Recurrent UTI risk may increase during menstrual cycle, can also affect ovarian health
Irregular menstrual cycles, vaginal infections, recurring UTIs (Urinary tract infections) and miscarriages are common amongst the women in the Sunderbans, said an expert.
With frequent storms over the years, the salinity of water of most of the rivers and ponds has increased in almost all areas of the Sunderbans, the expert said. I visit about 25 homes every day and most of these homes have women who have one or the other problems related to menstruation, she said.
Recurrent UTIs can have both direct and indirect impacts on menstrual health, explained a gynecologist.
Directly, the infection of urine will contaminate the vaginal flora, the organisms present in the vagina, and it will be altered, and it will lead to vaginal infection which in turn affects ovarian health, the Dr. said. Recurrent UTIs, may lead to miscarriages or even preterm labour, the Dr. said.
UTIs typically occur when bacteria enter the urinary tract through the urethra and spread in the bladder. The urinary system is designed to keep out bacteria. But the defences sometimes fail. When that happens, bacteria may take hold and grow into a full blown infection in the urinary tract.
The Dr. said that UTIs have a direct connection with hygiene and lifestyle. UTIs disturb the whole system of the body. It is not accurate to say the infection affects the menstrual cycle directly but there are a few indirect impacts.
UTIs directly affect menstrual health
In addition to pain, UTIs cause burning and stress. They can make you feel sick and worried too. If a UTI appears to delay your period, it may be stress rather than the infection. According to a 2006 research review and a 2015 study, high-stress levels impact your menstrual cycle.
Ironically, it may be that your menstrual cycle is affecting the timing of your UTI , not the other way around. The reason for this is lowered estrogen levels.
Estrogen has anti-inflammatory properties. When estrogen levels are high, you may be less susceptible to developing a UTI. Estrogen also helps keep Lactobacillus, the good bacteria in your vagina, healthy and active. Lactobacillus helps regulate vaginal pH, keeping bad bacteria levels low.
Estrogen production lowers around the time of menstruation. This may make you more vulnerable to developing an infection. Add extreme stress into the mix and your period may be delayed by a few days.
The medication, given to treat the infection, can also contribute in disturbing the cycle.
Higher skin bacteria in urinary microbiome during menstruation
Another biological change during menstruation has only recently been identified- the urinary microbiome. The urinary microbiome is a complex ecosystem of microbes living in the urinary tract. While it has been established that the vaginal microbiome undergoes change during the menstrual cycle, the urinary microbiome does as well, which likely plays an important role in UTI risk.
In March 2020, researchers demonstrated the variability of the urinary microbiome following both menstruation and vaginal intercourse. The researchers used RNA sequencing and enhanced quantitative urine culture (EQUC) to identify the organisms in the urinary tract and their relative abundance. While measurable changes to the urinary microbiome were found in all subjects, the changes were individualized and unique to each person.
The researchers did find higher than normal levels of common skin bacteria in the urinary microbiome during menstruation.
Recurrences usually occur within 3 months of the original infection
Around 50-69 % of women will experience a UTI in their lifetime. The estimated number of UTIs per person per year is 0.5 in young females. Recurrences usually occur within 3 months of the original infection, and 80 % of recurrent UTIs are reinfections. The incidence of UTI increases with age and sexual activity. The Dr. advised that maintaining proper hygiene and drinking appropriate water can help in decreasing the risk of UTIs.