What Is a Urinary Tract Infection?
A urinary tract infection, or UTI, is one of those really uncomfortable problems you simply can’t ignore. When you have a UTI, it can be painful to pee. Left untreated, serious complications can occur. We asked doctors to tell us why women are at greater risk of getting these infections and how someone would know if she has one. Plus, we got the latest scoop on UTI treatments and prevention strategies.
What is a UTI?
A UTI is an infection of all or part of the urinary tract. Most infections begin in the lower urinary tract, which includes the urethra (the tube that allows urine to exit the body) and bladder (where urine is stored). Sometimes these infections travel upward through the ureters (the tubes that ferry urine from each kidney to the bladder) to the kidneys (where urine is produced).
Common symptoms include pelvic pain, burning with urination, and urgent or frequent need to urinate. Women, men, and children of all ages can get a UTI. But women are at much greater risk. It’s estimated that roughly half of all women will have a UTI sometime during their lives. Some 150 million UTIs occur worldwide each year.
Types of UTIs
There are three main types of UTIs defined by the part of the urinary tract that becomes infected.
- An infection of the urethra only is called urethritis. It causes the urethra to come inflamed.
- The most common type of UTI is a bladder infection, also known as cystitis. It’s what people usually mean when they say they have a UTI.
- Kidney infections are a more serious type of UTI. The medical term is pyelonephritis.
What causes a UTI?
Normally, your body’s own immune system defends against possible infection. One way it does that is through the continual flow of urine. This helps to prevent bacteria from adhering to the walls of the urinary tract. But sometimes germs sneak through anyway.
It all begins when bacteria, usually E. coli, enter the urethra, stick to the bladder wall, and begin to multiply. The next thing you know, you’ve got a bladder infection (cystitis). And sometimes bacteria from the bladder invade the upper urinary tract, infecting one or both kidneys.
UTI risk factors
Some people are more likely than others to develop a UTI. Risk factors include:
- Being female. Women have much shorter urethras than men, and the opening of the urethra is much closer to the anus. Due to these anatomical differences, bacteria can easily enter a woman’s urinary tract.
- Being sexually active. Sex pushes bacteria into the urethra.
- Being older. After menopause, estrogen levels drop. That affects levels of healthy, infection-fighting bacteria, called lactobacillus.
- Using diaphragms or spermicide-coated condoms.
- Having trouble emptying your bladder. Incomplete evacuation of urine can promote bacterial growth.
- Having a kidney stone. (In men, an enlarged prostate can be a risk factor.)
- Having diabetes or a weak immune system.
- Having a prior UTI.
- Using a catheter or having undergone a recent surgery or medical procedure involving the urinary tract.
Common bladder infection symptoms
- Urge to urinate, even when the bladder is empty or you have only a few drops of urine to pass.
- Frequent urination.
- Aching, pressure, or pain in the lower abdomen or pubic area.
- Painful urination.
- Cloudy or bloody urine.
- Strong- or foul-smelling urine.
How to prevent a UTI
There are steps you can take to ward off future urinary tract infections.
Lifestyle measures
- Drink plenty of fluids, especially water. This dilutes urine and flushes out bacteria.
- Urinate when you feel the need. Holding it in promotes bacterial growth.
- Wipe from front to back after using the bathroom. You don’t want bacteria entering the urethra.
- Urinate after sexual intercourse to help flush out bacteria that may have entered the urethra during sex.
- Take showers, not baths, and wash your vulva using warm water.
- Avoid using powders, sprays, and douches.
- Stop using spermicide. If you use birth control method that are treated with spermicides, such as a diaphragm or condoms, consider switching to another type of contraception. Spermicides kill off good bacteria.
Medications
- If you get recurrent UTIs, ask your doctor about prescribing a low-dose antibiotic that you will take either after intercourse or daily for a period of months.
- If you are an older women who experiences frequent UTIs, consider vaginal estrogen cream. There’s good evidence that it decreases the risk of recurrent infections in postmenopausal women, Dr. Kaaki says. (This is not an option for women with a history of breast cancer.)
Nutritional supplements
- Consider using oral or vaginal probiotics. A small randomized trial found that a regimen of lactobacillus suppositories reduced UTIs in women with a history of recurrent infections.
- Drink cranberry juice or take cranberry pills. While the evidence is mixed, cranberry prevents bacteria from sticking to the cells of the urinary tract. Don’t consume cranberry if you take the blood-thinner warfarin (Coumadin) because it may raise your risk of bleeding.
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