Here’s why older women are especially at risk.
What’s incredibly painful, inconvenient, embarrassing, and has you drinking a lot of juice while bowled over sitting on the toilet for hours? If you’ve ever been in this position, you know the answer: A urinary tract infection.
UTIs aren’t uncommon — 8 to 10 million doctor visits are due to UTIs alone. And contrary to popular belief, they’re not necessarily a sign of poor hygiene or always associated with sex.
“UTIs can be related to sexual activity, but not always,” says Rebecca Brightman, MD, our resident women’s health expert. “Women who don’t urinate frequently or incompletely empty their bladder are at risk of UTI.”
She warns that women, particularly older, are more at risk of developing UTIs because of menopause – and the female anatomy. What’s worse is they’re often overlooked or even mistaken for other conditions among the elderly, and if left untreated, they can spread elsewhere.
“You don’t want to ignore it because if you have an untreated urinary tract infection, it can get into the ureters, which are the tubes that go from the kidney to the bladder, and then you can end up having an infection in the ureters, and a kidney infection and that is potentially serious,” she tells us.
In order to better understand this infection, Dr. Brightman breaks down the common causes and how to prevent them.
First, what’s a UTI?
UTIs are an infection that can happen in any part of your urinary system, which includes the bladder, kidneys, or urethra.
While they can affect men, women are more predisposed to them because their urethra — or the tube that carries urine from the kidneys to the bladder — is shorter than a man’s, making it easier for bacteria to get up into the bladder. To put this into perspective, about 1 in 2 women get a UTI in their lifetime, compared to roughly 1 in 10 men.
“There probably is some genetic or anatomic predisposition,” Dr. Brightman tells us. “For some women, the urethra is in very close proximity to the vagina and for others, it’s not.”
What are the different types of UTIs?
They generally fall into three main categories:
Cystitis (bladder infection): Bacteria such as E. Coli are generally to blame for this type of inflammation, but that isn’t always the case. For example, certain medicines like those related to chemotherapy treatments can also be culprits.
Pyelonephritis (kidney infection): This happens when bacteria travels from your bladder and infects one or even both kidneys. This can cause your kidneys to swell, and if left untreated, can lead to permanent damage.
Urethritis: Also known as inflammation of the urethra, this happens when the bacteria in your GI tract spread from the anus to the urethra. Since the female urethra is so close to the vagina, urethritis can be caused by sexually transmitted diseases like herpes or gonorrhea.
What are the common UTI symptoms?
These can vary widely, depending on which part of your urinary tract is infected, but they generally include the following:
- A strong and persistent urge to pee
- A burning sensation when peeing
- Low-grade fever
- Passing frequent and small amounts of urine
- Urine that looks cloudy or appears reddish, which is a sign of blood
- Urine that has a strong odor
- Feeling pain in your side or lower back
Why are older women at a higher risk for UTIs?
Risk factors can vary widely with age, so the reason your grandmother keeps getting UTIs may not be for the same reason your newly married cousin is getting them.
For young women, sexual activity is one of the most common risk factors because sex increases the number of bacteria in the bladder. That’s probably why you’ve heard the common piece of advice to pee after sex because it flushes them out and can help prevent UTIs from happening in the first place. But for those who are older, Dr. Brightman tells us that menopause becomes the main cause due to a drop in estrogen levels that leads to changes in the urinary tract that makes them even more vulnerable to infections.
“Postmenopausal women are prone to UTIs due to the lack of estrogen in the urogenital tract,” she says. “This loss of estrogen results in changes in bacteria in the vagina, changes in the anatomic relationship between the urethra and the vagina, and an increased tendency for bacteria to ascend the urethra and infect the bladder.”
How do you treat UTIs?
The good news is that urinary tract infections can be easily treated with antibiotics, though you have to be careful because overuse can lead to the body developing a resistance to them.
Still, if UTIs are recurrent, doctors might prescribe a low-dose antibiotic for six months, but this isn’t necessarily the case for older people. For instance, Dr. Brightman typically prescribes vaginal estrogen therapies for post-menopausal patients.
There are also other ways to relieve your discomfort without a prescription — such as using a heating pad to minimize pressure on the bladder and avoiding any drinks that could irritate your system further like alcohol or coffee.
Do certain UTI home remedies really work?
You may have grown up hearing your mom or girlfriends talk about drinking cranberry juice to help prevent or alleviate the pain caused by UTIs. While the studies on the benefits of these antioxidant-rich berries remain inconclusive, Dr. Brightman thinks certain extracts can potentially have certain benefits, especially with frequent UTIs.
“There are some purified cranberry extracts that have shown efficacy in terms of UTI prevention or lowering the incidence of recurrent UTIs,” she tells us.
Similarly, Dr. Brightman said probiotics also have “conflicting data” when it comes to whether they help prevent these types of infections. That’s why she says your best bet is to make sure you’re taking other preventive measures on a daily basis. This includes making sure you’re staying properly hydrated (doctors say you should aim for about 2 to 3 liters each day), making sure you completely empty your bladder every time you go, and wiping front to back after using the bathroom.
Do feminine hygiene products help at all with UTIs?
Though feminine wipes and vaginal cleansers have become part of a $21.6 billion dollar industry, Dr. Brightman doesn’t recommend them because she says they can mess up the vagina’s natural pH balance and actually increase your risk for infection. It’s true, intimate washes make you 2.5 times more likely to develop a UTI, according to Medical News Today.
“The vagina has a way of maintaining a normal pH and there are certain bacteria that are important that they stay in the vagina because they keep other bacteria in check, including keeping the yeast to check,” she tells us. “So the last thing you want to do is start sterilizing or changing the makeup of the bacteria in the vagina.”
