If you are a postmenopausal woman, you are at risk of experiencing delirium following a urinary tract infection (UTI). Given that the combination of postmenopause and lower estrogen levels is known to make this population “significantly more susceptible to developing recurrent UTIs,” this is a concern to many women and their physicians. A recent study looked at this serious problem. 

UTIs, delirium, and postmenopause: Study

The authors of the new study, which appeared in Scientific Reports, explored the impact of estrogen on the development of delirium associated with UTIs in postmenopausal women. Prior to this study, they discovered that compared with mice without a UTI, those with UTIs had much higher levels of IL-6 and greater impairments in areas of the brain involved with delirium, as well as elevated levels of substances associated with cell death.  

Read about menopause and urinary tract infections

The scientists then used this information and conducted a more recent study to see if giving estrogen to postmenopausal mouse models with UTIs would have a positive effect on delirium. It’s been shown that estrogen suppresses IL-6, which is why they chose to investigate its effects on UTI-induced delirium.

At the end of the study, the investigators found that administering estrogen worked to prevent symptoms of delirium, such as confusion and anxiousness. Estrogen seemed to help in two ways: by reducing levels of IL-6 in the blood and protecting brain cells directly.

Read about postmenopause: what women should know

Why this study is important

Delirium is a common condition among postmenopausal women, who also experience UTIs more than younger women. Overall, the prevalence of this infection among women older than 65 is about 20 percent compared with about 11 percent in the general population. 

When you look at the combination of UTI and delirium, there appears to be a clear relationship. In a review appearing in the Canadian Journal of Geriatrics, the authors reported on findings among patients with UTIs who were age 60 or older. Among individuals with a UTI, delirium rates ranged from 30 percent to 35 percent compared to 7.7 percent to 8 percent among those without a UTI. 

Since both UTIs and delirium are significant health issues among postmenopausal women, it is important to work toward finding effective and safe treatment options. This latest study is a step in that direction.

Bottom line

According to the study’s senior author Shouri Lahiri, MD, who is also director of the Neurosciences Critical Care Unit and Neurocritical Care Research at Cedars-Sinai, “I think it [this study] is a major step toward a clinical trial of estrogen in human patients with UTIs.” For now, much more research is needed before it can be determined whether estrogen replacement therapy is a wise option for UTIs and delirium in postmenopausal women.