Why UTIs are Different for Women

Urinary tract infections (UTIs) are infections caused by bacteria entering the urethra, i.e. the tube through which urine leaves the body, infecting the urinary tract. These painful infections mostly happen in the bladder (cystitis) but can also occur in the urethra and kidneys.

Though many bacteria cause UTIs, most such infections are caused by the presence of E. Coli in the urinary tract. E. Coli is a bacteria typically found in the lower intestine, including the rectum.

Why Women Get UTIs More Often

UTIs can happen to anyone, including children. However, for several reasons, they are more common in women, who are 50% more likely to get them than men. One such cause is female anatomy. Women have shorter urethras than men, and their urethras are closer to their rectum, making it easier for E. Coli to get into the urinary tract.

Other reasons include the following:

• Women have more sensitive skin "down there" that is more easily irritated (creating an environment for bacteria to grow),

• Using some types of contraception, like spermicide (which can also irritate the vagina) with diaphragms (where they are not adequately sanitized or worn for longer than recommended), and going through menopause.

UTI Symptoms in Women

• Pelvic cramps

• Burning sensation when peeing.

• Urge to pee that isn't relieved with urination (as the bladder is swollen)

• Frequent urination

• Discoloured urine

The "Lucky" Few: Asymptomatic Bacteriuria

For some women, bacteria in the urinary tract don't cause a problem, at least initially (more on that below). This phenomenon is called asymptomatic bacteriuria. It is more common in older women but can still impact women in during their childbearing years. It is typically diagnosed when a urine culture shows bacteria, but the woman has no classic UTI symptoms.

Pregnancy and UTIs

This can change when these women get pregnant, as pregnancy can cause these bacteria to multiply.

We asked Professor Horace Fletcher, Consultant Obstetrician-Gynecologist, why. He offered three reasons:

1. "During pregnancy, smooth muscle, as found in the urethra, becomes more sluggish. This prevents pregnant women from passing urine as readily, giving the bacteria a chance to multiply." This is caused by the increase in relaxin, a reproductive hormone that helps the body prepare for labour by loosening the muscles and ligaments in the pelvis.

2. "Secondly," he continued, "the urethra also becomes more dilated, making it easier for bacteria to move from the rectum to the urethra."

3. Finally, "in the early stages of pregnancy, the expanded uterus can obstruct the urine from coming out. During the late part of pregnancy, the baby's head can do the same."

Pregnant women need to get treated for any UTIs they may experience (many pregnant women endure recurrent infections), as these infections can impact the baby's growth and development in the womb and even result in miscarriages.

"If they start to show any signs, like protein in the urine or pelvic cramps, we test the urine. If bacteria are present, we treat them for UTIs."

Preventing UTIs

Avoid holding it in: If you have the urge to urinate, go. Holding your urine in can cause harmless bacteria to multiply, leading to infections.

Wipe properly: Front-to-back wiping after using the bathroom is important. This method of cleaning after using the toilet helps to prevent E. Coli from getting into the urinary tract, reducing your risk of developing these infections.

Stay hydrated: Be sure to drink enough fluids, especially water, every day. This helps to dilute your urine and encourages you to empty the bladder regularly, preventing bacteria from building up. Remember, while some studies have shown that drinking cranberry juice or taking cranberry supplements can help to prevent UTIs, once an infection begins, these methods are no longer helpful.

Don't overclean: Remember, the vagina is self-cleaning. Using feminine washes, especially scented ones, and douching can disrupt the natural pH balance of the vagina, causing bacteria to multiply. This bacteria can travel to the urinary tract, causing UTIs. Use clean, cool water to wash out the vulva (i.e. the outer part of the female genitals, including the vaginal opening, labia majora, labia minora, and clitoris).

Pee before after sex: Sex can push bacteria towards your urethral opening. Once inside, this bacteria can multiply if it is allowed to remain. Peeing before and within half an hour of sex helps flush out bacteria before they can cause an infection.

Be sure to visit the Our Doctors page to learn more about all our OBGYNs.