Urinary Tract Infections in Women: What You Need to Know

A urinary tract infection (UTI) is a type of infection (usually bacterial) that affects the urinary tract. UTIs can affect one or several parts of the urinary tract, including the urethra, ureters, kidneys and bladder.

Urinary tract infections develop when bacteria, often from the skin or anus, enters the urinary tract. Due to the difference in  distance between the anus and the urethra, UTIs tend to occur more frequently in women than in men.

If you have a UTI, you may experience a range of symptoms, including overly frequent urination and pain or burning feelings when you need to urinate. 

Most of the time, urinary tract infections can be treated with oral medications, e.g. antibiotics. However, UTIs that spread to your kidneys can become significantly more serious and, in some cases, may require urgent medical care.

Below, we’ve listed the symptoms and potential health complications of a urinary tract infection (UTI). We’ve also explained what causes UTIs, how they’re typically diagnosed by a healthcare professional and the UTI treatment and prevention options that are currently available. 

Symptoms of a Urinary Tract Infection (UTI)

Although not all urinary tract infections cause noticeable symptoms, there are several common symptoms that you may notice if you develop a UTI:

• A strong, persistent need to urinate, even shortly after going to the toilet

• Pain, discomfort and a burning feeling when you urinate

• Cloudy and/or strong-smelling urine

• Red, pink or brown-colored urine that contains blood

• Cramps, pressure and discomfort in the back and in the lower abdomen, near the pelvis and pubic bone

• In some people, a mild fever

When a urinary tract infection spreads to the kidneys, it can cause more severe and noticeable symptoms. These may include:

• Fever of 101°F (38.3°C) or higher

• Fatigue, tiredness and a feeling of general illness

• Nausea and vomiting

• Pain and discomfort in the back, sides and pelvic area

• Severe pain in the abdominals

• Red, flushed and warm skin

• Confusion and mental changes (usually seen in the elderly)

• Night sweats, chills and shaking

The exact symptoms of a UTI can vary based on the part of your urinary tract that’s affected. If you have a UTI, you may notice one or several of the symptoms listed above. Some symptoms may be more severe than others. In the elderly, confusion and mental changes may be the only sign that a person has a UTI.

Urinary tract infections can affect people of all ages. In infants and toddlers, the most common sign of a UTI is fever. Young children may not be fully able to properly identify or communicate about their UTI symptoms. If you think that your child has a UTI, you should talk to a healthcare professional.

Potential Complications Associated With Urinary Tract Infection (UTI)

Urinary tract infections generally don’t lead to complications, as long as they’re treated promptly and effectively. However, when left untreated, a UTI can potentially spread throughout the body and, in some cases, lead to serious and potentially life-threatening health complications.

If left untreated or inadequately treated, a UTI may lead to the following complications:

• Permanent kidney damage. When a UTI travels to the kidneys, it can potentially cause lasting damage. Kidney infection, referred to as pyelonephritis, can potentially lead to kidney disease, kidney failure, or an abscess of the kidney if ignored or inadequately treated.
  
  

• Recurrent infections. UTIs can reoccur, particularly in women. In fact, 25 percent to 30 percent of women who get a urinary tract infection experience a recurrent infection at some point in the next six months.
  
  

• Low birth weight. UTIs are common in pregnant women and may contribute to a higher risk of delivering premature or low birth weight babies.
  
  

• Urethral stricture. Recurrent inflammation of the urethra due to UTIs can cause stricture, or urethral narrowing. Stricture can develop when scarring from a urinary tract infection prevents or slows down the flow of urine from the urethra, making urination painful or difficult.
  
  This complication is more common in men than in women. When severe, it can require surgical treatment to improve urine flow and relieve symptoms.
  
  

• Life-threatening blood infections (sepsis). Severe urinary tract infections may lead to sepsis, a potentially life-threatening illness caused by the body’s response to a bacterial infection that spreads to your blood.
  
