Urinary tract infections (UTIs) are a pervasive and often underestimated health issue that affects millions of people. In fact, UTIs are among the most common types of infections, impacting over 400 million individuals globally in 2019 alone.1 This common health issue disproportionately affects females, with 50-60% experiencing at least one UTI in their lifetime.2 Despite being commonly perceived as minor inconveniences, these infections can have profound implications for female reproductive health that extend far beyond the immediate symptoms.
UTIs: What Are They and How Are They Caused?
UTIs are infections that occur in any part of the urinary system, including the kidneys, ureters, bladder, and urethra.3 However, most infections involve the lower urinary tract, which includes the bladder and urethra. The primary cause is bacterial invasion through the urethra and spread in the bladder, typically by Escherichia coli (E. coli) bacteria, which normally resides in the gastrointestinal tract.
Sexual activity can increase the risk of introducing bacteria into the urinary tract.3,4 However, it is not a prerequisite for developing a UTI; all females are at a greater risk due to their anatomy.3 This is due to females having a shorter urethra, which allows bacteria quicker access to the bladder.3 Additionally, the proximity of the urethral opening to the anus makes it easier for bacteria from the anal region to enter the urethra.3 Additional risk factors include using certain birth control methods, like diaphragms or spermicidal agents, and structural abnormalities or urinary tract blockages, like kidney stones, which impede urine flow and foster bacterial growth.4
Symptoms and Diagnosis of a UTI
Common symptoms of a UTI include:3
A strong, persistent urge to urinate
A burning sensation during urination
Passing frequent, small amounts of urine
Cloudy or strong-smelling urine
Pelvic pain, particularly in women
Diagnosis typically involves assessing symptoms and the collection of a urine sample to test for bacteria, white blood cells, and red blood cells.5 Sometimes, a urine culture is performed to identify the specific bacteria and determine the most effective antibiotic.5 In recurrent or complicated cases, imaging tests or a cystoscopy, where a thin tube with a camera is inserted into the bladder, may be recommended to check for underlying urinary tract issues.5
Management and Treatment
When UTIs do occur, prompt treatment is essential to prevent complications. The primary treatment for UTIs is a course of antibiotics prescribed by a healthcare provider.5 Over-the-counter pain relievers and medications are also used to relieve UTI discomfort and help manage symptoms, such as pain during urination.5
The Impact of UTIs on Reproductive Health
While UTIs are primarily an issue of the urinary system, their effects on female reproductive health can be far-reaching. Women who experience recurrent UTIs (defined as three or more UTIs in a year) and/or untreated UTIs are at risk of developing long-term complications such as permanent kidney damage, kidney disease, and sepsis.3,6
Pregnant women are particularly susceptible to UTIs due to hormonal changes and the physical pressure of the growing fetus on the bladder.7 Untreated UTIs during pregnancy can lead to severe complications such as kidney infections, preterm labor, and low birth weight.3,6,7
Lastly, women with a history of recurrent UTIs may experience pain during intercourse (dyspareunia), which can lead to decreased sexual activity and emotional distress.8,9 This not only affects their intimate relationships but also takes a toll on their overall well-being, with many expressing a noticeable decline in their quality of life.8,9 Therefore, given the disproportionate impact on women’s physical, sexual, and mental health, raising awareness and focusing on prevention are key in mitigating these effects and helping women lead healthier, happier lives.
Prevention Strategies
Preventing UTIs is crucial for maintaining overall female reproductive health. Common prevention strategies include:3
Drinking plenty of water to dilute urine and ensure regular flushing of the urinary tract, which reduces the likelihood of bacterial buildup.
Wiping from front to back after using the toilet to prevent the spread of bacteria from the anal region to the urethra.
Avoiding harsh soaps and douches that can disrupt the natural vaginal flora
Urinating after sex to flush out any bacteria that may have entered the urethra.
Taking probiotics, specifically containing lactobacilli, which have been shown to help prevent UTIs by promoting a healthy balance of bacteria in the urinary tract.10
Conclusion
UTIs may often be seen as just a nuisance, but their impact on women's lives can be profound. Beyond the physical discomfort, the emotional and psychological toll can be significant, affecting everything from daily routines to intimate relationships. By adopting preventive measures, spreading awareness, and advocating for women's health, we can work towards ensuring women have the knowledge and resources to protect their health and overall well-being.
References
Yang, X., Chen, H., Zheng, Y., Qu, S., Wang, H., & Yi, F. (2022). Disease burden and long-term trends of urinary tract infections: A worldwide report. Frontiers in public health, 10, 888205. https://doi.org/10.3389/fpubh.2022.888205
Medina, M., & Castillo-Pino, E. (2019). An introduction to the epidemiology and burden of urinary tract infections. Therapeutic advances in urology, 11, 1756287219832172. https://doi.org/10.1177/1756287219832172
Mayo Foundation for Medical Education and Research. (2022). Urinary tract infection (UTI) - Symptoms & causes. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
What is a urinary tract infection?: Symptoms & causes. Planned Parenthood. (n.d.). https://www.plannedparenthood.org/learn/health-and-wellness/urinary-tract-infections-utis#:~:text=It’s%20pretty%20easy%20to%20get,gets%20pushed%20into%20your%20urethra.
Mayo Foundation for Medical Education and Research. (2022). Urinary tract infection (UTI) - Diagnosis & treatment. Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/diagnosis-treatment/drc-20353453
Cherney, K. (2024, May 29). Chronic urinary tract infection (UTI): Symptoms and treatment. Healthline. https://www.healthline.com/health/chronic-urinary-tract-infection#causes
Habak, P. J., Carlson, K., & Griggs, Jr, R. P. (2024). Urinary Tract Infection in Pregnancy. In StatPearls. StatPearls Publishing.
Mondal, S., Noori, M. T., & Pal, D. K. (2022). Sexual dysfunction in female patients of reproductive age group with recurrent urinary tract infection-a cross-sectional study. AJOG global reports, 2(4), 100083. https://doi.org/10.1016/j.xagr.2022.100083
Krishnaswamy, P. H., Middleton, E., Hagen, S., Guerrero, K. L., & Booth, J. (2024). Women's Experiences of Urinary Tract Infections and Impact on Life: An Exploratory Qualitative Study. Urogynecology (Philadelphia, Pa.), 30(1), 80–86. https://doi.org/10.1097/SPV.0000000000001386
Falagas, M. E., Betsi, G. I., Tokas, T., & Athanasiou, S. (2006). Probiotics for prevention of recurrent urinary tract infections in women: a review of the evidence from microbiological and clinical studies. Drugs, 66(9), 1253–1261. https://doi.org/10.2165/00003495-200666090-00007
Commentaires