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Estrogenic action on innate defense mechanisms in the urinary tract.
- Source :
-
Maturitas [Maturitas] 2014 Jan; Vol. 77 (1), pp. 32-6. Date of Electronic Publication: 2013 Nov 05. - Publication Year :
- 2014
-
Abstract
- Clinical data suggest an impact of estrogen on the pathogenesis of urinary tract infections (UTI). In particular, women after menopause often suffer from recurrent UTI, characterized by at least three acute UTI episodes within a year. Aside from bacterial factors promoting persistence within the urinary bladder, the low estrogen levels induce structural and chemical changes in the urogenital tract which facilitate UTI. Increased residual urine volume and changes in the vaginal microflora are well documented risk factors. Local supplementation with estrogen can at least partly reverse these changes. Treatment allows the re-establishment of a lactobacilli-dominated vaginal microflora and improves epithelial differentiation and integrity in the urogenital tract. This estrogenic effect on the epithelium is marked by an increased production of antimicrobial peptides and a tighter intercellular connection, preventing bacteria from reaching cells where they can hide and later emerge and cause a new infection. Estrogen in the dosages and applications used to date is considered safe for the endometrium in the majority of women. Based on the actions and safety of estrogen, local supplementation thus offers a treatment option for postmenopausal women suffering from recurrent UTI.<br /> (Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.)
- Subjects :
- Estrogens administration & dosage
Estrogens pharmacology
Female
Humans
Urinary Bladder drug effects
Urinary Bladder microbiology
Urinary Tract Infections microbiology
Urothelium microbiology
Vagina drug effects
Vagina microbiology
Estrogens therapeutic use
Microbiota drug effects
Urinary Tract Infections prevention & control
Urothelium drug effects
Subjects
Details
- Language :
- English
- ISSN :
- 1873-4111
- Volume :
- 77
- Issue :
- 1
- Database :
- MEDLINE
- Journal :
- Maturitas
- Publication Type :
- Academic Journal
- Accession number :
- 24296328
- Full Text :
- https://doi.org/10.1016/j.maturitas.2013.10.018