After a woman reaches menopause, the production of reproductive hormones estrogen and progesterone sharply decline (1).
Declined estrogen causes vaginal/bladder atrophy and UTIs
Declined estrogen may cause a range of symptoms. These include vaginal dryness, atrophy, painful intercourse, changes in urinary habits, and pain and suffer associated with chronic urinary tract infections (UTIs) (2).
What is UTI?
The urinary system includes the bladder, kidneys, ureters (the tubes between kidneys and bladder), and urethra (the tube through which urine exits the bladder and leaves the body). A UTI is an infection that occurs in any part of the urinary system.
Difference between UTIs in pre- and postmenopausal women
In premenopausal women, UTIs often occur as acute infections. Sexual contact is a common risk factor. However, chronic, or recurrent UTI occurs more frequently in postmenopausal women and even in women who are not sexually active.
A major difference is that in younger women, UTIs are caused by true bacterial pathogen infection, often the E. coli bacteria. However, in older women or younger women who had breast cancer treatment, UTIs are often caused by reduced estrogen, which in turn results in aging-related vaginal atrophy manifested by painful sex and the atrophy of the bladder (3). When the bladder is atrophied, any bacteria from the skin can cause infection, but often chronic.
How is the bladder exposed to skin bacteria?
The bladder is open to the outside through the urethra, which is shorter in women comparing to men. Skin or fecal bacteria can easily travel up the urethra and enter the bladder, and colonize the inner skin surface of the bladder (4).
Can the bladder protect itself from a bacterial infection?
Yes. It can. The protection mechanism is frequent skin cell shedding from the bladder’s inner surface (5), like dandruff shedding from the scalp.
How does estrogen help protect the bladder?
Before menopause, the high level of estrogen promotes thick, multiple layered urogenital (vagina and bladder) skins (6). The top layer of the skin peels off regularly to renew its surface. This causes bacteria attached to the cells on the top layer to shed and be flushed out by urine regularly. As a result, the second layer of the skin that is free of bacteria becomes a new top layer. This regular skin cell shedding renews the surface frequently and protects the bladder from bacterial infection.
The protection reduces after menopause
After natural menopause or breast cancer treatment-induced menopause, estrogen reduces. The skin inside the bladder becomes atrophied. As a result, the atrophied skin shrinks its thickness (7). The number of skin cells reduces, and shedding becomes less frequent, causing bacterial accumulation inside the bladder and making it more prone to infection.
UTIs in postmenopausal women can be difficult to treat.
UTIs are one of the most common bacterial infections in women, accounting for about 25% of all infections. Recurrence can range from 26% in premenopausal women to 55% after menopause (8).
When chronic UTI occurs in postmenopausal women or in breast cancer survivors who had anti-estrogen therapies, it can be difficult to treat (9). Antibiotics can temporarily remove bacteria from the skin surface. However, due to a lack of frequent skin cell shedding, bacteria can come back as soon as the antibiotic treatment stops, causing recurrent UTIs. The repeated pain and suffering can severely interfere with the quality of life and sexual enjoyment.
Treatment options for chronic UTIs in older women
1. Antibiotics may not work well
When you have a chronic UTI and visit a doctor for treatment, the doctor may prescribe antibiotics to suppress the infected bacteria (10). Antibiotics may be effective in clearing the first episode of UTIs. After the treatment stops, however, UTIs may recur to become a recurrent and chronic infection. To avoid drug resistance, the same antibiotics should not be used repeatedly and for the long term (11).
2. Vaginal estrogen may be effective but unsafe
Your doctor may also give you prescription estrogen. Inserting estrogen cream or suppositories directly into the vagina can restore hormone levels in the vagina and its neighboring tissues like the bladder and urethra. This helps prevent UTIs because vaginal estrogen supports the growth of thick bladder skin that can frequently shed cells to remove bad bacteria (12).
Estrogen may be effective, but it may increase the risk of cancers including breast, ovarian, and uterine cancers, uterine fibroids, stroke, and heart disease (13). Estrogen products are either synthetic or natural. The natural one is isolated from horse urine, which has been linked to animal cruelty, increased heart attacks, and blood clotting disease (14). Therefore, women who are animal lovers, survivors of or susceptible to these diseases should not use this type of estrogen.
3. Frequent hydration helps but with reduced effect
Frequent hydration can reduce your risk of developing a UTI. Drinking plenty of water helps flush harmful bacteria out of the urinary tract. In the summer or where the weather is hot, excessive sweating can reduce the amount of urine. Reduced flushing increases the risk of UTI. Drinking a large amount of water frequently on hot days can help remove bacteria from the urinary tract.
While plain water is best for staying hydrated, other drinks can also help. Fruit and vegetable juices, soup, teas, coffee, and soda can contribute to your daily water intake. Additionally, drinking cranberry juice or taking daily supplements of cranberry powder or D-mannose helps reduce the risk of UTIs.
