Editorials

Postmenopausal cystitis

Recurrent lower urinary tract infections are common after the menopause and occur in more than 10% of women over the age of 60.¹ A rise in vaginal pH promotes an alteration in the normal vaginal flora, with decreased lactobacilli leading to increased colonisation by pathogenic faecal flora. This increases the incidence of urinary tract infections, especially in sexually active women. Oestrogen deficiency also results in generalised urogenital atrophy, and postmenopausal women are therefore at increased risk not only of recurrent urinary tract infections but also of dyspareunia, vaginal irritation, pruritus, pain, and symptoms of urgency, frequency, dysuria, and urinary incontinence.²

Unfortunately, urogenital atrophy is a late manifestation of the menopause and is consequently often underdiagnosed and undertreated. Many older women fear the side effects of systemic oestrogen therapy, and few wish to suffer monthly withdrawal bleeds from the commonly . . . [Full text of this article]

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• Moore, F. (1997). "I've just been bitten by a dog". BMJ 314: 88-88 [Full text]  
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