During the transition to menopause and beyond, up to 20% of women experience recurrent urinary tract infections (UTIs), with the risk increasing three to four times compared to premenopausal years. This is largely due to hormonal changes, especially the decline in oestrogen. The drop in oestrogen affects multiple systems, including the urinary tract, making it more vulnerable to infections. As a result, many women notice a rise in UTIs, which can be both uncomfortable and disruptive to overall wellbeing. Understanding why this happens and how to naturally support urinary and kidney health is key to staying healthy through menopause and beyond.
Decline in Oestrogen impacts the genito urinary tract in several ways
Oestrogen helps maintain the health of the urinary tract lining. As levels drop during menopause, these tissues become thinner and more fragile, making it easier for bacteria to invade and cause infections. Some research suggests that soy isoflavones—a type of phytoestrogen—may help reduce recurrent UTIs in postmenopausal women by mimicking estrogen’s protective effects on the urogenital tract. A systematic review in the European Journal of Obstetrics & Gynaecology and Reproductive Biology reported that phytoestrogens might alleviate estrogen-deficiency-related urinary symptoms, including recurrent UTIs.
Research has also found that lower oestrogen levels reduce collagen fibres type II and III and this may lead to reduced, elasticity of the urethra and bladder lining, making them more prone to irritation and inflammation, and increasing the susceptibility to UTIs. A mouse study found that supplementation of collagen may improve elasticity, leading to less UTIs.
Oestrogen also helps to maintain an acidic vaginal environment that discourages harmful bacteria. With less oestrogen, the vaginal pH becomes more alkaline, promoting bacterial overgrowth and raising the risk of infections such as bacterial vaginosis and UTIs. Whilst many women know that consuming unsweetened Cranberry helps to acidify the urine not many are aware of other foods and supplements which may help and these include citrus (for their vitamin C content), Grass fed red meat (methionine) and some whole grains. This once again highlights the importance of consuming a healthy balanced diet. Supplementing with Vitamin C may also help.
Reduced blood flow can result from declining oestrogen leading to reduced circulation in the pelvic region. Lower blood flow means slower tissue repair and reduced immune defence, making infections more likely and harder to clear. Research has shown that pelvic floor exercises may reduce the incidence of UTIs in women. It found that elasticity and tone increased leading to less urinary incontinence and complete bladder emptying, especially when stress related. As always the caveat here was as part of a healthy diet and lifestyle.
Changes to vaginal composition can lead to Loss of Beneficial Vaginal Flora Healthy levels of Lactobacillus bacteria, supported by oestrogen, protect against infection by maintaining microbial balance. The advice here would be to try the diet and lifestyle interventions mentioned throughout this article and to incorporate some fermented foods. A recent 2025 study found that incorporating fermented foods such as kefir may reduce the incidence of UTIs via their interaction with the gut microbiome. I don’t recommend taking probiotics without seeking advice from a practitioner who has undertaken some form of microbiome training.
Other factors that may lead to UTIs
In older women a Brain–UTI Connection can occur, UTIs can sometimes present with cognitive symptoms like confusion, delirium, or memory lapses. This is thought to be due to the body’s inflammatory response interfering with brain function. Consuming a Mediterranean anti-inflammatory diet has been shown to provide some protection against neuro inflammation.
The Link Between UTIs and Kidney Health
Untreated UTIs can spread to the kidneys, causing more severe infections like pyelonephritis. Recurrent or serious infections may lead to chronic kidney damage or kidney failure, particularly in those with pre-existing kidney conditions.
Excess weight can increase the risk of urinary tract infections through several mechanisms. Extra abdominal fat raises intra-abdominal pressure, which can prevent the bladder from completely emptying. This creates a favourable environment for bacterial growth. Excess weight is also associated with a weakened immune response, making it harder for the body to fight off infections. Additionally, the likelihood of pelvic floor dysfunction and urinary incontinence increases, both of which are known contributors to recurrent UTIs. Elevated glucose levels are also associated with increased UTIs. Eating a healthy balanced Mediterranean style diet and exercise can help reduce inflammation which can be a driver of excess weight
While UTIs are common, they’re not something you have to live with—especially when you understand the underlying factors that contribute to them. From maintaining a healthy weight and supporting your immune system to strengthening your pelvic floor and nourishing your microbiome with fermented foods, there are many natural steps you can take to protect your urinary health. Small, consistent changes can make a big difference. If you’re experiencing recurrent UTIs or want to take a more holistic approach to your bladder health, reach out and book an appointment.
ReferencesBottom of Form
European Journal of Obstetrics & Gynecology and Reproductive Biology. Phytoestrogens in postmenopausal urogenital health (2021).
Emam, S. A., & El-Wahab, A. A. (2021). Effect of Kegel Exercises on the Recurrence of Lower Urinary Tract Infections Among Women. Evidence-Based Nursing Research, 3(2), 1–9. https://doi.org/10.21608/ebnurs.2021.184830
Teskey, R. (2021). Physical Therapy Management for Recurrent Urinary Tract Infection: A Case Report. Academy of Pelvic Health Physical Therapy.
Naturopath, Nutritionist and Buteyko Practitioner at Elemental Health, St. Ives - Sydney.