Bladder infections: The risk increases during menopause

Most women know the symptoms: the burning sensation in the urethra, the pain when urinating, the constant urge to go to the toilet – typical signs of bladder inflammation (cystitis). Unfortunately, the incidence of the disease increases during the menopause.

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Causes of bladder infections during the menopause

The fact that the risk of cystitis increases during menopause is due to the decrease in estrogen production. Estrogens ensure that the mucous membrane in the area of the vagina and urethra is plump, elastic and well supplied with blood. Among other things, the healthy mucous membrane contains countless immune cells and defense substances. This first important protective shield against invading germs becomes more permeable during menopause. Potential pathogens can therefore spread more easily. In addition, the thinner and less moist mucous membrane no longer seals the entrance to the urethra as well – bacteria are therefore more likely to ascend into the bladder.

In addition, estrogens also influence the composition of the vaginal flora. During menopause, the proportion of lactic acid bacteria (lactobacilli), which normally slow down the proliferation of other microorganisms, decreases. This gives potential pathogens an easier time.

What promotes cystitis

The most common pathogens of cystitis are coli bacteria from the intestines. It is quite normal for them to enter the vagina – a healthy mucous membrane keeps them in check. They only become a problem when they ascend into the urethra and the immune system can no longer cope with them. Apart from the hormonal changes during menopause, there are several other factors that promote bladder infections.

Too little drinking

The less frequently the bladder is emptied, the easier it is for germs to multiply.

Excessive intimate hygiene

Soap and shower gel destroy the acid balance in the vagina. This facilitates the spread of pathogens. Better: Use only clear water or a mild washing syndet.


Cold reduces the blood flow to the mucous membranes. As a result, they are no longer sufficiently supplied with immune cells and defense substances.

Weak immune system

Stress, an unbalanced diet and lack of sleep can impair the body’s defenses against pathogens.

Sexual intercourse

Sex can put a lot of strain on the sensitive and often too dry vaginal mucosa during menopause. Germs are literally massaged into the female urethra. Urinating afterwards reduces the risk.


Antibiotics damage the vaginal and intestinal flora. Harmful germs can thus spread all the more easily after the end of therapy.

Underlying diseases

Metabolic diseases such as diabetes, a lowered pelvic floor or kidney and bladder stones increase the risk of cystitis.

Symptoms of cystitis

An inflammation of the bladder is mainly noticeable by a frequent urge to urinate and pain or burning when urinating. Usually, only small amounts of urine are emptied into the toilet. The urine is often cloudy and smells pungent, occasionally traces of blood are also visible. This is sometimes accompanied by severe abdominal pain that can radiate to the back.

This helps with cystitis during menopause

If you react correctly at the first symptoms, you can often nip cystitis in the bud.

Immediate help program for an incipient bladder infection

  • Drink a lot: at least a quarter of a liter of water every half hour.
  • In addition, drink two to three cups of bladder tea. They usually contain medicinal herbs that can have a diuretic and anti-inflammatory effect, for example goldenrod herb, bearberry leaves or horsetail herb.
  • Keep warm: It is best to lie in bed with a hot water bottle.
  • Rest: The body needs to gather strength to fight the disease.

If the symptoms do not improve significantly within two to three days, it is time to see a doctor – at the latest, however, if fever and chills are added.

Antibiotics for cystitis

If a bladder infection lasts longer than a few days, the doctor often prescribes an antibiotic. In some cases, this is necessary to prevent something worse – such as a kidney pelvic inflammation caused by germs rising to the surface. However, studies show that uncomplicated bladder infections heal within a week in 30 to 50 out of 100 women, even without antibiotics. Symptomatic treatment with anti-inflammatory painkillers and/or antispasmodic drugs is often sufficient.

Herbal medicines for cystitis

A whole range of medicinal plants can be helpful in the treatment of cystitis. For example, birch leaves, nettle herb, horsetail root, dandelion, orthosiphon leaves, parsley root, couch grass and horsetail herb are known for their diuretic and flushing effect. Goldenrod herb has additional anti-inflammatory and antispasmodic effects. Bearberry leaves release an active ingredient in urine that also has an antibacterial effect. Nasturtium and horseradish contain mustard oils that can promote circulation and inhibit bacterial growth.

Many of these medicinal plants are available in different combinations as teas or in higher concentrations as ready-to-use preparations. In any case, it is important to drink plenty of fluids. However, anyone suffering from water retention (edema) due to impaired heart or kidney function should avoid diuretic herbs.

In addition, the effectiveness of cranberry juice and extract for bladder infections has been proven and documented in studies. Cranberries (cranberries) contain active ingredients that block the binding sites of coli bacteria, with which they attach themselves to the mucous membrane of the bladder. Mannose, a type of sugar, has a similar effect: it too has been shown to prevent urinary tract infections by making it more difficult for bacteria to dock in the bladder.

Vaginal estrogen treatment

Local hormone treatment with estrogen cream or suppositories has proven to be an effective strategy for reducing bladder infections during and after menopause. It plumps up the thinned-out vaginal and urethral mucosa, making it more difficult for pathogenic germs to penetrate. According to current findings, topical application does not increase the risk of new breast cancer, nor does it increase the risk of recurrence after a cancer has been overcome.

Clara Wildenrath from


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