I have been on letrozole for 10 months and have had 8 uti’s in that time .My doctor is suggesting I try methenamine hippurate
to see if it helps. Anyone been on this drug?
I am slightly concerned when reading about it as I sometimes have bouts of gastritis and have to take anti acids which is one of things I read you shouldn’t take with it as urine has to be acid for it to work .??

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Hi @LottyS

Welcome to the forum. It is full of kind, helpful people and I feel sure that someone will share their experience with you on this drug.

In the meantime please do have a look through the various boards and topics to find those going through similar experiences or for places you may be able to share your experiences and knowledge.

Please know that our nurses are here for you anytime, here on the forum on the Ask our Nurses your questions or over the phone 0808 800 6000.

Sending our love,

Hi Lottys. Yes got put on it last year for recurrent UTIs. It tastes absolutely ghastly if it touches the sides going down - best taken with orange juice or another tasty drink. It is also quite a large pill. It seems to be what the docs prescribe instead of a low-dose antibiotic as they don’t like giving out anti-biotics these days unless necessary . I had no side effects (unusual for me!)

Once I was properly on it I didn’t have any more UTI’s.

I am not taking it now as there were other problems with my undercarriage (VA) which were responsible for the UTIs and Hiprex didn’t sort those . I didn’t want to take any more pills than I have to!!

I didn;t notice any stomach problems with it

Hi LottyS

I have no experience with that particular drug but I’ve suffered many a UTI since being peri menopausal and I had a uti in the early days of taking letrozole.

My GP was fantastic and prescribed hylafemme which I use 2 / 3 times a week internally. She also prescribed a lubricant which she recommended I use daily after all toilet visits to keep everything down there as it should be.

It’s definitely helped and maybe it’s an alternative to you taking drugs.

Take care xx

Hi Lotty S

I haven’t had experience with that either but a few years ago I had a UTI which wouldnt shift . Antibiotics helped but it came back as soon as I stopped taking them. Mine was an ecoli infection which most are ( if yours is not this might not help) and I found relief by taking a product called D- Mannose - it’s something we all have in our bodies naturally but some of us have lower levels than others. It works by tricking the bugs into binding with it instead of the bladder wall and then you flush it out when you wee. I also drank lemon barley water / apple juice /water / tea and avoided coffee, alcohol , orange juice + cranberry.

I get mine online from a company called SC Nutra / Sweet Cures - not cheap or a quick fix but it did work and I take a prophylactic dose occasionally. I’ve had odd flare ups which usually settle after a couple of days of treatment .I’ve seen it on Amazon and in Holland and Barratt . I’ve also found it helpful to eat fermented foods like kombucha and kefir .
I don’t know if this will help but I hope so as UTI’s are just miserable and I hope you feel better soon whatever you try.

Joanne. X

Hi Lottie
I was in the same position as you and my GP told me speak to my consultant and get the medication changed. My consultant wasn’t very happy and told me it wasn’t his medication that was the problem. I persisted and was given different medication. I have only had 2 uti’s in the last two years. Hope this helps.

Hi I have been taking it for about a year .
I suffer with reflux and IBS .
It has definitely helped I take my omprozole with my thyroxine’ as soon as I get up with a glass of water .
Then have my breakfast then take hippex with a glass of water this is what I read about it to drink water with it .
I was given it to take two a day ,with a 12 hr space between,drinking the water with it that late in the day had me up .
So I take 1 first thing ,if I feel something coming on I do have another .
I was getting many infections.
I can now hang on to pee longer and feel I empty my bladder better .
Google it there is a lot of success with it

As willow herb said, it can be caused by VA-vaginal atrophy. This is what happened to me. I had a simple pessary since 2018, very happy with it for mild uterine prolapse-I didn’t want surgery. The all of a sudden, in February, it became dislodged-I didn’t know why. Anyway, a VERY distressful week ensued trying to find someone ANYONE to remove it for me! I did eventually get it removed, and then followed 6-8 weeks of trying to get it replaced. The dr I saw said it was VA, and the pessary problem would resolve with treatment of the VA.There is an "Integrated Care Systems (ICSs) partnerships of organisations that come together to plan and deliver joined up health and care services, and to improve the lives of people who live and work in Buckinghamshire, Berkshire and Oxfordshire. The intermediate Gynae clinic here in Bucks is part of that-probably more across the country, so try to get referred to that, and see a gynaecologist who specialises in all things nether regions! Ute’s are very common with the hormone treatments, so don’t suffer, the doctors who run the clinics are very good. Many GP’s though are not aware of these partnerships! Good luck. I also had Vagirux prescribed for the VA and I am much better now. It’s awful though, to have to have drugs to overcome the side effects of the other drugs!!

