What Causes A UTI?

A UTI is an infection in any part of the urinary system which includes the kidneys, ureters, bladder, and urethra. A bladder infection may cause pelvic pain, increased urge to urinate, pain with urination and blood in the urine. A kidney infection may cause back pain, nausea, vomiting and fever. These infections are more common in women than in men, with nearly 50% of women experiencing at least one UTI in their lifetime. Women are also more prone to recurrent UTIs with between 20% and 40% of women having more than one UTI.

Several factors can increase your risk of getting a UTI. These include not drinking enough water, the use of certain contraceptives, catheter use and diabetes. It is not always possible to prevent getting a UTI but there are several steps you can take to minimise your risks. These include drinking plenty of water, urinating after sexual activity and not douching. Although research is ongoing, it is thought that supplements such as cranberry and D-Mannose can help prevent UTIs.

 

Why Do You Get UTIs?

UTIs occur when bacteria, often from the skin or anus, enter the urethra and infect the urinary tract. The female anatomy contributes to women's increased likelihood of contracting a UTI. This is because a woman’s urethra is shorter and closer to the anus than in men. This makes it easier for bacteria to enter the urinary tract, especially during sexual activity.

The most common bacteria found to cause UTIs is Escherichia coli (E. coli). Other bacteria can cause UTI, but E. coli is identified as the cause of infection about 90 per cent of the time. E. coli normally lives harmlessly in the human intestinal tract, but it can cause serious infections if it gets into the urinary tract.

 

UTI Risk Factors In Women

Not all urinary tract infections can be avoided. However, being mindful of the risk factors can often help in minimising the chances of getting an infection. The risk factors that increase a woman's risk of developing UTI include:

 

• Sexual Activity. Being sexually active or having a new sexual partner can lead to more UTIs. This is because the friction involved in sexual activity moves bacteria toward the urethra.
• Female Anatomy. Women have a shorter urethra than men and as a result, there is less distance for bacteria to travel to reach the bladder.
• Certain Types of Birth Control. Using diaphragms or spermicidal agents may increase the risk of UTIs.
• Menopause. After menopause, a decline in the female hormone oestrogen causes changes in the urinary tract. The changes can increase the risk of UTIs.
• Blockages in the Urinary Tract. Kidney stones or an enlarged prostate can trap urine in the bladder. Trapped urine can result in an infection.
• A Suppressed Immune System. Diseases such as diabetes can impair the immune system (the body’s natural defence system against germs. This can increase the risk of UTIs.
• Catheter Use.  Using a catheter increases the risk of UTIs. Catheters may be used by people who are in hospital or people who have neurological problems who find it difficult to control urination.
• A Recent Urinary Procedure. Urinary surgery or an exam of your urinary tract can increase the risk of developing a UTI. 

Menopause And UTIs

After the age of 40 most women will start to experience a drop in their oestrogen levels as they enter perimenopause (the years leading up to menopause). Many women experience UTIs during menopause due to their decreasing levels of oestrogen. This occurs because oestrogen regulates the pH (acidity) and consequently, the bacterial balance of the vagina and surrounding tissues. The changes in the microbiome (mix of ‘good’ and ‘bad’ bacteria) can weaken a woman’s natural immunity and make them more vulnerable to UTIs.

Vaginal atrophy can also render postmenopausal women more vulnerable to UTIs. Vaginal atrophy is characterised by vaginal tissues becoming thinner, drier, and less elastic. Oestrogen maintains the thick walls (epithelial layers) of the vagina as well as the levels of glycogen, which are used by good bacteria (Lactobacilli) for the healthy functioning of the vagina. A healthy vagina has a pH of between 4.0 to 4.5 but when oestrogen levels drop, the vagina becomes more alkaline (pH increases) which results in sub-optimal health in the vagina and sometimes also the urethra.

 

UTI Treatments

Although recurrent UTIs are mostly treated with antibiotics, a more holistic approach includes the use of topical oestrogen hormone replacement and lactobacillus colonisation therapy. Topical oestrogen treatments include creams and tablets which are inserted into the vagina. Oestrogen therapy may help prevent UTIs by restoring the health and natural defences of the urogenital area. Lactobacillus colonisation therapy attempts to boost the number of good bacteria in your vagina and re-establish a balanced vaginal environment, which in turn has a positive impact on the health of your urinary tract.

Can UTIs Be Prevented?

It is not always possible to prevent getting a UTI but there are several steps you can take to minimise your risks. These include:

 

• Urinate after sexual activity.
• Drink plenty of water.
• Take showers instead of baths.
• Minimise douching, sprays, or powders in the genital area.
• You should wipe from front to back after going to the toilet.