Recurrent Urinary Tract Infections in Peri- and Postmenopausal Women: Contemporary Approachesto Management : A Study of 50 Cases

Background: Recurrent Urinary Tract Infections (rUTIs) are a significant health issue in peri- and postmenopausal women, leading to morbidity and decreased quality of life. Hormonal changes, anatomical alterations, and decreased immunity contribute to increased susceptibility. Effective management requires a combination of pharmacological, non-pharmacological and preventive strategies. To evaluate the occurrences, clinical features, risk factors, microbial etiology and contemporary management strategies for rUTIs in peri- and postmenopausal women this research was performed. Materials and methods: A prospective observational study was conducted on 50 peri- and postmenopausal women presenting with ≥2 UTIs in the past 6 months or ≥3 UTIs in the past year. Detailed history, clinical examination, laboratory investigations including urine culture and sensitivity and imaging studies where indicated were performed. Management strategies were individualized, including short- or long-term antibiotic therapy, topical estrogen therapy, behavioral modification and prophylactic measures. Results: The mean age was 56.4 ± 6.2 years. The majority presented with dysuria (84%) frequency (78%) and urgency (66%). Escherichia coli was the most common pathogen (72%) followed by Klebsiella spp. (14%) and Enterococcus spp. (8%). 40% had underlying risk factors such as diabetes mellitus and urogenital atrophy. Management included targeted antibiotic therapy, local estrogen therapy in 30 patients and behavioral interventions. Recurrence rates decreased significantly over 6 months follow-up. Conclusion: rUTIs in peri- and postmenopausal women are multifactorial. A combination of targeted antimicrobial therapy, estrogen supplementation and preventive strategies is effective in reducing recurrence. Individualized management based on risk factor assessment is crucial for improving outcomes. IAHS Medical Journal Vol 9(1), June 2026; 51-56