Hi lottos,
I had the same problem constant UTI and my urologist suggested methenamine daily plus soluble vitamin c tablet daily. The methenamine tablets are huge! And after a week of trying I just couldn’t face taking them daily but she put me on a course of antibiotics 1 a day for 3 months and I take the vitamin c table daily. I haven’t had a uti for a year now ! Hope that helps


Thankyou for your reply. I also have vaginal atrophy which has become much worse since taking the letrozole so this will most likely be the cause of increase in uti’s too… Have you had any success in finding a solution for that ? I have tried a few different vaginal moisterisers to help

Hi Maureen,
Thanks for your reply, would be interested to know the meds you were on and what you were changed to . I am on letrozole sun pharma and have wondered myself if a different brand would make any difference but they all are aiming to cut the oestrogen which alas is the main cause I believe!

Hi Lottys

My GP gave me 2 choices - HIPREX or vaginal Estrogen. Naturally I chose the HIPREX being that adding Estrogen is not meant to be a good thing for us BC users.

However, the Prolapse-y type symptoms did not go away and after taking advice from the GP, BCN and Onc that topical Estogen (as a pessary) was a very minimal dose that would not enter the bloodstream I gave it a go.

Let’s just say I did not realise how bad the undercarriage had got (will spare you the gruesome details). Anyway, after about 3 weeks all weird feelings had gone.

However, I am still worried about it so switched to REPLENS as recommended by some of the ladies here. Their GP’s would not let them near Vagirux as it is a contentious area. It worked OK for a few months but then I noticed some of the interesting symptoms coming back so returned for a while to the VAGIRUX. Now I am doing 1 dose of each a week to see how it goes.

I am thinking of giving HYALOFEMME a go.

NO UTIs for me since this time last year.

The depressing thing is that this is what I shall have to do for the rest of my life - how did our Mums/grans/ancestors etc cope with VA? Maybe , once off the AI pills it won’t be quite as bad

Hi Lottie
I was on Letrozole for a year before op. They wouldn’t change meds till after op. Put on Exetamine (don’t know if I spelt it right) this caused multiple problems as I have arthritis so couldn’t walk in the morning. I’m now on Tamoxifen. Taking this for another year. They all take oestrogen out of the body.
Talk to your team they should be able to find a tablet that does the same job but without some of the side affects. I found the Breast care nurses more receptive than the consultant. Hope this helps

Hi @LottyS a bit late to the party here and you may have sorted out your new regime but I wanted to put a vote in for d-mannose for urinary tract problems. It’s brilliant stuff and completely natural. I get it from my local pharmacy but also buy bags from Your Supplements (a company) from Amazon as it works out a lot cheaper. I also swear by Hyalofemme for VA. I tried the Tamoxifen/Vagirux combo for a month but I hated Tamoxifen, refused to take it and went back to Letrozole and combined it with Hyalofemme which is as good as the oestrogen treatments in my opinion. It stings to start with but once it sorts out your vag, the stinging stops. Way better than vaginal moisturizers. If you do go with a moisturizer, don’t bother with Replens as it contains parabens which is not good.

Thankyou for info. I have just started using Hyalofemme myself but unfortunately have been hit with yet another uti this week !!! Agh !
Will continue though and going to give Hippurate a go too

The Vagirux works-it’s 10 mcg of oestrogen, a tiny amount, absorbed topically and not into the bloodstream. Taking antibiotics long term is not good-they kill off ALL bacteria in your gut good as well as bad-and cause digestive issues! The Vagirux once tor twice a week, works fine.