Your Guide to UTIs

Your Guide to UTIs

Are UTIs (urinary tract infections) just part of being a woman? Something we have to put up with? By the time they turn 24 years of age, one in three women will have had a UTI, and they affect more than 50% of all women during their lifetime.

Recurrent UTIs are also common, with some women getting an infection again and again, impacting many aspects of life – from sex and relationships, to work or study.

UTIs can affect any part of the urinary system, with the bladder being the most common site. A UTI affecting the bladder is also known as cystitis, or a bladder infection.

Read on to find out what causes a UTI, how to manage and treat a UTI and how to reduce their frequency of recurrent UTIs.

Causes & risk factors
Jean Hailes gynaecologist Dr Judith MacNaughton explains the causes of UTIs and why women are more at risk than men. "UTIs are caused by bacteria that enter the body, usually through the tube where urine comes out [the urethra]," she says. "In women, this tube is much shorter than in men, and it's a lot closer to the bottom, where bacteria live. This means that these bugs don't have as far to travel and therefore the risk of getting a UTI is higher."

While UTIs can happen to anyone, they are more commonly seen in women who are sexually active or menopausal, or those with health conditions such as diabetes or urinary incontinence. It is important to note that these factors do not directly cause UTIs, but may play a part and add insight as to why they are occurring.

Women using spermicides or diaphragms as contraception are also more at risk of UTIs and may want to consider alternative options if they get recurrent UTIs.

Signs & symptoms
While not every UTI causes signs and symptoms, when they do, they may include:

Burning sensation when passing urine
Lower abdominal pain when passing urine
Passing urine more frequently than usual
Read more common signs and symptoms of UTIs

Management & treatment
If you are experiencing these symptoms or suspect you have a UTI, it is important to make an appointment with your GP as soon as possible. Your doctor will likely ask you for a urine sample and, if an infection is present, prescribe a course of antibiotics.

Antibiotics are very effective at treating UTIs. It's important to follow your doctor's instructions and take the full course of antibiotics, even if your symptoms clear up sooner. This helps decrease the risk of the UTI coming back.

"A good option for women with recurrent UTIs is to take a smaller dose of antibiotics ongoing, or as a preventative after they have sex, if sex is a trigger for them," says Dr MacNaughton. "There is also another medication called Hiprex, which suppresses and eliminates the bacteria that can cause UTIs. However, both these options need to be discussed with your doctor."

Many women treat UTIs at home with urinary alkalinisers (powder sachets available over the counter at chemists). While these products can help to relieve some of the symptoms of UTIs such as painful and frequent urination, Dr MacNaughton reminds us that they don't actually treat the infection, and that a proven UTI should always be treated with antibiotics.

Changing times
At menopause, many things are changing, and some women find they get more UTIs than before. This is usually due to a drop in levels of the hormone oestrogen. Oestrogen levels decrease during menopause and the vaginal and vulval tissues are often affected – becoming thinner, drier and more susceptible to infection.

"If this seems like it's happening to you, speak to your doctor about the suitability of a topical oestrogen cream [oral oestrogen is not effective for UTIs] and ensure you use a natural lubrication for sex," says Dr MacNaughton.

The phytoestrogens in soy and linseeds may also improve vaginal dryness. See Jean Hailes naturopath Sandra Villella's Linseed, banana and date muffins recipe for an easy way to get the required amount of phytoestrogen in your daily diet.

The case for cranberry
There is conflicting information on whether cranberries can reduce the frequency of UTIs. Some research suggests that cranberry supplements are useful; however, as Sandra says, it's important for women to know that not all cranberry supplements are the same. Research suggests that it depends on the amount of certain compounds in the cranberry supplement. These key compounds are called proanthocyanidins, or PACs.

"PACs may help with recurrent UTIs, as they prevent the unfriendly bacteria from sticking to the walls of the urinary tract. If they don't stick, they don't grow – instead they are flushed out and the infection may not occur," says Sandra.

In line with the research, Sandra recommends checking the labels on supplements for one that contains a daily dose of 36mg of PACs. "Don't worry too much about the total amount of cranberry fruit in the supplement; more is not necessarily better – it's the amount of PACs in it that you really want to pay attention to," she says. "Good products will specify."

New kid on the block
Another supplement option called Mannose, or D-Mannose, is showing promise in the management of recurrent UTIs. Mannose is a natural sugar that occurs in many fruits, and a recent study found that taking it in the form of a supplement was similar to an antibiotic in its effectiveness for reducing UTIs.

As always, discuss any supplements you are taking, or thinking about taking, with your GP and a qualified naturopath.

Additional tips
These self-help tips may help to reduce the frequency of UTIs:
Wipe yourself gently from front to back (urethra to anus) after going to the toilet
Drink plenty of water and fluids Treat vaginal infections such as thrush or trichomonas promptly
Go to the toilet when you feel the urge to urinate, rather than holding on
Urinate after sex, to flush the urinary system.

UTIs are common, but be cautious
It's important to remember that although UTIs are common, they can develop into more serious kidney infections if left untreated. If your symptoms persist for more than 24 hours and include fever, chills, back pain, nausea or vomiting you should see your doctor immediately. Your symptoms should completely resolve within a few days of starting a course of antibiotics. If this is not the case, it's important to go back to your doctor.

Also, UTIs can be more dangerous for pregnant women due to an increased risk of kidney involvement. If you are pregnant and you think you have a UTI – even with mild symptoms – see your doctor immediately.

Visit our Urinary tract infections webpages to learn more.

Published with the permission of Jean Hailes for Women's Health
jeanhailes.org.au
1800 JEAN HAILES (532 642)