Frequent hydration may work well in younger women, but it may be less effective in older women (15). The reason is that the atrophied bladder has reduced cell shedding. Flushing urine does not remove unshed cells. As a result, bacteria attached to the bladder may persist in the bladder even if you drink a lot of water, making treatment of UTIs difficult in older women.
4. NeuEve – Safe and effective home remedy
NeuEve products are safe alternatives to estrogen. NeuEve works by nutritional supplements. It provides nutrients, such as vitamins, minerals, and fatty acids, to promote healing of the affected urogenital lining skin (16). Topical nourishment by NeuEve can make the bladder skin to grow thicker. As a result, cell shedding in the bladder will become more frequent, thereby reducing the attached bacteria and the risk of UTIs. The process is like putting nutrient cream on the face to smooth wrinkles.
NeuEve is a natural product, not a drug. Therefore, a doctor’s prescription is not required. NeuEve can be used as an effective home remedy for self-treatment of menopause-related chronic UTIs.
To date, NeuEve has helped thousands of women with menopause-related chronic UTIs to find relief safely and effectively, with no reported side effects. Many urologists have been recommending NeuEve.
5. What are the right products to start?
The products most often used for UTIs in older women are NeuEve cream and NeuEve Silk suppositories.
The method is to insert a suppository intravaginally once every 4 days and apply the NeuEve Cream a tiny bit (a dime size) daily on the external vulva.
These products can make a thinned vaginal and bladder skin thicker and more resilient, but it takes time. Although some customers reported noticeable relief within 1 day, for a full recovery, it may take several weeks or months depending on how severe your UTI symptoms are.
Interestingly, many patients who previously did not respond to estrogen treatment for years have found immediate relief by using NeuEve. For breast cancer survivors who cannot use estrogen, NeuEve has provided an alternative option for them to find relief safely from chronic UTIs.
Customer reviews on UTI relief
September 3, 2020
Yesterday I received my NeuEve Silk and I knew I had to try it at bedtime. I have been in menopause since I was 33 years old and I am 64 now. I had cancer and therefore was afraid to use estrogen cream vaginally which is what doctors have said for years that I need. I was afraid to use it, so I just did not listen.
Fast forward to now and I have been miserable. I have had a dull aching and it feels like when you feel like a UTI is coming on not to mention the awful dryness, so the doctor said I had no choice but to use the estrogen.
I was so miserable I started using it. Taking the instructions out and reading all the warnings freaked me out! So, I got on the internet and prayed there was something else out there to help me, there just had to be!
That is when I stumbled upon the info about NeuEve. I read everything I could find on it and felt like I had nothing to lose because the options were few and far between. I put my first suppository last night and it didn’t take long to melt, and my body absorbed it almost immediately that is just how dry I am “down there”! This is what I do not understand…how can the dull aching and the feeling of getting a UTI be gone?
One application and I feel this good? After suffering for years and sex being so painful?
I have hope now. My plans are to use all three stages of NeuEve. This is an absolute miracle and bless you Dr. Chang for creating a product like this that is going to help so many of us. Wait till I see my doctor and if things keep progressing like this, I will be stopping the estrogen cream and will stay on NeuEve for the rest of my life.
August 20, 2020
I ordered these for my mother-in-law and this is what she has to say:
“My urologist told me to get these! I was having constant UTI’s for the past few years, I’m 58 and after being diagnosed with breast cancer at 49 and then being told to have my ovaries removed too. I had everything taken out except my vagina. After that, it was much too painful for any of that kind of fun!
I do believe in miracles and maybe your product will make it possible again!!! Your product has made me feel so much better! I do not have the horrible feeling of getting a UTI anymore or any dryness and not one UTI since I started!!! Which is huge!!! So, thank you for caring enough for women’s health to make such a wonderful product!!!
This is such a hard subject to discuss no one talks about it and not something I normally would but I think I need to tell you it is working so far! The price is high, but I will just have to save somewhere else!!!
It’s been about 6 weeks since I started and I can feel the walls of my vagina are starting to soften which had hardened ( I’ve even had surgery to clip scar tissue that was like rings actually closing my vagina) I didn’t even know if I could get one of your suppositories in!!! But had no problems!!!
I felt I needed to write this because it is the first thing that has worked!!! I’m not sure I would have tried this because of the price if my doctor hadn’t told me to. I think if you were to give some samples to doctors so more women could try them. More women would be using them even if they tried them once they could see how they could change their lives too!!!
Please know you really are helping women like me and I just have to say Thank you again!!!”
June 2, 2020
I will try not to go into a lot of detail, but at 61, I was beginning to wonder whether I should once again use an estrogen-based product for vaginal atrophy.
I first tried estrogen when my GYN. recommended it after post-menopause. I used it for about a year and it did work very well, but just did not like using estrogen – I especially do not like that it comes from horse urine. That was about 6 or 7 yrs. ago.
