Can this sugar heal these infections?

Q:

Ever since I started menopause, I’ve been getting frequent urinary tract infections. I read that a sugar called D-mannose powder can help, but I’m not sure I can take it because I’m diabetic. Is this something that can work for me?

A:

It might. Urinary tract infections (UTIs) are common in menopause, thanks to plummeting estrogen levels, which cause the vaginal tract to weaken and become more susceptible to infection-causing bacteria, like

E. coli—the most common culprit in UTIs. But you have an additional risk factor: diabetes. Excess sugar in the blood and urine raises your risk of UTIs. Diabetes also compromises the immune system, making it harder to fight off infection, and causes nerve damage that may make it more difficult for your bladder to empty, leaving you susceptible to UTIs.

Since your infections are recurring, I recommend seeing your doctor to make sure your blood-sugar levels are in a normal range. If they are, D-mannose might be an option. The simple sugar contains the same antibacterial components found in cranberry juice, but without all the fructose. And while it is a sugar, D-mannose isn’t absorbed by the body and isn’t metabolized like other sugars, so it won’t easily get into your bloodstream and raise blood sugar. For that reason, it tends to be a safe option for people with diabetes. Instead, D-mannose passes directly through the kidneys and bladder, coating the urinary tract and making it extremely difficult for E. coli to stick.

If you decide to try D-mannose, make sure to drink at least eight glasses of water a day. And if your symptoms don’t improve within 24 hours, I suggest making an appointment with your doctor for testing, as your infection may not be caused by E. coli.

Q Lately my breasts have been sore like they used to get right before my period, but I’m 58—I haven’t had a period in years.

What is this?

A Breast pain tends to be thought of as strictly a PMS symptom, but it’s actually quite common after menopause—a condition called noncyclic mastalgia. The pain can be caused by trauma or injury to the breast, but it’s also been linked to antidepressants and HRT.

I always suggest that women with any breast change see a breast specialist for an exam, but this is likely nothing to worry about. And there are ways to ease your discomfort. First, try cutting back on caffeine and sodium, both of which can worsen breast pain. Also, supplement with evening primrose oil—its fatty acids make breast tissue less sensitive. In one study, 69 percent of women who took 1,000 mg a day reported relief from breast pain.

If these steps don’t help, or if you notice other changes to your breasts, I recommend seeing your doctor.