Hormone therapy may protect against recurrent UTI

US researchers compared genitourinary microbiomes in postmenopausal women: European Association of Urology Virtual Congress 2020

22nd July 2020 By Reuters Health

Older women who take menopausal hormone therapy have a greater variety of beneficial bacteria in their urine that may help guard against recurrent urinary tract infections, according to research presented virtually at a US conference.

Recurrent UTIs have a “profound impact on the quality of life of postmenopausal women and current therapies, namely antibiotics, are failing,” said lead author Dr Nicole De Nisco, from the Department of Biological Sciences, University of Texas in Dallas.

The researchers used whole-genome metagenomic sequencing to define and compare genitourinary microbiomes of three groups of postmenopausal women:

• 25 women who never had a UTI.
• 25 with recurrent UTIs in the past but no active infection.
• 25 recurrent UTIs and active infection.

“The DNA analysis showed two things,” Dr De Nisco said in a press statement at the European Association of Urology Virtual Congress 2020 on 17 July.

“Firstly, women who have recurrent infections have fewer types of bacteria in their urine than women who do not have infections; women who don’t have recurrent UTIs have around 10 times greater variety of bacteria.

“Secondly, 34 of the women were taking menopausal hormone therapy, and they tended to have more Lactobacillus-type bacteria in their urine, which may imply that the estrogen in menopausal hormone therapy supports the growth of Lactobacillus in the urogenital tract.”

Interestingly, Dr De Nisco said women who were taking menopausal hormone therapy via patches or orally had more Lactobacilli than women taking it via vaginal cream.

“The finding that urinary Lactobacillus, which is associated with health in the vaginal environment, was strongly associated with particular forms of estrogen hormone therapy (oral and patch) but not vaginal was unexpected,” she said.

“This finding fuels even more questions as to why this is the case and what forms of estrogen hormone therapy may be best to prevent recurrent urinary tract infection in postmenopausal women.

“We are now looking towards clinical trials to test the effectiveness of combining estrogen hormone therapy and probiotic therapies in breaking the cycle of recurrent infection,” she added.