Urinary Tract Infection in Women: Causes, Symptoms and Treatment

A urinary tract infection (UTI) is an infection of any part of the urinary system, including the kidneys, ureters, bladder or urethra. Urine naturally contains bacteria and infection occurs when there’s an imbalance, caused when bacteria, often from the skin or rectum, enter the urethra, and infect the urinary tract. This type of infection is very common, especially among women, and it can be extremely unpleasant and painful.

Chronic or recurrent UTI in women is also very common, due to factors that include ageing and hormonal changes. It is a debilitating condition and is poorly understood.

Urine infection in pregnancy can also occur, due to the physiological and hormonal changes the body goes through during this time. Complications of UTI in pregnancy can be severe and, if not treated promptly, can lead to an infection of the upper urinary tract (upper UTI).

In most women, bacteria from the bowel such as E. coli are the primary cause of a UTI, but in younger women other types of bacteria can cause an infection. 

Women are at a higher risk than men, and this has primarily to do with anatomy. The main cause of UTI in women is that the tube that carries urine from the bladder, the urethra, is relatively short and is also located close to the anus. This can allow bacteria to more easily find its way into the urinary tract.

For many women, UTI becomes more frequent during the menopause and, generally speaking, recurrent infections are far more common as women get older. This is primarily because oestrogen hormone levels also decline with age, which can cause the walls of the urinary tract to become thinner and dryer. The protective mucous membrane, or mucosa, becomes less acidic, which reduces its ability to fight off infection. This is why oestrogen hormone treatment is recommended to prevent UTIs in older women. 

• Feeling of pain or burning when urinating
• Constant need to go to the toilet
• Frequent urination
• Small amounts of urine passed
• Traces of blood in the urine
• Strong-smelling urine, or urine that is dark, or cloudy
• Feeling cold, however, often not with an actual fever
• Sudden urinary incontinence

The most common type of UTI occurs in the lower urinary tract, infecting the urethra and bladder. An untreated UTI can spread up to the ureters and kidneys causing an upper UTI.

Upper UTI symptoms are considerably worse, and may include back pain, nausea and fever. This type of infection is serious and can potentially damage the kidneys or even cause kidney failure. If left untreated it can also lead to sepsis, which is when the infection enters the bloodstream. This is a dangerous and potentially life-threating condition, which requires intensive care.

In most cases, a UTI in women is treated effectively with antibiotics. Sometimes a urine test will be done to find out which type of bacteria is causing the infection. This will help identify the most effective antibiotic. In healthy women, mild infections can be fought by the immune system without the need for antibiotics, so sometimes your GP might give you a prescription for antibiotics but suggest you wait for 48 hours before taking them, in case your symptoms go away on their own.

What can you do to relieve UTI symptoms?

• Taking a painkiller, such as paracetamol, up to 4 times a day. This will help with some of the symptoms, like pain, fever and inflammation. Paracetomol is recommended over aspirin or ibuprofen.
• Place a hot water bottle or heating pad on your lower back or stomach, to reduce inflammation and relieve pain.

The most important method of prevention is to keep the genital area clean and healthy. Staying hydrated is important, too, but it’s a myth that you can treat a UTI by flushing bacteria out. Finally, try to ensure you empty your bladder entirely, as bacteria can thrive in any remaining urine.

You may frequently encounter advice about how to prevent UTIs, much of which has not been backed up by science — at least not yet. But there’s no harm in trying sensible ideas to see if they work for you. Below are some useful tips that might help you to prevent a UTI, which are more or less scientifically proven. 

A few tips on how to avoid UTIs:

• When going to the toilet, wipe from front to back
• Try not to over-wash or use harsh soap on your sensitive genital area as it can cause imbalance and irritation
• Use TENA wash cream for your intimate area, and TENA barrier cream for protection
• Dry yourself thoroughly when washing or changing hygiene products, as bacteria thrive in damp conditions.
• Use high quality, breathable TENA incontinence products which are safe and gentle to the skin
• It is recommended to urinate after having sex to help flush away any bacteria that may have found its way to your intimate area
• Getting enough vitamin D has a positive effect on your immune system
• Locally applied vaginal oestrogen can be used, sometimes even in pre-menopausal women
• Avoid condoms with spermicides, they may increase the risk of infection

• When going to the toilet, sit in a posture that relaxes the pelvic floor, leaning slightly forward with bent knees and feet resting on the ground or on a footstool
• When you have finished passing urine, stand up and sit down again a few times. This may encourage urine to be voided that was left behind the first time.

If you want to continue learning, read our articles on living with bladder weakness and frequent urination in women. If you're struggling with incontinence and are looking for support, view our range of products.