My 69-Year-Old Mother Keeps Getting UTIs — Five Courses of Antibiotics Haven't Helped
A reader writes: My mum, 69, has had recurrent UTIs since June and has already had five courses of antibiotics. She has to urinate every 30 minutes, but it's not just a dribble. She also has a sore vaginal area, made worse by sitting, walking, going out, every bump in the road. What frustrates her most is that she hasn't seen a doctor or nurse, only handed in urine samples.
Dr. Zoe Williams responds: GP services are under huge pressure, and unfortunately, people who are less likely to push can struggle to get the attention they need. With her permission, you are within your rights to contact the surgery on her behalf and could also attend with her if she would find that helpful.
Why Recurrent UTIs Happen After Menopause
One reason recurrent urine infections can happen after menopause is that lower oestrogen levels change the tissues around the vagina, vulva, urethra and bladder. Called genitourinary syndrome of menopause, it can cause soreness, burning, urgency, frequency and recurrent UTIs.
Vaginal oestrogen treatment can be very effective for some women. But your mum needs an examination and proper investigation, as there are other potential causes too, including:
- Antibiotic-resistant bacteria
- Vaginal atrophy
- Vulval skin conditions
- Prolapse
- Bladder pain syndrome
- Stones
- Incomplete bladder emptying
- Diabetes
- Less commonly, something more serious
Symptoms this severe and lasting for months should not be managed only by repeated antibiotics. After five courses, doctors need to know whether this is persistent infection, repeated new infections, resistant bacteria or symptoms mimicking UTI. Urine samples should be sent for culture so antibiotics can be targeted.
She should ask clearly for a face-to-face appointment with a GP or nurse practitioner. If this fails, try 111. Seek urgent help if she develops fever, loin pain, vomiting, confusion, blood in the urine, weakness or becomes unable to pass urine.
Post-Menopausal Symptoms: A 52-Year-Old Woman's Question
A 52-year-old woman had her last period 15 months ago. For the last couple of weeks, she's been experiencing an achy stomach and breast tenderness, which she used to get before her period. She's also noticed a clear slimy discharge when wiping after the toilet. Are these normal menopause symptoms?
The doctor explains: Even after periods stop, hormone levels do not switch off overnight, and some women still notice occasional hormonal-type symptoms for a while. A clear, slippery discharge can also happen and is not automatically serious. However, because these symptoms are new after 15 months without a period, it's advisable to see your GP. They may suggest a urine test, swabs, and an abdominal, pelvic or speculum examination.
Vaginal bleeding or spotting (red, pink or brown) after menopause is a red flag — even a small amount. You should also seek assessment for discharge that smells unpleasant, changes colour, causes itching or soreness, or if you develop fever, worsening pelvic pain, persistent bloating, feeling full quickly, unexplained weight loss, or needing to urinate more often.
Severe Shaking Chills for 30 Years: A 70-Year-Old Man's Mystery
A 70-year-old man with heart failure has had an unusual problem for 30 years: he gets extremely cold with severe shakes like hypothermia and can barely walk or drive. Even when it's not cold, it feels like -20C and his heart rate is elevated. All he can do is curl up and wait for it to pass, usually sleeping.
The doctor says: Severe shaking chills can happen with infection, but also potentially with sudden changes in blood pressure, blood sugar problems, thyroid or adrenal issues, medication effects, abnormal heart rhythms, or problems with the nervous system's temperature regulation. A next step is to gather more information during an episode. Your wife could note your temperature, pulse, blood pressure, how long it lasts, and whether you are confused, breathless, clammy, blue-lipped or having chest pain. She could take a video to show your doctor. Ask whether heart rhythm monitoring (a 24-hour, 48-hour or seven-day Holter monitor) is needed, and request a review of your heart failure, medications and blood tests.
If you or a family member have similar health concerns, seek medical attention promptly. The Xiaoshu Health App can sync with Apple Health to track relevant metrics and help you better manage your health data.