Women’s health centre

Your guide to urinary tract infections (UTIs)

You've coped with cramps, tampons and padded bras, but being a woman can also mean having to cope with urinary tract infections, or UTIs. In fact, some experts rank your lifetime risk of getting one as high as one in two -- with many women having repeat infections, sometimes for years on end. Here's how to handle UTIs, whether you're experiencing your first or fifth infection, and how to make it less likely you'll get one in the first place.

What causes UTIs in women

UTIs are a key reason we're often told to wipe from front to back after using the toilet. That's because the urethra (the tube that transports urine from the bladder to the outside of the body) is located just in front of the anus. Bacteria from the large intestine, such as E. coli, are in the perfect position to escape the anus and invade the urethra. From there, they can travel up to the bladder, and if the infection isn't treated, continue on to infect the kidneys. Infection of the bladder is the commonest cause of cystitis - inflammation of the bladder. Women may be especially prone to UTIs because they have shorter urethras, which allow bacteria quick access to the bladder. Having sex can introduce bacteria into the urinary tract, too.

Symptoms of UTIs

To identify a UTI, keep an eye out for the following symptoms:

• a burning feeling when you urinate
• a frequent or intense urge to urinate, even though little comes out when you do
• pain or pressure in your back or lower abdomen
• cloudy, dark, bloody, or strange-smelling urine
• feeling tired or shaky
• fever or chills (a sign the infection may have reached your kidneys)

Tests and treatments for UTIs

If you suspect you have a urinary tract infection, seek medical advice. You'll be asked to give a urine sample, which will be tested for the presence of UTI-causing bacteria. The treatment? Often antibiotics will be recommended to kill the intruders. As always, be sure to finish the prescribed course of antibiotics completely. Your doctor may prescribe a medication to soothe the pain -- a heating pad may also be helpful. In addition, drink lots of water.

Drinking cranberry juice, which research has shown may have special antibacterial properties, may help to help flush the bacteria from your system. In 2001, the British Medical Journal reported a randomised, controlled trial of 150 women with UTI’s that showed drinking 50 ml of cranberry-lingonberry juice concentrate daily reduces recurrences of symptomatic urinary tract infection by about 50%. The conclusion was that regular drinking of cranberry juice appears to reduce the recurrence of UTIs.

Chronic UTIs

About one in five women experience a second urinary tract infection, while some are plagued incessantly. In most cases, the culprit is a different type or strain of bacteria. However,  some types can invade the body's cells and form a community safe both from antibiotics and the immune system. A group of these renegades can travel out of the cells, and then re-invade, ultimately establishing a colony of antibiotic-resistant bacteria primed to attack again and again. In some cases of what seems to be chronic urinary tract infection or chronic cystitis, there is no evidence of bacteria. This condition is known as Interstitial Cystitis and, while infection can’t be pinpointed, tiny ulcers and haemorrhages can be found inside the bladder of 90% of those affected.

Some women are genetically predisposed to UTIs, while others have abnormalities in the structure of their urinary tract that make them more susceptible to infection. Women with diabetes may be at higher risk, as well, because their compromised immune systems make them less able to fight off infections like UTIs. Other conditions that increase risk include pregnancy, multiple sclerosis, and anything that affects urine flow, such as kidney stones, stroke and spinal cord injury.