Postmenopausal Women and Urinary Tract Infection: A Literature Narrative Review

Ala'a Ibrahim Ali Matalka


Urinary tract infection (UTI) is a serious matter of concern worldwide. Urinary tract infections affect
women more than men and are caused by normal bacterial flora that enters the urinary tract via urethra
from bowel, vagina, or perineum. Postmenopausal women are more prone to developing symptomatic
UTI due to estrogen deficiency as a leading factor. In a study conducted by Dason, Dason & Kapoor,
the incidence of single and recurrent UTIs was 27% and 3% respectively. Recurrent infection was
mostly a result of bacterial re-infection or persistence. Gram negative bacteria such as- E.coli and
Klebsiella spp. have been reported to be the most common UTI causing organisms. E. coli causes around
70-95% of upper and lower UTI and is the cause for 80-85% of community-acquired UTI, while
Staphylococcus saprophyticus accounts for 5–10% of urinary tract infections. In very rare cases, UTI is
caused by viral or fungal infections. The clinical presentation of UTI is different in postmenopausal
elderly women compared with younger women. Symptoms like frequency, dysuria, hematuria, and
fever are not reported by postmenopausal women, but they are likely to report flank pain.
Postmenopausal women are also affected by recurrent UTI, which is defined as ≥3 UTI per year or ≥2
urinary tract infection per half year. Increased mortality rates go hand in hand with bacteriuria in elderly
women; though bacteriuria is mostly asymptomatic and does not cause death; this is a major concern.
The aim of this paper is to conduct a narrative review of UTI in postmenopausal women to reach a
better understanding of this problem.


Urinary tract infection, Bacteriuria, Estrogen, Postmenopausal women, Antimicrobial prophylaxis, Probiotic lactobacilli.

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