Recurrent UTIs and Estrogen Therapy: How It Helps Postmenopausal Women

A urinary tract infection, or UTI, is an infection that occurs when bacteria get into your urinary tract — the kidneys, bladder, or urethra. The Urology Care Foundation has found that UTIs affect more than 8.1 million people each year. About 60 percent of women and 12 percent of men are likely to have at least one UTI during their lifetime. A study conducted by the University of Texas at Dallas has identified that a specific bacteria in the bladder may indicate recurrent urinary tract infections (UTIs). Postmenopausal women are more susceptible to this bacteria. The study also found that the female sex hormone estrogen may be important in reducing that sensitivity.

“What we found is that women who are in the midst of an infection—those who have a history of recurrent UTIs but are currently UTI negative—had a microbiome that was full of microorganisms capable of causing urinary tract disease, while there were fewer good bacteria,” said Michael Nugent, first author of the article. He is also a postdoctoral fellow in the laboratory of Dr. Nicole De Nisco, assistant professor of biological sciences in the School of Natural Sciences and Mathematics.

A stark contrast was observed when studying women taking estrogen therapy. They didn’t have “bad” bacteria in their bladders. The researchers concluded that the higher the amount of estrogen found in the urine, the greater the predominance of good bacteria such as lactobacilli in the microbiome.

This is important because it has been found that women with recurrent UTIs have more antibiotic resistance genes in their microbiomes than their counterparts. These antibiotic resistance genes can be exchanged between cells. This creates the perfect environment that allows resistance to spread rapidly through the bacterial population. Thus, treating the infection becomes more difficult.

The biggest obstacle Dr. De Nisco has found in treating UTIs is . It has been found that while antibiotics have been somewhat effective in fighting disease-causing bacteria, prescribing when they are not needed can accelerate antibiotic resistance.

Associate Professor of Biological Sciences at UTD, Dr. Kelly Palmer has said that this study is groundbreaking because it addresses an often overlooked demographic, namely postmenopausal women. Dr. De Nisco and his team conducted this five-year longitudinal study to track the microbiome of postmenopausal women over time. Their subjects included both those who experience frequent UTIs and others without a UTI history.

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