Three words to describe a urinary tract infection (UTI)? Burning. Itching. Uncomfortable — but that’s not the least of it. Here are some more facts that will explain what UTIs are, what causes them, how to treat them and so much more.
What’s a UTI? Causes, Risks and Symptoms
A UTI is an infection in any part of your urinary system — your kidneys, ureters, bladder and urethra. Most infections involve the lower urinary tract — the bladder and the urethra. However, serious consequences can occur if a UTI spreads to your kidneys.
Although women are at greater risk of developing a UTI than men (the ratio is 8:1!) and often experience them more than once in their lifetimes, that doesn’t mean men can’t contract these pesky infections, too.
Doctors typically treat urinary tract infections with antibiotics, but there are plenty of steps you can take to reduce your chances of getting a UTI. Before we get there, let’s look at what causes UTIs.
Urinary tract infections typically occur when bacteria enter your urinary tract through the urethra and multiply in the bladder.
Although your urinary system keeps out these microscopic but impactful invaders, those defenses sometimes fail. When that happens, bacteria can linger and grow into a full-blown infection in your urinary tract.
These are the most common UTIs, and they affect your bladder and urethra:
- Cystitis (infection of the bladder). Escherichia coli (E. coli), a type of bacteria commonly found in the gastrointestinal (GI) tract, usually causes this type of UTI. But sometimes other bacteria are the cause, too.
While sex can lead to cystitis, you don’t have to be sexually active to develop it. In fact, all women are at risk of cystitis because of their anatomy, specifically, the short distance from the urethra to the anus and the urethral opening to the bladder.
- Urethritis (infection of the urethra). Speaking of vulnerability to this infection because of proximity, this type of UTI can occur when GI bacteria spread from the anus to the urethra. But it’s also commonly caused by STIs like chlamydia or gonorrhea.
🔑 While these are the most common UTIs, here’s what you should keep in mind: Anything that reduces your bladder emptying or irritates the urinary tract can lead to UTIs.
Beyond bacteria, sexual activity and the female anatomy, other factors that increase your risk of getting a UTI include:
- Certain types of birth control
- Urinary tract abnormalities from birth
- Blockages in the urinary tract (like kidney stones!)
- Diabetes and other diseases that impair or suppress the immune system
- Using a catheter
- A recent urinary procedure or reduced mobility after surgery or prolonged bed rest
- Age — older adults are more likely to get UTIs
- A previous UTI
- A weakened immune system
So, how will you know you have one?
Urinary tract infections don’t always cause signs and symptoms, but when they do, they may include:
- → A strong, persistent urge to urinate
- → A burning sensation when urinating
- → Passing frequent, yet small amounts of urine
- → Urine that appears cloudy
- → Urine that appears red, bright pink or cola-colored (a sign of blood in the urine!)
- → Strong-smelling urine
- → Pelvic pain in women, especially in the center of the pelvis and around the area of the pubic bone
UTI Prevention and Treatment
It’s important to discuss with your doctor what the right prevention plan is for you. But even without doing so, all women can take these steps to help prevent UTIs:
💧Drink six to eight glasses of water daily.
Pro-tip: Drinking water helps dilute your urine and ensures that you’ll urinate more frequently, which lets you flush out bacteria from your urinary tract before an infection can begin.
🚽 Don’t hold urine for long periods of time and empty your bladder immediately after sex.
👩⚕️ Talk to your doctor about managing any urinary incontinence or difficulties fully emptying your bladder.
🧻 Wipe from front to back. Doing so after urinating and after a bowel movement helps prevent bacteria in the anal region from spreading to the vagina and urethra.
❌ Avoid potentially irritating feminine products.
Pro-tip: Using deodorant sprays or other feminine products, such as douches and powders, in the genital area can irritate the urethra.
👶 Consider changing your birth control method.
Pro-tip: Diaphragms or unlubricated or spermicide-treated condoms can all contribute to bacterial growth. But if you’re perimenopausal or postmenopausal, using topical or vaginal estrogen prescribed by your doctor could make a difference in preventing UTIs.
If you’re past the point of prevention, here’s what you can expect from the treatment aspect of a UTI.
First thing’s first: UTI treatment always depends on the cause. To determine which organism is causing the infection, your doctor will review your symptoms and perform a physical examination. Then, to confirm a diagnosis of a UTI, they’ll test your urine for microbes.
