Typically women get more UTIs as they age. This is because of changes to our bodies. As women get older, we tend to have less estrogen. This causes two issues: 1) It changes the pH of our genital areas making it more agreeable to bacteria. 2) It causes the vagina to atrophy or collapse which creates more bacteria friendly space between the urethra (where we pee) and the anus (source of fecal bacteria.) To complicate matters, as we age we often develop small anal fissures. Oh, and of course our immune system gets weaker with age. Really, what fun!

Since no one wants the spend their life taking antibiotics, these are things I have learned that help to avoid UTIs. (Because my breast cancer was hormone positive, I had to take "anti" hormone drugs so I experienced the hormone issues at a much younger age than most.)

• Keep hydrated If your urine isn't fairly light in color you should be drinking more.
• Keep the area super clean.
  Keep the area near the urethra very clean. Always wipe with toilet paper from front to back, using a clean piece or section each time. When you poop, after you clean yourself with paper, use wet flushable wipes or baby wipes (not flushable) for the final clean. Even if you aren't getting UTI's this is a good idea.
• Wear breathable underwear and slacks Cotton underwear is best. Cotton, rayon or linen slacks.
• Take cranberry pills.
  If you find you are getting UTI's, cranberry has been shown to help prevent bacteria from attaching to the bladder wall. Choose the "one a day" cranberry pills to keep it simple. I have found them at CVS, WalMart and Costco. In fact if you are getting symptoms you can even take one twice a day for a week or two and see if that clears it up.

If you find you are still getting UTI's even when using the above steps, then it is time to see your doctor. First have the doctor (urologist or OB/GYN) verify there is no physical issue. Your doctor may recommend an estrogen cream to smear in the genital area to fix the pH problem. (The cream makes the area less basic/more acid so it is unattractive to the bacteria.) My doctor only has me apply it once a week and it seems to have helped. If they don't suggest the estrogen cream ask them about it because many doctors don't know about this. I learned about it from my urologist, but my internist didn't know about it.

Despite all of this I still occasionally get a UTI but it usually is less than one a year, which is pretty good.

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