My recurring UTIs were caused by common problem that affects all women

It was in November, when I developed my ninth urinary tract infection (UTI) in four months, that I began to wonder if I had some awful disease. Could I have kidney disease – or even bladder cancer? What was going on?

Each time the symptoms were the same – stinging and burning whenever I went to the loo, together with a need to urinate all the time – often urgently.

This, along with blood in the urine and pain in the abdomen, is typical of the symptoms of a UTI – an infection of the bladder, kidney or urethra (the tube that takes urine out of the body). They are referred to as ‘recurrent’ if you have three or more a year.

The reason I had become so prone to them was not due to a dreadful disease – but, as I would discover, due to the menopause.

What upset me was the discovery that there was a ‘wonder-drug’ solution. So why did no one suggest it to me sooner?

The increased risk of UTIs is a characteristic of the menopause (and post menopause) but ‘we don’t talk about and we should’, says Mary Garthwaite, a former urology consultant surgeon wh is now CEO of the charity The Urology Foundation.

The drop in oestrogen that accompanies the menopause leads to thinning of the tissues around the vagina and urethra – making it easier for bacteria, such as E. coli, to find its way from the bowel.

‘The vagina and the bowel are in very close proximity,’ says Dr Garthwaite, ‘and when the tissue around the vagina becomes thin after menopause, as oestrogen leaves the body, it makes it easier for infections to thrive’.

What’s more, the make-up of ‘good’ bacteria in the area is in constant flux, making infections more likely.

Like many women, however, I knew none of this when I went through the menopause in my mid-50s in 2016.

It was in July 2025 that I was hit by the early telltale signs of a UTI – an uncomfortable burning sensation whenever I went to the loo – something I hadn’t experienced in decades.

I did what I used to do when I was struck by UTIs as a younger woman (when they are often linked to sex rather than thinning tissues) – I bought some cranberry juice and a powder remedy made from cranberries, which always used to work. It didn’t this time.

A few days later I went to my GP who agreed I probably had a UTI and prescribed antibiotics.

They worked, but a week or so after finishing the pills my symptoms returned – and this time, I was on holiday in France.

It was an hour’s drive on a motorway to see a doctor to get a prescription. And by the time I got to the late-night chemist I was tearful and in chronic pain but gratefully collected the prescribed antibiotics, the same one I had in the UK.

Again, it worked for a few days and again a week later my symptoms came back with a vengeance. This time, as my GP earlier instructed, I took a urine sample before starting the antibiotics (the test result is void if the sample has been impacted by drugs).

It showed traces of E. coli and my GP prescribed a different, stronger (and I was told more expensive) antibiotic called Augmentin. It worked in just two days - the previous ones took four days to work.

Delighted, I thought, I’ve had the best antibiotic on the market and the infection must have gone for good.

A fortnight later it was back – and just as painful as before. I wept in desperation.

This latest recurrence happened over a weekend, and having failed miserably to get anywhere from dialling 111 I took some leftover antibiotics prescribed in France. (They had given me a few more than I needed for the three-day course as the prescription packets contain larger amounts.)

I got to my GP on the Monday, and another prescription was issued, this time for the antibiotic amoxicillin – but my concern was also mounting. I was becoming convinced I had something sinister wrong. I barely slept from worrying.

I was doing everything my GP suggested – keeping hydrated, keeping the genital area clean, and showering after sex.

But it wasn’t enough and in November, I went back to my GP who suggested I get checked out at a genitourinary clinic. ‘Isn’t that where they check people over with sexually transmitted diseases, or STDs?’ I asked, somewhat perplexed.

My GP said that STDs such as chlamydia can lie dormant for years but still be present in our bodies and cause problems such as UTI-like symptoms.

But the doctor I saw at the clinic listened to my UTI history and said I needed hormone replacement therapy (HRT) – as the problem was my lack of oestrogen.

She described oestrogen as ‘a kind of wonder drug for UTIs’ and encouraged me to ask my GP to prescribe it.

Dr Garthwaite urges any post-menopausal woman getting recurrent UTIs – two or more in six months, or three or more in a year – to talk to their GP about oestrogen cream, adding the hormone impacts only that area, not the whole body, making it safe for most women to use.

‘Oestrogen creams improve the health of the vagina and the part of the “waterpipe” that is inside the vagina, protecting against infection,’ she says.

‘It also restores and maintains good bacteria, which is needed for vaginal health and acidity.’

A retrospective study involving 5,600 women (with an average age of 70), published in the American Journal of Obstetrics & Gynecology in 2023, found that giving them vaginal oestrogen cut the number of UTIs from an average of more than three a year by 50 per cent – and a third had none at all.

When I went, as advised, to see my GP about this she agreed I should try an oestrogen cream, which is inserted into the vagina via a syringe. I used it as instructed every day for one week, and then twice a week – and I haven’t had a UTI in two months.

The relief was immense. But why did I have to go through four months of hell to get there?

Dr Sami Hamid, a urology consultant at Charing Cross Hospital, says that ‘awareness is low among health professionals’ of how recurrent UTIs can be prevented with oestrogen creams.

‘So much of the focus around menopause is on obvious things such as hot flushes, but UTIs – and the health problems that the degraded vaginal tissue causes – are overlooked, and many women are unaware of the link to the menopause as a result,’ he says.

‘I now reject referrals of recurrent UTIs for women who aren’t already using topical oestrogen, to save wasting mine and their time.

‘If it doesn’t work, then we look at something else, but it is an important first-line treatment that GPs can prescribe.

‘It needs to be made more widely available in primary care, not just as something to be prescribed by a specialist.’

There are other ways to help prevent UTIs: for example, the National Institute for Health and Care Excellence (NICE) recommends methenamine hippurate, an antiseptic taken in tablet form that breaks down into formaldehyde, which helps kill bacteria in the urinary tract that might cause a UTI.

There is also now a vaccine, Uromune or Urovac, given as a spray under the tongue daily for three months – it works by attacking the four main types of bacteria that commonly cause UTIs and can help some patients remain free of infection for several years.

However, it has yet to be approved by NICE, although some patients who haven’t responded to other treatments may get it through an ‘enhanced access’ scheme.

Yet experts say the vaccine is not as effective as oestrogen.

‘Vaginal oestrogen has a 60 to 70 per cent success rate for treating recurrent UTIs, against the vaccine’s estimated 50/50,’ says Dr Garthwaite.

‘The vaccine is expensive and it doesn’t work for everyone – if you don’t have one of the four main bacteria causing your UTI, it won’t work.’

Dr Hamid adds that the vaccine is ‘a silver bullet for those who are desperate, a salvage treatment. One of my patients took it for three months but it came back as soon as she stopped taking it.’

However, he adds: ’Alternative treatments are important as we really now need to stop prescribing antibiotics for UTIs because superbugs are winning the battle, and we are having problems getting on top of it.’

I’m grateful I got the help I needed in the end – but I wonder how many other post-menopausal women are struggling on with recurrent UTIs, unaware there is a simple way to end their misery.