in larger trials.
Ultra-Low-Dose Estriol Gel
A 2024 study found this 0.005% estrogen gel reduced UTI’s by 26 per cent compared to placebo.
➡ Ideal for: Women looking for a very gentle, localized hormone option.
➡ Still emerging as a mainstream treatment.
Methenamine Hippurate
A non-antibiotic oral medication that changes the chemistry of your bladder to make it harder for bacteria to grow.
➡ Best for: Preventing UTI’s without contributing to antibiotic resistance.
➡ May be used long-term with regular medical supervision.
🌿 Natural Approaches
Cranberry Supplements
Long marketed as a UTI remedy, cranberry may help prevent bacteria from sticking to the bladder wall—but there is limited scientific proof of its efficacy to prevent or treat recurrent UTI’s.
➡ May help some prevent UTI’s
Probiotics
Some research supports lactobacillus probiotics to help rebalance vaginal bacteria after antibiotics or hormone changes.
➡ Helpful as a complement, but not strong enough on their own for UTI prevention.
Hydration & Hygiene Habits
Drinking more water, avoiding bladder irritants (like caffeine or alcohol), and wiping front to back are simple steps that support urinary health.
➡ Low-risk, and good habits—but alone, they likely won’t prevent recurrent infections tied to menopause.
UTI Vaccine on the Horizon: What You Should Know
There’s exciting news on the medical front: a vaccine aimed at preventing recurrent UTI’s, called Uromune (also known as MV140), is currently licensed or available through special access programs in countries like Spain, Mexico, and several others—but not yet in Canada.
Taken as a sublingual spray each day for three months, studies have shown it can reduce recurrent UTI’s by over 70 per cent, significantly extend the time until the next UTI, and has shown to keep about half of the users UTI-free for up to nine years. That’s a powerful outcome.
In Canada, Red Leaf Medical is exclusively licensed by the vaccine developer Immunotek to distribute the vaccine. They have submitted it for approval to Health Canada.
Find a Urogynecologist in Canada
Women experiencing recurrent UTI’s should consider seeing a urogynecologist. They specialize in pelvic floor disorders, including those related to the urinary tract, and can offer expertise in diagnosing and managing recurrent infections.
As with other specialists, finding a urogynecologist in Canada generally requires a referral from your family doctor or another healthcare provider, who will assess your situation and determine if a referral to a urogynecologist is necessary.
What This Means for You
If you’re dealing with recurrent UTI’s, the arrival of a vaccine like Uromune could be a real game-changer—offering a long-term alternative to repeated antibiotics. It’s especially significant now, as rising antibiotic resistance makes infections harder to treat.
With the development of options to treat recurrent UTI’s, this is a hopeful time for women’s health. We’re finally seeing options designed for post-menopausal bodies—and fewer UTIs in your future.
Subscribe to The Health Insider to stay on top of availability of Uromune in Canada and other important health topics.
~ Read more from The Health Insider ~
- Post-Menopause and Dealing with Recurrent UTI’s? These New Options Could Change Everything
Recurrent UTI’s are more common after menopause. Learn why this is, which treatments actually help and more on the new vaccine that’s in the works. - Your Gut’s in Menopause Too: The Surprising Link Between Hormones, Digestion and Your SanityThe hormonal shifts that take place during menopause change a lot in your body – including disrupting your microbiome. Here’s how to restore gut health from within.
- Endometriosis Care in Canada: Get Diagnosed and Find the Experts Who Can HelpEndometriosis affects 1 in 10 Canadian women, but navigating care can be challenging. Here’s how to advocate for yourself and find the right treatment.
- Maternal Mental Health: New Study Supports Expanding Ways To Get HelpOne in five Canadian pregnant and postpartum women experience depression and anxiety, but fewer than 10% receive proper treatment. A new study shows effective ways to expand access.
- Ignored Risk: Bone Scans For People Over 50A fall, a fracture, and an unexpected diagnosis: learn how osteoporosis can strike silently and how to protect your bones.
- Thriving in Your Sex Life During MenopauseMenopause can shift sexual health, but open communication and self-care can enhance intimacy and joy in this life stage.
The information provided on TheHealthInsider.ca is for educational purposes only and does not substitute for professional medical advice. TheHealthInsider.ca advises consulting a medical professional or healthcare provider when seeking medical advice, diagnoses, or treatment. To read about our editorial review process click here.