  People with a damaged or suppressed immune system, such as people with HIV/AIDS or those undergoing cancer treatment, as well as the young and very old, have a higher risk of developing sepsis from a UTI.

When Should You Talk to a Healthcare Professional?

You should talk to a healthcare professional as soon as you notice any of the symptoms listed above. If you have a UTI, acting quickly will allow you to start treating the UTI before it can spread further into your urinary tract and potentially damage organs such as your kidneys. 

Most urinary tract infections can be treated at home using antibiotics. However, if your UTI has spread or you have a severe UTI, you may need to be treated in the hospital.

If you’re concerned that your child may have a UTI, it’s best to talk to a healthcare professional as soon as you can. You should seek medical assistance right away if your child is younger than three months and has a temperature of 100.4°F (38°C) or higher.

What Causes Urinary Tract Infection (UTI)?

Urinary tract infections occur when bacteria or other pathogens get into your urethra and bladder. They can spread into the urethra from your vagina, fingers, skin or rectum, or from your sexual partner’s genitals, fingers or skin.

UTIs can also develop from bacteria on sex toys and other objects that come into contact with the skin near your urethra. Certain sexually transmitted diseases (STDs), such as gonorrhea and chlamydia, may also cause UTIs.

Who Is Most at Risk?

Urinary tract infections can affect men and women of all ages. However, certain risk factors may cause you to have a higher chance of developing a UTI. 

Because of the short distance between the urethra and the bladder, as well as the closeness of the rectum to the vagina, women have a higher risk of developing UTIs than men. Around half of all women will develop a UTI at some point in life.

Several other factors can increase your risk of developing a urinary tract infection. You may be more at risk if you:

• Have had a urinary tract infection before. Recurrent UTIs are common, with 25 to 30 percent of women experiencing a second urinary tract infection within six months of their previous infection.
  
  

• Are sexually active.  The bacteria that cause UTIs can be transferred to the urethra during sexual activity, causing a UTI to develop.
  
  

• Use of spermicides or a diaphragm. These forms of birth control may increase your risk of developing a urinary tract infection by coming into contact with and introducing bacteria into your urethra.
  
  

• Are pregnant. According to information published in American Family Physician, up to eight percent of pregnant women will develop a urinary tract infection. Pregnant women are at increased risk for UTI because of normal anatomic and physiologic changes related to pregnancy — for example, the widening of the ureters — increased urine production, loss in bladder tone, and more.
  
  

• Are going through menopause. Hormonal shifts during the menopause transition can cause changes within the genitourinary tract  which may increase your risk of developing a UTI.
  
  

• Have an existing chronic disease, such as diabetes or obesity. Both of these may increase your risk of developing a urinary tract infection. Diabetes may worsen certain urologic conditions due to its effects on immunity, blood flow, nerves and sensory function.
  
  

• Have a condition that causes structural problems in the urinary tract, such as an enlarged prostate or kidney stones. Injuries that cause nerve damage, such as spinal cord injuries, may also increase your risk of developing a UTI.
  
  

• Have a weakened immune system. Diseases, medications and medical conditions that suppress your immune system may increase your risk of developing a UTI, as your body is less able to fight off bacterial infections.
  
  

• Use a urinary catheter. Catheter use, particularly in a hospital setting, can lead to a type of UTI referred to as catheter-associated urinary tract infections (CAUTI). Patients who require a urinary catheter for long periods of time have a particularly elevated risk of developing UTIs.
  
  

• Need to stay still for long periods of time. Immobility, such as following surgery or an injury, may increase your risk of developing a urinary tract infection and other urinary health issues such as kidney stones.
  
  

• Don’t practice good personal hygiene habits. Not washing your hands, genitals and other parts of your body may increase your risk of developing a UTI. This is a common cause of urinary tract infections in young children who are potty training. 

Diagnosis of Urinary Tract Infection (UTI)

If you’re worried that you might have a urinary tract infection, it’s best to talk to a healthcare professional. UTIs are usually easy to diagnose and treat and, if treated early, are less likely to spread and cause health complications. 

