Causes and Risk Factors of Urinary Tract Infections (UTIs)
UTIs are caused by bacteria entering the urinary tract, which consists of the kidneys, ureters, bladder, and urethra. While any of these parts can become infected, most UTIs involve the lower urinary tract, which includes the bladder (where urine is stored) and the urethra (the tube through which urine passes out of the body). A UTI that infects the bladder is called cystitis; one that infects the urethra is called urethritis. (3)
The majority of UTIs that affect the bladder and the urethra are caused by E. coli or other bacteria that are normally found in the digestive tract, which can travel from the anus to the urethra. UTIs that affect the urethra are also caused by sexually transmitted infections, including herpes, gonorrhea, chlamydia, and mycoplasma. Most of the time, urinating flushes out lingering bacteria in the urethra before it causes problems, though your body isn’t always able to do this. (4)
Less often, UTIs involve the upper urinary tract, which includes the kidneys (the organs that filter liquid waste from the blood and create urine) and the ureters (the tubes that connect the kidneys to the bladder). A UTI infection in the kidneys, called pyelonephritis or a kidney infection, most often begins in the bladder and moves up through the ureters to one or both kidneys. In certain cases, a kidney infection can lead to serious health problems. (5)
Risk Factors That Make You More Likely to Get a UTI
UTIs are much more common in women than men, and they're especially rare in young and middle-aged men. This is partly due to the female anatomy — women have shorter urethras, making it easier for bacteria to enter the bladder.
Having sex more frequently, and with new partners, can increase a person's risk of developing a UTI. A woman’s urethra is located next to both the vagina and anus, enabling bacteria to easily travel into the urinary tract during sexual intercourse. (6) (A UTI caused by frequent intercourse is sometimes dubbed honeymoon cystitis.)
Other factors that can increase the risk of a UTI include:
- Pregnancy
- Perimenopause and menopause
- A blocked urinary tract: kidney stones, an enlarged prostate, or benign prostatic hyperplasia (BPH) can trap urine in the bladder and increase the risk of UTIs
- Diabetes: This condition suppresses the immune system, increasing one's vulnerability to UTIs
- Catheter use
- Recent urinary surgery
- Wearing thong underwear
Getting a UTI While Pregnant May Be More Serious
One’s risk of developing a UTI increases during pregnancy, starting at week 6 through week 24, thanks to a number of factors, including hormonal changes that can make it easier for bacteria to travel into the urinary tract.
Urinary Tract Infections During Pregnancy: Symptoms, Treatment, and Common Questions
In addition, as the uterus grows throughout pregnancy, it can put pressure on the bladder, making it more difficult to empty completely. (7)
Pregnancy can also make a UTI more difficult to treat, which can have serious consequences, including pyelonephritis (when the infection moves to the kidneys); preterm labor; low birth weight; and sepsis.
A urinalysis and a urine culture are routinely performed at an initial prenatal visit to screen for UTIs, but if you're pregnant and suspect you may have an infection, seek medical attention quickly. (8)
Physical Changes Spur Urinary Tract Infections During Menopause
Frequent sexual intercourse is one of the biggest UTI risk factors for younger women. For menopausal women, however, physical changes such as the thinning of vaginal tissue, difficulty fully emptying the bladder, incontinence, and pelvic organ prolapse are the main culprits. (Prolapse is when a pelvic organ, like the bladder, drops and pushes against the walls of the vagina.)
In addition, during menopause, the body produces less estrogen, a hormone that — among other functions — helps keep the bacteria levels in the lining of the bladder and urethra healthy. Vaginal estrogen creams may restore the normal bacterial balance of the vagina, thus helping to stave off recurrent UTIs. (9)
Treatment and Medication Options for Urinary Tract Infections
UTIs are treated with antibiotics and sometimes additional medication for pain relief. While antibiotics are still considered the gold standard of UTI treatments, there are some home remedies you can use to help relieve symptoms as well.
Medication Options
Antibiotics are the first line of treatment for urinary tract infections. While most UTIs are considered simple or uncomplicated UTIs, the particulars regarding which antibiotics are prescribed — and for how long — depend on factors such as the type of bacteria detected in your urine and your current health.
If you've been treated for a UTI in the past, your doctor may recommend a different antibiotic the next time you get an infection. This is because some types of bacteria that cause UTIs have become resistant to certain antibiotics.
Alternative and Complementary Therapies
8 Home Remedies for Urinary Tract Infection (UTI) Symptoms
In addition to antibiotics, many people seek natural, at-home remedies to help UTIs. A heating pad can relieve pressure and pain, and wearing loose cotton clothing is recommended. For those with recurrent UTIs, modifying certain habits may help: Choose fragrance-free personal care products to reduce the risk of irritation, and cut back on foods that can irritate the bladder — caffeine, alcohol, spicy food, raw onions, citrus fruits, carbonated drinks, and artificial sweeteners.
Learn More About Treatment for Urinary Tract Infections: Antibiotics, Medication, and Home Remedies
Prevention of Urinary Tract Infection (UTI)
There are several steps you can take to reduce your risk of getting a UTI:
- Drink plenty of water and other liquids to help flush out bacteria.
- Urinate frequently, or about every two to three hours.
- For women: Wipe from front to back after urinating or having a bowel movement.
- Urinate before and soon after having sexual intercourse.
- Avoid synthetic underwear, tight pants, and lingering in wet gym clothes or a bathing suit. Though none of this can cause a UTI, these habits can increase the spread of bacteria.
- Avoid vaginal deodorants, douches, powders, and other potentially irritating feminine products.
- Use a method of birth control other than a diaphragm, spermicide, or unlubricated condoms.
For Those Who Experience Frequent UTIs, Managing Risk Factors May Help With Prevention
In some people, urinary tract infections come back again and again. Women, especially, are likely to have recurrent UTIs. While recurrences usually develop within three months of the original infection, having more than two within six months (or three or more within a year) is technically considered a recurrence.
Besides precautions and at-home strategies to help prevent UTIs, sometimes antibiotics are used as a preventive measure for those with frequent UTI recurrences.
Managing risk factors — by maintaining good hygiene, such as wiping from front to back for women and avoiding spermicides — can lower your likelihood of repeat UTIs.
Learn More About Urinary Tract Infection (UTI) Prevention
