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Recurrent UTI after menopause — DRCOG MCQ

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ModerateUrogynaecologyRecurrent UTI after menopauseDRCOG

A 63-year-old woman has recurrent culture-proven lower UTIs and vaginal dryness. She is postmenopausal and has no haematuria or renal impairment. She wants to reduce antibiotic use. What is the most appropriate management?

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Correct answer: D — Offer vaginal oestrogen after discussing benefits and risks

Vaginal oestrogen can reduce recurrent UTI risk in postmenopausal women with genitourinary atrophy and may reduce antibiotic use. Long-term antibiotics may be considered in selected cases after other measures and review, not as automatic first-line. Culture confirmation matters. Ovarian cancer referral is not indicated from recurrent cystitis symptoms alone without concerning features.

Reference: NICE NG112; NICE NG23; BNF