Phytoestrogens: Pharmacological Potential and Therapeutic Insights for Urinary Tract Infections

Urinary tract infections (UTIs) are exceptionally common in postmenopausal female or patients with diabetes mellitus or nephrolithiasis, carrying substantial burden on patients and healthcare system. Increasing proportion and ongoing spread of antibiotic-resistant pathogens have further debilitated the condition in battlefield against the UTIs. Lack of estrogen may contribute to high inclination of UTIs after menopause and hormone replacement therapy can mitigate symptoms of hot flashes, vaginal dryness and UTIs, rationalizing the usage of estrogen and analogues in treatment and prophylaxis of UTIs. Phytoestrogens which comprise flavonoids, coumerins, stilbenes, and lignans, are natural botanical compounds with estrogen structural similarity and biochemical features. Phytoestrogens have emerged as adjuvant remedy and prophylaxis for uropathogenic bacteria even for multidrug-resistant ones, with the multifaceted mechanisms such as inhibition of adhesion and invading ability of bacteria, destruction of biofilms, synergistically enhancement of antibiotics activity. It is plausible to propose phytoestrogens as potential agents or combination with other strategies to ameliorate the challenge of multi-drug resistance in UTIs.