Why are older women more prone to UTIs?

Pelvic Floor Post

Women become more prone to developing urinary tract infections (UTIs) as they grow older due a number of reasons, including female anatomy, hormonal changes, medications, a weaker immune system and menopause. If a UTI is overlooked or even mistaken for other conditions, and if left untreated, it can spread elsewhere. An untreated infection can get into the ureters, which are the tubes that connect the bladder to the kidneys, and then you can end up having a kidney infection, which is potentially serious, especially if it turns into sepsis.

I explore why older women are more likely to get a UTI in this video.

What are the causes?

Menopause is one of the main causes due to a drop in oestrogen levels that leads to changes in the urinary tract, making menopausal women even more vulnerable to infections.

The further a woman transitions into menopause, the higher the risk of getting a UTI is as oestrogen levels decline. The vaginal walls can become thinner, less elastic, and drier. The condition known as vaginal atrophy or atrophic vaginitis can lead to discomfort, pain during intercourse and an increased susceptibility to vaginal infections. Likewise, the walls of the urethra can change, increasing the risk of infections.

The majority of UTIs are caused by E.coli bacteria that should only be found in the bowel. If our bowels are in tip-top health and the dominant species are the healthy ones, then there is less of a risk of the E.coli bacteria migrating from the bowel to the urethra and ultimately into the bladder. However, as we age, the balance of bacteria in the bowel can change, where the more dominant species are the pathogenic ones, including E.coli, so there is more of a risk of E.coli moving from the bowels to the bladder. To reduce the risk of UTIs, it’s important to maintain good bowel health by ensuring there are plenty of species of friendly lacto and bacilli bacteria and this is why, to any women over the age of 45, I recommend taking one of our Live Bacteria capsules twice daily, one upon rising and one before bed with a little cold water. If you are prone to UTIs, then take a Live Bacteria capsule upon rising and a For Women capsule before bed.

UTIs can become more serious as women age because the good bacteria that fight infections in our bladders and urinary tracts – part of the microbiome – can become depleted with time and replaced with pathogenic, disease-causing species.

This inability to fight infection occurs for a number of reasons. As mentioned already, a decline in the female hormone oestrogen is a major factor because its acidic presence in the vagina discourages the overgrowth of harmful microorganisms and maintains healthy levels. Once the pH of the vagina begins to turn alkaline, this can cause changes in the microbes in the vagina, increasing the risk of UTIs. Some menopausal women who suffer with recurring UTIs, are sometimes prescribed an oestrogen vaginal cream to help prevent this from happening. This change in the pH of the vagina also increases the risk of getting persistent thrush.


After menopause, when oestrogen levels drop, the tissue between the urethra and vaginal opening lose that acidity. Without that acidic barrier, bad bacteria can more easily grow and work their way up the urethra to the bladder.

I also talk in the video about how weakened pelvic floor muscles are a common condition among postmenopausal women who have had children, and contribute to UTIs. This is because a weak pelvis makes it harder to completely empty the bladder, and disease-causing bacteria breed well inside inactive, concentrated urine, but not just that, a weak pelvic floor can cause pelvic organs to shift from their normal positions, causing prolapses that may need medical intervention.

Constipation can also be the cause of a UTI. If your bowel is getting full with impacted faeces and pushing into the bladder, it makes it harder for the bladder to empty properly, again leaving disease-causing bacteria multiplying and breeding in the remaining urine. There is also the risk of bacterial translocation where bacteria may migrate from the bowel across to the bladder causing a UTI.

Unfortunately, many women can find themselves trapped in a vicious cycle of recurring UTIs as they are prescribed broad spectrum antibiotics to treat the infection. While antibiotics can be very effective at wiping out the pathogenic strains of bacteria, they also destroy the friendly strains needed to prevent the infection from coming back. Certain strains of pathogenic bacteria, including E.coli can be very resistant to antibiotics which means that UTIs can often come back.

Supplements to help

I cannot stress enough therefore the importance of maintaining good gut, urinary and bladder health as we age, and one of the simplest ways to do this is to ensure that the balance of friendly bacteria is kept topped up so that the more pathogenic strains, such as E.coli, the bacteria most likely to trigger a UTI, are kept at bay. As our immune system weakens with age, we become prone to all kinds of infection, not just UTIs, which is why I recommend a daily Live Bacteria probiotic capsule to help support immunity and build resilience.

If a menopausal or older woman is getting recurring UTIs, then I would recommend a For Women probiotic capsule twice daily, one upon rising and one before bed. Remember to take the Live Bacteria capsule with the morning For Women one to support gut health. I’d also recommend an Omega 3 capsule daily with food and a Garlic tablet daily with food. This combination of supplements help improve the immune system generally, but especially the bladder’s own immune system, preventing the E.coli from finding attachment points on the bladder wall, and also help crowd out the E.coli competing for space in the bladder. You want the friendly bacteria competing for space, not the pathogenic E.coli.

To help with the constipation, I recommend including a Digestive Enzymes tablet just before lunch and just before dinner, then review symptoms in about a month.

I hope you find this information and the insights that I share in the video helpful. If you would like to know more about a tailored supplement protocol, please get in touch.