Your healthcare provider may ask you about recent symptoms, such as pain, discomfort or burning sensation while you urinate, or a need to go to the toilet often. They may also perform a physical exam.

While it can feel embarrassing to talk about topics such as urination with a healthcare professional, it’s important that you provide clear, accurate information to help your healthcare provider make an accurate diagnosis and provide the best possible treatment.

To accurately diagnose a urinary tract infection, your healthcare provider may ask you to complete one or several tests:

• Urine test. Your healthcare provider may ask you to provide a urine sample for a uninalysis. This sample will then be analyzed in a lab to check for red or white blood cells, nitrites, or bacteria, which may indicate an infection. They will explain how to provide a sterile urine sample.
  
  

• Urine culture. A urine culture test checks for bacteria in your urine. Your healthcare provider may use this type of test to verify that you have a UTI and identify the exact type of bacteria that’s causing the infection and the most appropriate medication to treat it.
  
  

• Ultrasound, CT or MRI scan. If your healthcare provider suspects that your UTI may be caused by an abnormality, such as an issue affecting your kidneys and bladder, they may request that you take an ultrasound, CT or MRI scan to provide precise, accurate imaging.
  
  Imaging procedures are rarely used for first-time urinary tract infections — instead, your healthcare provider may use this kind of test if you get frequent UTIs without any obvious reason. 
  
  

• Cystoscopy. This procedure allows your healthcare provider to examine your urethra and bladder using a device called a cystoscope — a long, thin tube with a camera and light that’s inserted into your bladder.
  
  Cystoscopy can help to identify the potential cause of recurrent UTIs. 

Your healthcare provider may request that you take additional tests, such as a complete blood count (CBC) and blood culture. These can help to identify if the infection has spread beyond your urinary tract to your bloodstream. 

Urinary Tract Infection (UTI) Treatment and Prevention

Most urinary tract infections can be treated using oral medications such as antibiotics for bacterial UTIs. Your healthcare provider will prescribe the most effective antibiotic based on the type of bacteria that’s causing your infection. Commonly prescribed antibiotics for uncomplicated UTIs include:

• Sulfamethoxazole and trimethoprim

• Nitrofurantoin

• Cephalexin

• Fosfomycin

Antibiotics work by killing the bacteria that cause a urinary tract infection to develop. When you have a UTI, you may notice an immediate improvement in your symptoms, often within a day or two of starting treatment.

Even if your symptoms stop after you start using antibiotics, it’s important to continue using your medication as directed by your healthcare provider. Stopping treatment before you finish the entire course of your medication may increase the risk of the UTI coming back as well as promote antibiotic resistance.

If your urinary tract infection is causing you pain, such as a burning feeling during urination, your healthcare provider may also prescribe medication to treat this. 

Treatment for Recurrent Urinary Tract Infections

Many urinary tract infections disappear for good after treating with antibiotics. However, some people experience recurring urinary tract infections that come back, even after treatment with prescription medication. 

Recurrent urinary tract infections often require a more regular treatment than more sporadic infections. 

To treat recurrent UTIs, healthcare providers will occasionally prescribe prophylaxis to be taken either daily or before sex . 

If you are  postmenopausal, your healthcare provider may prescribe an estrogen-based treatment to help with recurrent UTIs.  Estrogen deficiency in postmenopausal women has been shown to play a role in the development of a UTI.

If you experience recurrent urinary tract infections after sexual activity, your may need to take a single dose of an antibiotic after sex.

Treatment for Complicated Urinary Tract Infections

Most urinary tract infections are considered simple. However, UTIs that develop due to certain anatomical abnormalities, medical conditions or atypical organisms, during pregnancy or after treatment with antibiotics are categorized as complicated urinary tract infections. 

In addition, all UTIs in males are considered complicated due to the protective nature of the long male urethra.

Complicated UTIs can often require different, more thorough treatments than simple UTIs. If the infection spreads into the kidneys or bloodstream, it can potentially cause life-threatening health complications that may require hospitalization and emergency treatment. 