The conversation came up again after a stubborn UTI, then an antibiotic-induced yeast infection. There seems to be some literature suggesting that atrophy and UTI’s are connected. But I just do not want to use estrogen – and literature is varied on the opinions – health benefits and risks. I thought I’d give NeuEve a try as I had used another brand of vaginal suppository before – but the other brand had a medicinal smell I didn’t like, and it didn’t do much to change the atrophy.
This product has impressed me. I also ordered the small jar of cream to put on daily. So far, so good. I have felt much more comfortable. The product is more than I would like to pay, but I ordered my second box. I started with Silk – their recommendation but ordered Silver the second time by accident –because I think the Silk formula was doing its job. But now I will be able to compare anyway. I recommended at least trying it.
April 10, 2018
My urologist recommends these suppositories. I found them to be most effective. Still use in conjunction with estrogen cream, so cannot say how effective they would be on their own. For now, they meet my immediate needs in the manner that I am using them.
January 8, 2018
When deciding whether to purchase this product I read through almost all the reviews. Most said either the product worked or did not and no other information is given, so I want to write a review that will hopefully be helpful to others.
I was widowed at a relatively young age and had not had sex for over 12 years. I recently met someone, and we wanted to be intimate. I talked to my doctor and she gave me a prescription for hormone cream. It did not work and having sex was a disaster! It was very painful, I had spotting due to vaginal atrophy, and got a flaming UTI. I did not want to give up so I went online looking for a product that would work for me.
I found the New Eve products and saw that they were available on Amazon, so I tried them. The next time we had sex, there was NO spotting at all which I was thrilled about. The 3rd time there was no spotting, no pain, and no UTI. The product worked for me and it was worth the price. I am not going to go looking for something cheaper because there is no guarantee it will work. I have something that works and I’m happy about that.
September 17, 2016
NewEve Exceeds Expectations
It has been 4-1/2 months since I started using NewEve, following the regimen with the cream, Silk, and Silver. Lesson learned: The more advanced the atrophy, the more time and patience it takes to reverse the condition. In fact, at age 76, the results are nothing short of miraculous.
NewEve has delivered on its promises – and more. I may move on to the Gold formula at some point, but in the meantime, life is great. That said, I have a clear recall of the misery I suffered before finding the solution – and I did not even have BV or UTIs! Still, I want to shout about this from the rooftops.
Every woman out there deserves to know about NewEve so she can make her own choices. Yeah, it is pricey, but it’s worlds ahead of the alternatives. Thank you, Dr. Chang.
March 4, 2016
Helped my UTIs
I am a breast cancer survivor with chronic UTIs. I was told that they were caused by vaginal atrophy due to loss of estrogen, but I cannot use any estrogen due to the cancer diagnosis. I tried this product to see if it would help, and to my amazement, it did!
The atrophy was causing inflammation in my urinary tract, and the inflammation was attracting bacteria, generating an infection. I had one almost constantly for 3 years.
Literally the first time I used the product I could see and feel a difference. I have not had a UTI since starting this product. The rest of the benefits of no atrophy are great, but I am so grateful to have found this helpful product for my urinary tract. Hopefully, other sufferers will find the same result.
February 14, 2016
My BV causes UTI and this is the only thing that breaks the cycle for me.
July 14, 2015
I have been using the Silk formula for about five months. I had post-menopausal vaginal dryness which was contributing to repeated UTIs. The dry atmosphere promoted bacterial growth. In addition, I had extreme vulvar pain (vulvodynia) and every remedy I tried felt as though I was applying acid.
I was desperate after three rounds of antibiotics in four months and still had horrible burning pain. My doctor prescribed hormone cream but I was reluctant to use it since there is a history of breast cancer in my family.
While desperately searching online (sitting on a cold compress at the time) I came across NeuEve and ordered immediately, both the silk formula and the cream to start with. I experienced immediate relief, using the cream daily for about the first month and the suppositories twice weekly as directed. No more UTI’s!
Immediate relief and freedom from the burning! I saw my GYN for the yearly checkup two weeks ago and he is very happy that the dryness has resolved. He thanked me for the information about NeuEve and said that he is pleased to have a safe alternative to the hormone cream to recommend to patients.
I am just about to try the Silver formula. I will never be without NeuEve! Dr. Chang is obviously very knowledgeable about this problem to have created such an effective treatment. I will be forever grateful that she did!
April 14, 2015
Thank you so much and I am sure you’ve heard it before, but this is such an answer to prayer!!!! Thank you.
I am just turning 50 this year but very healthy, young, and live very organic and holistically. I was devastated to start having painful sex issues thinking there was nothing all-natural to help.
To find your product was a little miracle for me! Also, I think it took care of the other little issue I had with small tiny but growing white bumps on the outside of the Urethra and the Urologist said it was an Estrogen problem. THANK YOU!!