Postmenopausal cystitis and the role of cranberry polyphenols in its prevention
DOI: 10.32364/2618-8430-2025-8-1-5
M.S. Selikhova1, N.A. Burova1, O.Yu. Syanova2
1Volgograd State Medical University, Volgograd, Russian Federation
2Akvion JSC, Moscow, Russian Federation
The increasing trend of life expectancy has resulted in approximately one-third of a woman's life being spent in the postmenopausal period, during which genitourinary syndrome and urinary tract infections (UTIs) are common clinical manifestations. The decline in sex steroid levels during menopause leads to atrophic changes in the mucosal lining of the vagina, urethra, and bladder. These changes contribute to dysbiosis and the development of recurrent postmenopausal cystitis. Numerous studies in the medical literature have explored the treatment of UTIs in women with postmenopausal cystitis, emphasizing the use of herbal remedies, probiotics, and prebiotics, with cranberry-based products being particularly prominent. The anti-adhesive properties of cranberry polyphenols, which inhibit the attachment of uropathogens to uroepithelial cells, are well-documented. In addition, D-mannose prevents bacterial adhesion to the urothelium, complementing the effects of cranberry extract. Ascorbic acid (vitamin C) supports an acidic environment in the urinary tract, creating conditions unfavorable for bacterial proliferation. Current evidence supports the use of a combined therapy containing cranberry polyphenols, D-mannose, and vitamin C as a preferred option for the treatment of postmenopausal cystitis and the prevention of its recurrence.
Keywords: postmenopausal cystitis, urinary tract microbiota, intestinal dysbiosis, vaginosis, relapse, cranberry polyphenols, probiotics, combined herbal medicine.
For citation: Selikhova M.S., Burova N.A., Syanova O.Yu. Postmenopausal cystitis and the role of cranberry polyphenols in its prevention. Russian Journal of Woman and Child Health. 2025;8(1):32–37 (in Russ.). DOI: 10.32364/2618-8430-2025-8-1-5
ABOUT THE AUTHORS:
Marina S. Selikhova — Dr. Sc. (Med.), Professor, professor of the Department of Obstetrics and Gynecology, Volgograd State Medical University; 1, Pavshikh Bortsov sq., Volgograd, 400131, Russian Federation; ORCID iD 0000-0002-4393-6111
Natalia A. Burova — Dr. Sc. (Med.), Professor of the Department of Obstetrics and Gynecology, Volgograd State Medical University; 1, Pavshikh Bortsov sq., Volgograd, 400131, Russian Federation; ORCID iD 0000-0002-0546-8732
Olga Yu. Syanova — obstetrician-gynecologist and ultrasound diagnostics specialist, Medical Adviser of Akvion JSC; 8, build. 1, Northern Block, Tower "Moscow", Presnenskaya Emb., Multifaceted Complex "Gorod Stolits", Moscow, 123112, Russian Federation; ORCID iD 0009-0008-7612-8234
Financial Disclosure: no authors have a financial or property interest in any material or method mentioned.
Conflict of interest: Olga Yu. Syanova is the employee of Akvion JSC.
Contribution of authors: Selikhova M.S., Burova N.A. — article concept development and literature data preparation and editing; final article version approval; Syanova O.Yu. — editing the article, analyzing the literature and providing additional references to the literature.
Received 29.11.2024.
Revised 24.12.2024.
Accepted 16.01.2025.