When they test your sample, your doctor looks for many white blood cells in your urine — this can indicate an infection. They’ll also do a urine culture to test for bacteria or fungi. The culture can help identify the cause of the infection and help your doctor choose the treatment right for you.
In most cases, the cause is bacteria, which doctors treat with antibiotics. But sometimes, bacteria develop resistance to antibiotics — to reduce your risk of antibiotic resistance, your doctor will probably put you on the shortest treatment course possible, which typically lasts only one week.
In other cases, the causes are viruses or fungi. Doctors treat viral UTIs with medications called antivirals, often with a drug called cidofovir. And they treat fungal UTIs with medications called antifungals.
From your health history and test sample, your doctor may also diagnose you with:
👉 Upper tract UTI: If your doctor suspects that you have an upper tract UTI, they may also need you to do complete blood cultures (CBC) and blood count along with the urine test. FYI, A blood culture can make certain that your infection hasn’t spread to your bloodstream!
A UTI is usually easiest to treat in the lower urinary tract. But an infection that spreads to the upper urinary tract is much more difficult to treat and is more likely to spread into your blood, which can cause sepsis.
👉 Recurrent or Chronic UTI: Most UTIs go away after treatment, but chronic UTIs either don’t go away after treatment or keep recurring. If you have recurrent UTIs, your doctor may also want to check for any abnormalities or obstructions in your urinary tract.
Recurrent UTIs are common among women, and reinfection with the same type of bacteria causes many cases. When it’s not the same type of bacteria, an abnormality in the structure of the urinary tract increases the likelihood of UTIs.
If your doctor believes sex is a factor in your recurrent UTIs, they may recommend taking preventive antibiotics after intercourse or long-term.
Otherwise, some tests for this include an ultrasound, an intravenous pyelogram (IVP), a cystoscopy or a computerized tomography (CT) scan to get more detailed images of your urinary system.
Can You Treat UTIs Without Antibiotics?
Not everyone has access to healthcare through medical facilities that often offer costly services to provide antibiotics, so it’s important to know how to prevent and possibly treat active UTIs outside of them.
Scientific research supports some at-home or natural UTI remedies as preventative methods. Here are a few supplements that’ve been studied and are considered effective:
💊 Bearberry leaf: Also known as uva-ursi, one study showed that a combination of bearberry leaf, dandelion root and dandelion leaf decreased UTI recurrence.
💊 Cranberry extract: Like cranberry juice, cranberry extract prevents bacteria from setting up shop and growing in your urinary tract.
💊 D-mannose: A type of sugar found in cranberries available in capsules or powders, researchers have found D-mannose to be effective in preventing UTI recurrence and even treating them.
💊 Garlic extract: Garlic has been shown to have antimicrobial properties and may be able to block the growth of bacteria to prevent UTIs.
💊 Probiotics: Probiotics are beneficial microorganisms you can consume through food or supplements. Whether you take them in supplement form or eat them in fermented foods (like yogurt or kombucha), probiotics promote a healthy balance of bacteria in your gut.
Some studies also show that certain strains of probiotics may decrease the risk of UTIs. Plus, this study found that taking both probiotics and antibiotics was more effective to prevent recurrent UTIs than antibiotics alone. And another study found that Lactobacillus, a common probiotic strain, helped prevent UTIs in adult women.
When natural remedies don’t do the trick, you have to see a doctor.
If you don’t have insurance but you need antibiotics to treat a UTI, skip urgent care. One of my favorite alternative resources for cheap and quick medical care is GoodRx Care’s telehealth services.
Through this online service, you don’t need insurance, and the visit fee you see is the full price — there are no hidden fees. The medical team you’re paired with works with you to find medicines and pharmacies near you, plus you can use GoodRx coupons to get your prescription at the lowest price.
The Bottom Line
When it comes to treating a UTI, the earlier, the better. If not, untreated UTIs get more and more severe the further they spread.
If you suspect you have a UTI, contact your doctor ASAP to get a simple examination and urine or blood test.
Meet Dr. Savita Ginde
Dr. Savita Ginde is an advocate and thought leader for reproductive health and served as Chief Medical Officer of Planned Parenthood of the Rocky Mountains for over 13 years. And, until very recently, she served as the Chief Healthcare Officer for STRIDE Community Health Center where she oversaw all of STRIDE’s healthcare services and led their COVID-19 vaccination efforts.