Urinary tract infections (UTI) are a serious health problem affecting 8.3 million Americans each year. 53% of all women have had at least one urinary tract infection during their lifetimes. Many women suffer from frequent UTIs. Nearly 20 percent of women who have one UTI will have another infection. This article will cover the causes, symptoms, and treatment of UTIs in women.
What are the causes of UTI?
Most infections arise from bacteria, Escherichia coli (E. coli), which normally lives in the colon. These bacteria gain access to the urinary tract through the urethra or the tube that carries urine from the bladder to the outside of the body.
An infection limited to the urethra is called urethritis. If bacteria move to
the bladder and multiply, a bladder infection, called cystitis, results. If the infection is not treated promptly, bacteria may then travel to the kidneys. A kidney infection is called pyelonephritis.
Microorganisms called Chlamydia and Mycoplasma may also cause UTIs in women, but these infections tend to remain limited to the urethra and reproductive system. Unlike E. coli, Chlamydia and Mycoplasma may be sexually transmitted, and infections require treatment of both partners.
Who is at risk?
In women the rate of UTIs gradually increases with age. Scientists are not sure why women have more urinary infections than men. One factor may be that a woman’s urethra is short, allowing bacteria quick access to the bladder. Also, a woman’s urethral opening is near sources of bacteria in the anus and the vagina. For many women, sexual intercourse seems to trigger an infection, although the reasons for this linkage are unclear.
Some women are more prone to getting a UTI than others. Women with diabetes have a higher risk of a UTI because of changes in the immune system. Any other disorder that suppresses the immune system raises the risk of a urinary infection.
According to several studies, women who use a diaphragm are more likely to develop a UTI than women who use other forms of birth control. Recently, researchers found that women whose partners use a condom with spermicidal foam also tend to have growth of E. coli bacteria in the vagina.
What are the symptoms of UTI?
The most common symptoms include a frequent urge to urinate and a painful, burning feeling in the area of the bladder or urethra during urination. It is not unusual to feel bad all over-tired, shaky, washed out-and to feel pain even when not urinating. Often women feel an uncomfortable pressure above the pubic bone. The urine itself may look milky or cloudy, even reddish if blood is present. Normally, a UTI does not cause fever if it is in the bladder or urethra. A fever may mean that the infection has reached the kidneys. Other symptoms of a kidney infection include pain in the back or side below the ribs, nausea, or vomiting.
How is UTI diagnosed?
To find out whether you have a UTI, your doctor will test a sample of urine for pus and bacteria. In the urinalysis test, the urine is examined for white and red blood cells and bacteria. Then the bacteria are grown in a culture and tested against different antibiotics to see which drug best destroys the bacteria.
How is UTI treated?
UTIs are treated with antibiotic medications. The choice of drug and length of treatment depend on the patient’s history and the urine tests that identify the offending bacteria. The sensitivity test is especially useful in helping the doctor select the most effective drug. The drugs most often used to treat routine, uncomplicated UTIs are trimethoprim (Trimpex), trimethoprimlsulfamethoxazole (Bactrim, Septra, Cotrim), amoxicillin (Amoxil, Trimox, Wymox), nitrofurantoin (Macrodantin, Furadantin), and ampicillin (Omnipen, Polycillin, Principen, Totacillin). A class of drugs called quinolones includes four drugs approved in recent years for treating UTI. These drugs include ofloxacin (Floxin), norfloxacin (Noroxin), ciprofloxacin (Cipro), and trovafloxin (Trovan).
Often, a UTI can be cured with I or 2 days of treatment if the infection is not complicated by an obstruction or other disorder. Many doctors ask their patients to take antibiotics for a week or two to ensure that the infection has been cured. Most doctors suggest that drinking plenty of water helps cleanse the urinary tract of bacteria. During treatment, it is best to avoid coffee, alcohol, and spicy foods.
Recurrent Infections in Women
Women who have had three UTIs are likely to continue having them. Four out of five such women get another within 18 months of the last UTI. Many women have them even more often. A woman who has frequent recurrences (three or more a year) can take low doses of an antibiotic such as TMP/SMZ or nitrofurantoin daily for 6 months or longer. If taken at bedtime, the drug remains in the bladder longer and may be more effective.
Additional steps that a woman can take on her own to avoid an infection:
I. Drink plenty of water every day.
- Urinate when you feel the need; don’t resist the urge to urinate.
- Wipe from front to back to prevent bacteria around the anus from entering the vagina or urethra.
- Take showers instead of tub baths and avoid bubble baths.
- Cleanse the genital area before sexual intercourse.
- Avoid using feminine hygiene sprays and scented douches, which may irritate the urethra.
- Use cotton underwear as synthetics will trap bacteria.
Bottom line: UTIs are one of the most common infections occurring in women. The diagnosis is easily made and most women can be cured with a single course of antibiotics. Others need low-dose daily medication to control their infections.