By Linda Gale, PA
Among the most common conditions we see at our urology practice is urinary tract infection, commonly known as UTI. These infections are (unfortunately) very common in women, and can cause severe discomfort. While UTIs are common, they can also be quite serious if not treated properly.
UTI symptoms can vary, but most experience painful or burning urination, a frequent and strong urge to urinate, and sometimes blood in the urine. These symptoms often signal an infection in the bladder. A fever or back pain may indicate a more serious infection of the kidneys.
While urinary tract infections can happen at any age, they tend to cluster around the late teen years and early 20s, and again after menopause. UTIs in children are less common and should be evaluated and treated by a medical provider.
Women vs. Men
The female anatomy makes women much more likely to develop urinary tract infections than men. The urethra is close to the vagina, the source of bacteria for urinary tract infections. Also, a woman’s urethra is short, making it easier for bacteria to enter the bladder.
The Role of Sex
Women often report increased occurrence of UTIs related to sexual activity, especially in young women or women in new relationships. Emptying your bladder before and after sexual activity can help with this. Spermicidal jelly may increase the likelihood of UTIs, and alternative birth control methods are recommended for patients who are contracting UTIs. Some women require a low-dose antibiotic on days of sexual activity to avoid infection.
Bathing in a tub or swimming also have been associated with increased UTIs. Avoiding bath tubs and showering immediately after swimming will lower the risk.
Not emptying one’s bladder frequently enough can also cause UTIs. Not drinking enough fluids or holding urine can increase risk. Drinking 6-8 glasses of water per day and voiding every 3-4 hours or less will help.
Proper hygiene is important in avoiding UTIs. Avoid contamination of feces into the vagina or urethral by wiping front to back. Wear cotton underwear and avoid G-string type underwear to minimize irritation. Avoid douching and harsh soaps, which can irritate and remove good bacteria. Use a gentle cleanser like Cetaphil instead. Remember we cannot “sterilize” the genital region and trying to do so will actually increase risk of infections. Finally, it is important to change pads frequently (with each urination).
Low estrogen, which occurs after menopause, is a very common reason women are seen for UTIs. Estrogen is protective in that it keeps the chemistry and anatomy of the genital tissue more inviting to good bacteria. Often women also complain of dryness and irritation in that area, which can signal low estrogen as a problem. Being gentle in this area and avoiding soaps can help. Practitioners can treat many of these women with estrogen cream or supplements to help alleviate this problem.
There are also some dietary changes that may help, such as over-the-counter cranberry capsules or D-Mannose. Again, increasing fluids is an important defense.
Patients with UTI symptoms should be seen by a medical provider. Most female UTIs are not serious and are easy to treat. However, certain medical conditions can increase risk of UTI, including diabetes and other conditions affecting the immune system, kidney stones, neurological disorders, bladder tumors and certain anatomical abnormalities.
Linda Gale is a physician assistant at McDowell Urology.