Abstract
Hormonal and age-related physiological changes significantly predispose postmenopausal women to recurrent urinary tract infections (rUTIs). The low estrogen levels characteristic of menopause can lead to genitourinary syndrome, which disrupts vaginal microbiota, weakens urinary defenses, and increases susceptibility to infections. A history of rUTIs, diabetes mellitus, sexual activity, and estrogen therapy is among the key risk factors for rUTIs. These factors may compromise urinary tract defenses, enabling bacterial colonization and infection. Given that frequent antibiotic treatment can lead to antimicrobial resistance, bioactive natural compounds are promising alternatives for UTI management. This review explores the role of bioactive compounds in natural remedies and functional foods as potential non-antibiotic approaches for rUTI management in postmenopausal women. Key bioactive compounds, including benzoic acid, proanthocyanidins, D-mannose, arbutin, phytoestrogens, berberine, vitamin C, and oleuropein, inhibit bacterial adherence and support urinary health. Functional foods enriched with these compounds, along with probiotics and cranberry products, may enhance urinary health and quality of life in postmenopausal women. However, due to the paucity of corroborating evidence, further well-designed clinical research is essential to validate efficacy, determine safety, and establish evidence-based dietary recommendations for UTI prevention.