Understanding Urinary Tract Infections (UTIs)

The urinary tracts of women and men are similar in many ways but there are differences that make it easier for bacteria to enter a woman’s urinary tract. First, the urethra in women is shorter than in men (1.5 inches vs. 4 inches) and near the vagina which is normally heavily colonized with bacteria.  This makes it easy for bacteria to find their way into the bladder. Most UTIs are caused by bacteria that move up into the bladder from the vagina and rectum. Rarely, an infection can be caused by bacteria that spread from the kidneys, or by fungus. It is not unusual for women to have one or two UTIs a year. This frequency of UTIs does not usually require any special evaluation or treatment. When women have 3 or more UTIs in a year, this usually prompts more evaluation to see if there is a particular reason why they are occurring frequently.    

Women can get different kinds of UTIs. UTIs usually affect the urinary bladder, but they can also involve the urethra or kidneys. Symptoms of a UTI include urgency, frequent urination, burning with urination, fever, or blood in the urine. A diagnosis of a UTI is confirmed with a test called a urine culture.

It is not possible to prevent every UTI.  However, some recommendations that may reduce your risk are:

  • Wipe from front to back.
  • Wear cotton underwear during the day and, if possible, no underwear at night.
  • Only use water to cleanse the vaginal area. Use hypo-allergenic soaps (e.g. Dove) and detergents.
  • Urinate before and after having intercourse.
  • Make sure you are well hydrated. 6-8 glasses of liquids a day is good.
  • There is some evidence that Cranberry extract reduces the risk of UTIs. Take in pill form as directed on the bottle or drink one glass of Cranberry juice a day.
  • Avoid douching or use of spermicides
  • If you have gone through menopause ask your doctor about vaginal estrogen use. Vaginal estrogen has been shown to reduce the risk of UTI’s.
  • Some women seem to have more trouble with UTI’s after taking a bath, using a hot tub, or swimming. If this is the case for you, you may want to avoid these activities.
  • D-mannose (2g) taken daily may reduce UTI risk.
  • Methenamine tablets (1g) taken twice daily also help reduce infections.

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