Urinary Tract Infections (UTIs) in Women

A urinary tract infection (UTI) is an infection of the bladder, kidneys, ureters, or urethra. It is the most common infection in the urinary tract and can be caused by bacteria, viruses, and fungi. Urinary tract infections (UTIs) are prevalent, especially in women, babies, and older people. Almost one in two women and one in every 20 men get a UTI in their lifetime. It is important to see a doctor if you suspect you may have a UTI, as untreated UTIs can lead to complications.

Sign and Symptoms of UTIs

The most common and prominent symptoms of UTIs are:

• Urge to urinate more frequently and urgently, if only a few drops

• Burning pain or a ‘scalding’ sensation while urinating

• A feeling of bladder not emptying even after urinating

• Pain above the pubic bone

• Cloudy, bloody, or very smelly urine

Along with the general symptoms of UTIs, a person with a kidney infection can also experience chills, fever, loin (lower abdominal) pain, back pain, and vomiting. Infection of the kidneys demands immediate medical attention.

Causes and Risk factors of UTIs

Urinary tract infections (UTIs) are caused by bacteria entering the urinary tract. The most common type of UTI is caused by Escherichia coli, a type of bacteria commonly found in the gastrointestinal tract. Germs like Mycoplasma and Chlamydia can cause urethritis in both men and women and can be passed on during sexual intercourse, so both partners need medical treatment to avoid re-infection. 

Other causes of UTI include poor hygiene, holding urine for too long, using a diaphragm for birth control, using a catheter, and sexual intercourse. Risk factors for UTI also include age, menopause, and pregnancy. Some people may have a higher risk of infections due to blocked urinary flow or when the urine flows back up from the bladder to the kidneys.

Reason for susceptibility of women to UTIs

Women have short and straight urethra making it easier for germs to travel into the bladder. As the woman ages, the tissues of the urethra and bladder become thinner and drier, which may result in increased UTIs. In some women, UTIs may occur due to changes in their hormonal levels, especially during menstruation, pregnancy, and menopause.

Other factors that contribute to the susceptibility of women to UTIs include:

• Use of spermicide jelly or diaphragm for contraception as spermicides may kill good bacteria that protect from UTIs.

• An increase in sexual activity

• Prior UTI at or before 15 years of age.

• Family history of repeated UTIs, especially their mother.

• Constipation

• Diabetes as it lowers the immune (defense) system and causes nerve damage that makes completely emptying the bladder harder.

• Clinical condition, like a kidney stone, that may block the urine flow between kidneys and bladder.

• Recent history of catheter placement.

UTIs and Pregnancy

Nearly all women are prone to UTIs during pregnancy. The hormonal alterations during pregnancy can disrupt the bacteria in the urinary tract, leading to a higher prevalence of UTIs in pregnant women. Additionally, the uterus can obstruct the bladder’s ability to empty, leaving bacteria in the urine and potentially causing a UTI. Furthermore, the drainage system from the kidney to the bladder widens and slows during pregnancy, making it easier for germs to travel to the kidney and cause a kidney infection. Apart from kidney infections, UTIs during pregnancy can cause-

• Premature birth of the baby (birth before 39 to 40 weeks).

• Low birth weight babies (smaller than 5 1/2 pounds at birth).

• High blood pressure further triggers a more serious condition called preeclampsia.

Recurrent UTIs in women

Women who suffer from two UTIs in six months or three a year are known to have recurrent UTIs. The doctor may prescribe some tests to find the cause. If the test results are normal, the doctor may prescribe a small dose of antibiotics daily to prevent infection. The doctor may also advise taking antibiotics right after sex or at the first sign of infection.

Treatment for UTIs

It is essential to seek medical advice when you experience the symptoms of UTI. It is even more crucial if you think you may have a bladder or kidney infection because both are severe conditions, and early treatment can help prevent further consequences.

The doctor will prescribe urine tests to check the presence of any micro-organisms. Urinary tract infections usually respond fast and well to antibiotics.

Prevention of UTIs

Although not always supported by clinical research, some women advocate certain tips for reducing the risk of developing urinary tract infections. These are-

• Drink lots of water and other fluids to flush the urinary system. It is advisable to drink six to eight glasses of water daily.

• Treat vaginal infections like thrush or trichomonas at the earliest possible.

• Avoid using spermicide-containing products, specifically with a diaphragm contraceptive device.

• Urinate as soon as you feel, rather than holding on.

• After using the toilet, wipe yourself from front to back (urethra to anus).

• Empty your bladder following sex.

• Avoid constipation.

• Practice good hygiene during the menstrual cycle to avoid infections. Changing pads and tampons frequently and not using feminine deodorants can also help prevent UTIs.

• Use a water-based lubricant during sex in case you experience vaginal dryness and use a lubricant during sex.

• Avoid using tight-fitting clothing. A loose-fitting cloth can help keep you dry and prevent bacteria from growing in the urinary tract. 

• Switch to cotton underwear to prevent extra moisture from getting trapped around your urethra.

• A healthcare provider may suggest an estrogen-containing vaginal cream in some post-menopausal women, which may lower the risk of developing a UTI by changing the pH of the vagina. 

The bottom line

UTIs are a common problem in women. Practicing good hygiene and acknowledging the symptoms will help get treatment early and prevent harmful consequences.