If your healthcare provider thinks that you have a complicated or severe UTI, you may need to go to hospital to be treated. If the UTI is caused by a structural problem in your urinary tract, you may need to get surgery to avoid recurrent infections.

Home Remedies and Lifestyle Changes

Most urinary tract infections can be treated effectively using antibiotics. If you have a UTI, it’s important to closely follow your healthcare provider’s instructions and take all of your medication to prevent the infection from returning.

To reduce discomfort and make the recovery process easier, you may want to try the following home remedies and lifestyle changes:

• Urinary anesthetic. It may take a day or 2 for you to notice the antibiotics kicking in. If you are having pain with urination during this time, try an over-the-counter urinary pain reliever like Uristat.

• If your abdomen hurts, use a heating pad. You may experience pain and discomfort around your pelvis if you have a UTI. To relieve this, you can apply a hot water bottle or heating pad to your lower abdomen.

After you’ve completed treatment with antibiotics or other prescribed medications, it’s important to follow up with your healthcare provider to check that the infection is completely gone. If you don’t experience any improvement after using antibiotics as prescribed, contact your healthcare provider. 

Prevention

Practicing healthy habits and making small changes to your lifestyle may help you to prevent urinary tract infections. To reduce your risk of developing a UTI, try doing the following:

• Drink plenty of water. Staying hydrated is important for your general health, physical performance and wellbeing. It may also help to flush out bacteria and help you recover from your infection.
  
  

• Don’t wait to pee. While there’s no need to pee the minute you feel the urge, it’s best not to hold in your urine for too long if you need to go to the bathroom. Holding it in for too long isn’t just uncomfortable — it also gives harmful bacteria longer to multiply.
  
  

• Wipe yourself from front to back. After you use the toilet, make sure that you wipe from front to back instead of back to front. This reduces your risk of spreading E. coli bacteria from the skin near your anus to your vagina and urethra.
  
  

• Urinate before and after sex. During sex, the bacteria in and around your vagina or on your partner’s penis may enter into your urethra. Peeing before sex eliminates the medium for bacteria to grown in and peeing after sex may flush these bacteria out and reduce your risk of developing a UTI.
  
  

• Avoid douching. Douching is medically unnecessary and can change the balance of bacteria in your vagina, making you more prone to a variety of infections.
  
  

• Use sanitary pads instead of tampons. Some healthcare professionals believe that tampons increase your risk of developing certain infections. If you’re prone to UTIs, consider switching to sanitary pads to reduce your UTI risk.
  
  

• Avoid overly tight-fitting pants. Wear underwear and clothing that’s loose and allows for breathability, such as cotton-cloth underwear. Make sure to change your undergarments (pantyhose, underwear, etc) as often as needed (at least once per day) to avoid letting bacteria develop.
  
  

• Avoid or limit your consumption of alcohol and coffee. These can irritate the wall of your bladder, which may increase your risk of developing a UTI.
  
  

• Clean around your genitals before and after sex. Before and after sex, clean the vulva and area around the anal opening with warm water and mild soap. This actually decreases the amount of bacteria present, reducing your risk of developing a UTI.
   

• If you have menopausal dryness, consider using a vaginal estrogen cream. Topical estrogen creams may prevent UTIs caused by hormonal changes in menopausal women. These creams require a prescription, meaning you’ll need to discuss this with your healthcare provider.

Talk to a Healthcare Professional About Urinary Tract Infection (UTI)

If you think that you have a urinary tract infection (UTI), it’s important to talk to a healthcare professional as soon as you can. Acting swiftly to diagnose and treat your infection will reduce your risk of developing complications.

Consult with a licensed healthcare provider now to discuss your symptoms and learn more about what you can do to treat a urinary tract infection (UTI).  

If appropriate, the provider can write you a prescription on the spot and send it directly to a local pharmacy of your choice, allowing you to get the relief you need fast, all without having to go to a healthcare provider’s office.