Something else? Ask Aunt Vadge – bottom left of your screen!
Hi Aunt Vadge,
I’m perimenopausal with symptoms, but I’ve also got urinary symptoms bothering me. I had a PCR test for bacteria in my bladder and vagina, and my bladder test came back positive for Gardnerella. But the nurse practitioner said it was contamination from my vagina, and that I actually have bacterial vaginosis.
The thing is, I have no vaginal symptoms, and my vaginal BV test came back negative twice. I think I have Gardnerella in my bladder, but I’m not being treated because they say it’s BV. So frustrating!
Regards,
Feeling Ignored
Dear Feeling Ignored,
I hear you, and your instinct is well-founded. Your tests really do point to a bladder and urinary issue, not a vaginal one: you have urinary symptoms, a positive bladder result, no vaginal symptoms, and two negative BV tests – that’s a coherent picture, and ‘it’s just contamination’ doesn’t fit it well.
The idea that Gardnerella ‘doesn’t belong’ in the bladder is outdated, too. Not so long ago the bladder and uterus were both wrongly assumed to be sterile, but we now know the bladder has its own microbiome, and Gardnerella specifically has been recognised as a urinary tract pathogen since the 1980s, with a solid body of research behind it.
So a positive bladder result deserves to be taken seriously, not waved away.
Because you’re perimenopausal, there’s a second thread worth holding: falling oestrogen thins and changes the tissue of the bladder and urethra – part of what’s now called genitourinary syndrome of menopause – which makes urinary symptoms and recurrent UTIs much more common around this time.
So your urinary symptoms may have both a microbial and a hormonal driver, and addressing the hormonal side often makes the urinary side far more manageable.
Perimenopausal urinary symptoms paired with an awkward microbiology result are a familiar combination. And they respond best to treating the whole picture – the urinary microbiome and the hormonal changes together – rather than arguing over a single test.
So keep advocating: you’re allowed to ask your clinician to explain why a positive bladder PCR is being dismissed, or to seek a second opinion, because your symptoms and your results both deserve a proper response.
And a practitioner who works with recurrent UTIs and perimenopause can address the urinary symptoms and the hormonal changes together, so you can book an appointment if you’d like that.
One safety note: do seek prompt medical care if you develop a fever, back or flank pain, blood in your urine, or symptoms that suddenly worsen, because an untreated urinary infection can climb to the kidneys. You’re not imagining this, and you’re not being difficult – trust what your body and your tests are telling you.
Warm regards,
Aunt Vadge
This is general information based on current research and our clinical experience, not a substitute for personalised medical advice.
