URINARY TRACT INFECTION (UTI) IN WOMEN

What causes Urinary Tract Infections?

Urine is formed by your kidneys, then passes through a tube called the ureter and accumulates in your bladder until you feel the need to urinate. When you urinate, you empty your bladder by letting the urine flow through a tube called the urethra. Normally, urine is sterile, meaning it contains no pathogens (bacteria, viruses, etc.).

If bacteria manage to travel up the urethra to the bladder, they can multiply and cause a urinary tract infection (UTI) called cystitis. If they make their way up the ureter to the kidneys, they can cause a more serious infection that can damage the kidneys, known as pyelonephritis.

Since a woman’s urethra is shorter than a man’s, it’s easier for bacteria to reach a woman’s bladder. It is estimated that the risk of urinary tract infection is 50 times higher in women than in men!

Once she’s had a first UTI, a woman is likely to have others throughout her life. Several other factors can also increase a woman’s risk of developing a UTI:

• Frequent intercourse or having a new sexual partner
• Pregnancy
• Menopause
• Diabetes, especially if poorly controlled
• Weakened immune system (due to illness or treatment)

How do I know if it’s a urinary tract infection?

Common symptoms of uncomplicated UTI in women include the following: 

• Strong and frequent urge to urinate, often resulting in only a small amount of urine 
• Pain or burning sensation when urinating 
• Pain in the lower abdomen

In addition to these symptoms, urine may appear cloudy, have a strong smell, or contain traces of blood. 

If the symptoms below are also present, it may be pyelonephritis, in which case it is important to see a doctor immediately:

• High fever (over 38.5 °C)
• Back or side pain
• Chills
• Nausea or vomiting

Since the symptoms of a UTI are easily identifiable, it’s usually not necessary to perform a test to confirm the diagnosis. However, a urinalysis may be needed to determine exactly which bacteria are involved, for example, if the healthcare provider suspects they may be resistant to certain antibiotics.

Sometimes, the infection may not cause any of the typical symptoms, particularly in the elderly and those who need to use a catheter to urinate (e.g., after a medical procedure or because of a health problem). These infections are usually detected during routine urinalysis.

How are Urinary Tract Infections treated?

All urinary tract infections that cause symptoms must be treated with an antibiotic to prevent complications. The choice of antibiotic will be personalized to each woman’s needs.

Depending on the antibiotic used, treatment lasts from 1 to 7 days for cystitis, or 7 to 14 days for pyelonephritis. Even if symptoms improve rapidly, it is essential to continue taking the antibiotic until the end of the prescribed treatment.

Some women suffer from recurrent urinary tract infections. In such cases, a small dose of antibiotic can be taken daily, a few times a week or after intercourse as a preventive measure.

If the presence of bacteria is detected during a routine urinalysis when the woman has no symptoms, an antibiotic may be prescribed, but this is not always necessary.

How to reduce your risk of getting a urinary infection

Here are a few tips to help lower your risk of contracting a UTI: 

• Drink fluids regularly so you urinate regularly. Go to the bathroom as soon as you feel the urge to urinate. As urine flows, it flushes out any bacteria that may have spread into the urethra. 
• Always wipe from front to back after urinating or after a bowel movement. Stools and the anal region contain bacteria that can cause infection if allowed to spread into the urethra. 
• Empty your bladder after sexual intercourse. Skin-on-skin contact can lead to bacteria entering the urethra. 
• If you experience vaginal dryness, use a lubricant during sexual intercourse, to avoid irritating the urethra. 
• If your vaginal dryness is related to menopause, talk to your doctor. Estrogen supplements may be an option. 
• Avoid using feminine hygiene products like vaginal douches. These products can irritate the urethra. The inside of your vagina does not require cleaning.

Is cranberry juice effective against UTIs?

What about cranberry juice? Cranberry juice should not be used to treat UTIs. Some studies have shown that concentrated cranberry juice or cranberry supplements have a modest preventive effect, but they would have to be consumed in unreasonable amounts. If you are taking medication, especially anticoagulants, talk to your pharmacist before consuming any cranberry products.

Suspect you have a urinary infection? Talk to your pharmacist!

If you think you have a UTI, consult your pharmacist without delay. In all Canadian provinces, pharmacists can prescribe antibiotics to treat uncomplicated urinary infections in women. You will need to meet certain criteria to be eligible for this service. If you do not, your pharmacist will refer you to a health professional who can help.