If you’ve ever had a urinary tract infection (UTI), you know how uncomfortable it can be, with frequent bathroom trips and “the urge to go now” — as Ohio State University Wexner Medical Center family Dr. Barbara Bauer, M.D. – has a burning sensation when you try to pee, along with lower abdominal pain.
UTIs, also known as cystitis, are a common problem. They account for nearly 25 percent of all infections and occur in as many as 60 percent of women once in their lifetime. Women are especially vulnerable to these infections. In fact, they suffer from UTIs 30 times more often than men.
Why does this happen? Here, experts analyze it.
First, what causes a UTI?
UTIs are caused by bacteria in the stool, such as E. coli, that enter the vaginal opening, travel to the urethra, and then down the urethra into the bladder, causing an infection, Bawer said.
So how exactly did the bacteria get there? There are a few different ways, experts say. The most common cause is sexual activity, which can push bacteria near the urethra. Sex can also cause microtrauma to vaginal tissue, which makes women more susceptible to infection, like “when you have a wound, you’re more prone to infected”.
In older women, going through menopause is a factor. “The loss of estrogen reduces the population of good bacteria” — known as lactic acid bacteria — “that defend the bladder from infection,” says Nettey. “The walls of the bladder and vagina also become thinner”—and thus more susceptible to infection—”because of the loss of estrogen.
Other factors that increase the risk of UTIs include spermicide use, previous recurrent UTIs, having a urinary catheter, structural abnormalities in the urethra or genital area due to birth or surgery, diabetes, pregnancy and poor hygiene, such as not wiping back and forth properly, according to Bawer. Still, as Nettey points out, even if you’re vigilant about UTI prevention by urinating to flush away germs after sex, wiping and washing the area back and forth, germs are hard to beat. “No matter what you do, it never gets clean,” says Nettey, “meaning the bacteria are never completely eliminated,” so bacteria can easily transfer to the urethral area, “causing an infection.”
Why are UTIs more common in women than in men?
The reason why women suffer significantly more UTIs than men has a lot to do with anatomy. In women, “the distance from the urethra to the anus is shorter than in men, so it’s easier for bacteria to get into the urethra,” Bawer explained. “The length of the urethra itself is also shorter in women than in men, which leads to more UTIs”.
As Nettey points out, women’s urethras are 3 centimeters long, while men’s are about 14 centimeters “so there’s a big difference”, and women have “a shorter distance to travel for bacteria to get into the bladder”.
What happens if a UTI is left untreated?
In short, the infection gets worse. If the UTI is left untreated, “bacteria can travel through the ureters into the bladder and cause a more serious infection called pyelonephritis,” Bawer explains. “Individuals typically experience fever, chills, severe fatigue, malaise, and pain on one side of the abdomen and back.”
In more severe cases, the bacteria can enter your bloodstream and cause sepsis, organ dysfunction, shock, kidney failure and, in far fewer cases, death if all of these are left untreated, Bawer said.
How are UTIs treated?
Uremia is usually treated with antibiotics, but not just any antibiotic will do. Normally, when you see your healthcare provider for a UTI, they test your urine (urinalysis), but Nettey explained that “the real test is a urine culture,” which involves plating a sample on Petri dish to see what type of bacteria is there and which antibiotic is best for treating it. “Unfortunately, it can take up to 48 hours, but it’s important to know what bacteria it is, especially if it’s a recurring bacteria. Sometimes you get treatment and it doesn’t help. You want the antibiotics to be targeted “.
Bawer agrees, saying: “Which antibiotic we choose depends on factors such as the severity of the infection, your specific allergies, the rate of resistance to certain antibiotics in the area where you live”.
While finding the right antibiotic is key, Nettey adds, “it’s also important to complete the course” so the bacteria don’t keep multiplying, which could lead to a UTI recurrence.