Dealing with urinary tract infections
Monique Rainford, HER HEALTH
"Does my partner need to be treated, Doc?" I am frequently asked that question when I diagnose a woman with a urinary tract infection (UTI). Intercourse can cause some women to have frequent UTIs, but it is not a sexually transmitted infection.
Strictly speaking, a UTI is an infection anywhere in the urinary tract, including the bladder, urethra and kidneys. However, the term is commonly used to refer to a bladder infection (cystitis). Women with recurrent UTIs have at least two or more infections in a year.
A woman is at a higher risk of a UTI compared to a man, and more than half of all women will have at least one UTI in their lifetime. Her increased susceptibility is largely due to the short length of her urethra (the tube that drains her bladder) compared to a man and the closeness of her urethra to the vagina and rectum.
Other risk factors depend on her age and her stage in life. For example, older women past the menopause are at higher risk because of the decrease in oestrogen in the vagina. Her risks are further increased if she is incontinent of urine, has a bladder prolapse, had UTIs in the past, or has diabetes. Women who live in nursing homes are at increased risk because they are more likely to have urinary catheters, are less mentally and physically functional, and are more likely to be treated with antibiotics.
Recent sexual activity is a significant risk factor for younger women and frequent sexual intercourse can also place a woman at risk for recurrent UTIs.
Pregnant women are also at a higher risk for a UTI and, if untreated, can lead to complications in pregnancy, such as preterm labour, low birth weight and pre-eclampsia, whether or not they have symptoms.
Symptoms that suggest UTI include dysuria (burning with urination), frequency, haematuria (blood in the urine), back pain and vaginal discharge or irritation. In fact, women who diagnose themselves with a UTI are often correct.
The diagnosis is confirmed by obtaining a culture of the urine, which is usually accompanied by further test to determine which antibiotics are effective for treatment.
Simple bladder infections can usually be easily treated with a three-day course of oral antibiotics. If a woman has recurrent UTIs, she may require daily prophylactic antibiotics, antibiotics after sex or after discussion with her physician, she could consider having a prescription available for use if symptoms start. Drinking cranberry juice may also decrease her risk of recurrent infections.
Women are often advised to practise certain habits to avoid infections such as urinating after intercourse, increasing fluid intake, wiping from front to back, avoiding holding urine, and douching, but unfortunately, there is no evidence that these behaviours work.
Dr Monique Rainford is a consulting obstetrician and gynaecologist; email: email@example.com.