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10. Al-Badr A., Al-Shaikh G. Recurrent Urinary Tract Infections Management in Women: A review. Sultan Qaboos Univ Med J. 2013;13:359–367. DOI: 10.12816/0003256
11. Renard J., Ballarini S., Mascarenhas T. et al. Recurrent Lower Urinary Tract Infections Have a Detrimental Effect on Patient Quality of Life: A Prospective, Observational Study. Infect Dis Ther. 2014;4:125–135. DOI: 10.1007/s40121-014-0031-0
12. Dominoni M., Scatigno A.L., La Verde M. et al. Microbiota Ecosystem in Recurrent Cystitis and the Immunological Microenvironment of Urothelium. Healthcare. 2023;11(4):525. DOI: 10.3390/healthcare11040525
13. Gasiorek M., Hsieh M.H., Forster C.S. Utility of DNA Next-Generation Sequencing and Expanded Quantitative Urine Culture in Diagnosis and Management of Chronic or Persistent Lower Urinary Tract Symptoms. J Clin Microbiol. 2019;58:e00204–e002019. DOI: 10.1128/JCM.00204-19
14. Pohl H.G., Groah S.L., Pérez-Losada M. et al. The Urine Microbiome of Healthy Men and Women Differs by Urine Collection Method. Int Neurourol J. 2020;24(1):41–51. DOI: 10.5213/inj.1938244.122
15. Finucane T.E. ‘Urinary Tract Infection' and the Microbiome. Am J Med. 2017;130(3):e97–e98. DOI: 10.1016/j.amjmed.2016.08.018
16. Amabebe E., Anumba D.O.C. Female gut and genital tract microbiota-induced crosstalk and differential effects of short-chain fatty acids on immune sequelae. Front Immunol. 2020;11:2184. DOI: 10.3389/fimmu.2020.02184
17. De Nisco N.J., Neugent M., Mull J. et al. Direct detection of tissue-resident bacteria and chronic inflammation in the bladder wall of postmenopausal women with recurrent urinary tract infection. J Mol Biol. 2019;431:4368–4379. DOI: 10.1016/j.jmb.2019.04.002
18. Foxman B., Gillespie B., Koopman J. et al. Risk Factors for Second Urinary Tract Infection among College Women. Am J Epidemiol. 2000;151:1194–1205. DOI: 10.1093/aje/151.12.1194
19. Robino L., Scavone P., Araujo L. et al. Intracellular Bacteria in the Pathogenesis of Escherichia coli Urinary Tract Infection in Children. Clin Infect Dis. 2014;59:e158–e164. DOI: 10.1093/cid/ciu432
20. Czaja C.A., Stamm W.E., Stapleton A.E. et al. Prospective cohort study of microbial and inflammatory events immediately preceding Escherichia coli recurrent urinary tract infection in women. J Infect Dis. 2009;200:528–536. DOI: 10.1086/597576
21. Ejrnaes K., Sandvang D., Lundgren B. et al. Pulsed-field gel electrophoresis typing of escherichia coli strains from samples collected before and after pivmecillinam or placebo treatment of uncomplicated community-acquired urinary tract infection in women. J Clin Microbiol. 2006;44:1776–1781. DOI: 10.1128/JCM.02418-05
22. Luo Y., Ma Y., Zhao Q. et al. Similarity and divergence of phylogenies, antimicrobial susceptibilities, and virulence factor profiles of escherichia coli isolates causing recurrent urinary tract infections that persist or result from reinfection. J Clin Microbiol. 2012;50:4002–4007. DOI: 10.1128/JCM.00962-12
23. Skjøt-Rasmussen L., Olsen S., Jakobsen L. et al. Escherichia coli clonal group A causing bacteraemia of urinary tract origin. Clin Microbiol Infect. 2013;19:656–661. DOI: 10.1111/1469-0691.12107
24. Kõljalg S., Truusalu K., Stsepetova J. et al. The Escherichia coli phylogenetic group B2 with integrons prevails in childhood recurrent urinary tract infections. Apmis. 2014;122:452–458. DOI: 10.1111/apm.12170
25. Yoo J.-J., Song J.S., Bin Kim W. et al. Gardnerella vaginalis in recurrent urinary tract infection is associated with dysbiosis of the bladder microbiome. J Clin Med. 2022;11:2295. DOI: 10.3390/jcm11082295
26. Parvez S., Rahman D. Virulence Factors of Uropathogenic Escherichia coli: Microbial Agents and Predisposing Factors. In "Microbiology of Urinary Tract Infections — Microbial Agents and Predisposing Factors"; IntechOpen: Hamilton, NJ, USA, 2019; DOI: 10.5772/intechopen.89426
27. Ismail M.D., Ali I., Hatt S. et al. Association of Escherichia coli ST131 lineage with risk of recurrent urinary tract infection among young women. J Glob Antimicrob Resist. 2018;13:81–84. DOI: 10.1016/j.jgar.2017.10.009
28. González De Llano D., Moreno-Arribas M.V., Bartolomé B. Cranberry polyphenols and the prevention of urinary tract infections: current considerations. Molecules. 2020;25:3523. DOI: 10.3390/molecules25153523
29. Flores-Mireles A.L., Walker J.N., Caparon M., Hultgren S.J. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015;13:269–284. DOI: 10.1038/nrmicro3432
30. Tamadonfar K.O., Omattage N.S., Spaulding C.N., Hultgren S.J. Reaching the end of the line: urinary tract infections. Microbiol Spectr. 2019;7:1–16. DOI: 10.1128/microbiolspec.UTI-0005-2012
31. Whiteside S.A., Razvi H., Dave S. et al. The urinary microbiome: roles beyond infection. Nat Rev Urol. 2015;12:81–90. DOI: 10.1038/nrurol.2014.361
32. Kline K.A., Lewis A.L. Gram-positive uropathogens, polymicrobial urinary tract infection, and the emerging microbiota of the urinary tract. Microbiol Spectr. 2016;4:1–54. DOI: 10.1128/microbiolspec.UTI-0012-2012
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