Magazine 15 June 2021

Cystitis in Menopause

  1. Causes of perimenopausal cystitis
  2. Causes of post-menopausal cystitis
  3. Treatment and prevention
  4. Summary


Dear Reader,
We know very well that women are more prone to cystitis than men, due to anatomical differences that, unfortunately, we cannot remedy!
It appears that the risk of cystitis may further increase for women during and after menopause.
Let’s find out together what elements in menopause increase this likelihood and everything that can be done to limit the discomfort.

Causes of Cystitis in Menopause

Perimenopausal Causes

Perimenopause is the period before menopause. It can last a few years or a few months and is characterized by mood swings, first flushes and menstrual irregularities.
While for some women the symptoms are mild, for others it is a more critical period.
But what does perimenopause have to do with cystitis? Why does the risk of cystitis increase at this time in a woman’s life?

  • Fluctuation in estrogen levels
    During this phase the level of estrogen, the main female hormone, fluctuates and leads to the development of typical perimenopausal symptoms. A woman’s body is full of estrogen receptors, including the urinary tract. As estrogen levels gradually decrease, the function and structure of the urinary tract can change and become more susceptible to developing infections.
  • Physical changes
    Several physical changes can make a woman more vulnerable to cystitis and urinary tract infections. As we age, the structure of the vagina and its surrounding areas can change. These changes can directly affect the structure of both the vagina and the bladder. Among the consequences is incontinence, which increases the risk of infections. Vaginal atrophy or vaginal dryness are other important changes and contributing factors when it comes to recurrent urinary tract infections.
  • Changes in Sex Life
    With hormonal surges, emotions, and sex drive go up and down. Plus, because of the physical changes associated with menopause, a woman’s sex life inevitably changes (sometimes for the better!). Often, the drop in estrogen can mean vaginal dryness and sensitization of certain areas. In sexual intercourse, these changes translate into a risk of microinjuries or mechanical microtrauma that encourage pathogens to ascend to the bladder.

Post-Menopausal Causes

Although menopausal symptoms tend to subside a year or two after the last menstrual cycle (i.e. when post-menopause begins), scientific research states that urogenital symptoms can sometimes persist for several years.
But what leads to the prolongation of these inconveniences?

  • The Consequences of Vaginal Dryness
    Many women experience the backlash of vaginal dryness during menopause, but this issue can persist for much longer, as estrogen levels remain near zero even in post-menopause. If this situation is not properly managed, vaginal atrophy can also take hold. As the vaginal walls become thinner, they become more delicate and susceptible to damage and subsequent infections. In addition to increasing discomfort, vaginal atrophy can be a reason for recurrent cystitis.
  • Changes in vaginal pH
    As estrogen levels fall, there is an inevitable change in vaginal pH. Normally, vaginal pH balance supports the process of repelling pathogenic bacteria. When this balance is broken, “bad” bacteria can multiply and spread, increasing the chances of infection.
  • The Effects of Poor Habits
    After passing through menopause, retirement is upon us, and we tend to be a little more sedentary. Some incorrect habits or routines start to take hold in our lives, leading to unpleasant effects on bladder health. You start to drink less water, begin to prefer sweet foods, or increase your use of caffeinated beverages, all behaviors that predispose you more to developing cystitis.
  • Weakening of the immune defenses
    Weakening of the immune defenses in post-menopause occurs both systemically and locally. We can easily understand, therefore, how the immune defenses in the vagina and bladder are weakened, leaving more opportunities for pathogenic bacteria to move and reproduce.
  • Presence of other pathologies
    Just as one’s eating style and habits change, one’s state of health can also undergo changes with the consequent onset of certain problems that, among other things, complicate the situation at the urogenital level. Some more common examples are:
    Vaginal prolapse.
    This is a change in the structure inside and surrounding the vagina that increases the risk of cystitis. Also, if the vagina or adjacent structures negatively affect bladder emptying, stagnant urine becomes the perfect breeding ground for bacteria. The pressure on this area can worsen in the presence of excess fat, another common problem as we age.
    Mobility issues.
    Muscle and joint problems, although not directly related to the onset of cystitis, can still be considered predisposing factors. First and foremost, the pelvic floor muscles play their part if their state is not ideal (contracture or weakening). With the tendency to decrease motor activity, typical of this phase of life, healthy habits such as eating well, drinking enough water, and going to the bathroom are also reduced: all those fundamental behaviors that, however trivial they may seem, should not be underestimated when it comes to the risk of cystitis.
  • Constipation
    All the lifestyle changes we have previously mentioned also have negative consequences on intestinal well-being. Sedentary lifestyles and poor hydration are the perfect ingredients for constipation. The stagnation of feces in the rectal ampulla increases the probability that pathogens will pass from the anus to the urethra and possibly return back to the bladder, causing inflammation and cystitis.

Cystitis in Menopause: Treatment and Prevention

Here we go! Now that we understand all the factors that predispose a woman to cystitis, before and after menopause, let’s move on to practical advice on how to prevent or treat it.

  • Take D-Mannose

D-Mannose is a natural ingredient useful for the treatment or prevention of bacterial cystitis.
D-Mannose deactivates the pathogenic bacteria present in the bladder without creating resistance from the bacteria themselves. This means that prolonged use of D-mannose does not result in its gradual loss of effectiveness.
To learn more about how D-Mannose works and all the benefits of D-Mannose for cystitis, we wrote Cystitis and D-Mannose.
For an all-around treatment of menopausal bacterial cystitis, evaluate the Bacterial Cystitis Kit.

  • Strengthens Bladder Defences

The physiological reduction of immune defenses in the bladder, which characterizes this period of a woman’s life, can be countered through the oral intake of ingredients aimed at strengthening these defenses. Among the notable ingredients, I would mention GAGs, which are long chains of sugars that repair and strengthen the bladder walls.

  • Solve Constipation

Enrich your diet with fiber and fluids, increase physical activity, and, if necessary, take dietary supplements based on probiotics.

  • Change Your Diet

Set a goal to eat fresh, less processed foods as possible. Banish sugar-laden foods from your table, drink plenty of water, and avoid excess caffeine to optimize blood sugar levels and support your immune system.

  • Manage Stress

Stress can have “surprising” consequences on the likelihood of the onset of cystitis. Stress has, in fact, damaging effects on the immune system.

  • Move More

Movement will help you keep your muscles and joints healthy. A regular trip to the toilet, whenever you feel the need, will help you empty your bladder regularly as well as keep the muscles in and around your pelvic floor exercised.

A hug,





In this article, we have understood what factors increase the risk of cystitis in women, before and after menopause.

Predisposing factors include:

  • Hormonal changes, particularly the fall in estrogen levels.
  • Physical changes, such as thinning of tissues in the urogenital tract and reduced vaginal discharge.
  • Changes in vaginal pH, which alters the balance of good and bad bacteria.
  • The tendency to reduce motor activity and drink less, resulting in the development of constipation and weakening of the muscles, including at the urogenital level.

Cystitis before and after menopause can:

  • Be treated or hindered with the use of D-Mannose and other key ingredients such as GAGs.
  • Be hindered by starting with a healthy lifestyle and regular movement.
  • Be hindered by adequately supporting the immune system, which tends to weaken at this stage.

Did we help?

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