Recurrent Urinary Tract Infections in Postmenopausal Women: Clinical Burden, Risk Determinants, and Management Strategies

Background: Recurrent urinary tract infections (UTIs) are a prevalent and distressing condition amongpostmenopausal women, contributing to significant morbidity and reduced quality of life. Objective: This study aimedto assess the prevalence, risk factors, and management strategies associated with recurrent UTIs in this vulnerablepopulation. Methods: A cross-sectional study was conducted from October 1, 2024, to March 31, 2025, involving155 postmenopausal women with a history of recurrent UTIs. Participants were recruited from a private chamberand two private clinics in Jashore, Bangladesh. Data were collected using structured interviews and analyzed usingdescriptive statistics and chi-square tests to identify significant associations. Results: The majority of participants wereaged 55–64 years (41.9%) and from rural areas (63.9%). Common risk factors included diabetes mellitus (46.5%),overweight or obesity (58.7%), low water intake (50.3%), and improper perineal hygiene (56.8%). A significantassociation was found between diabetes and higher UTI frequency (p = 0.004), as well as poor hygiene and recurrence(p = 0.008). Most patients were managed with empirical antibiotics (65.8%), while only 23.9% received culture-guided therapy. 94 (60.6%) experienced ≥4 episodes per year. The recurrence rate was significantly lower in thosereceiving combined hormone therapy (18.5%; 10 of 54) compared to those who did not receive hormone therapy(83.2%). Conclusion: Recurrent UTIs in postmenopausal women are influenced by modifiable risk factors such ascomorbidities, hygiene practices, and treatment patterns. Interventions focusing on education, proper diagnosis, andindividualized management are essential to reduce recurrence and improve patient outcomes.