Win the Fight Against UTIs: Tips for Prevention and Treatment

Let’s be honest, UTIs (urinary tract infections) are a total pain.

Showing up out of nowhere, like a nosy neighbor knocking at your front door without warning or welcome, UTIs can make life pretty miserable. They’re painful, they’re annoying, and, yep, sometimes they’re embarrassing. But just because UTIs have symptoms that can affect your genitals or cause incontinence, there is nothing shameful about getting a UTI, and it’s important to remember you haven’t done anything wrong. UTIs are common, especially if you have a vagina, and over half of all women and people assigned female at birth (AFAB) will experience a UTI once in their lifetimes. And 20-40% of that population will have two or more UTIs—or even become chronic sufferers. Thankfully, if diagnosed and treated after experiencing the first symptoms (generally with a short course of oral antibiotics), a UTI is easy to quell before it spreads from the bladder or urethra to the kidneys and becomes a more serious infection that is more difficult to treat.

That’s where Tia comes in. Our providers offer personalized women’s health care , from gynecology to primary care, mental health, and wellness—including UTI appointments where you’ll get treatment ASAP *and* build a plan to prevent them.

What is a UTI? What are the symptoms?

At its simplest, a UTI is an infection in any part of the urinary system, which includes the urethra, bladder, ureters, and kidneys. The vast majority of infections are caused by E. coli bacteria and involve the bladder (cystitis) or urethra (urethritis), but left untreated, a UTI can spread to the kidneys (pyelonephritis) and cause a more dangerous infection that’s more difficult to treat.

Symptoms of a UTI can sometimes be vague—generalized aches, chills, low-grade fever—but a UTI is almost always accompanied by a burning or painful sensation when urinating (dysuria), urinating often but only passing small amounts of urine (frequency), or having a strong urge to urinate that doesn’t go away, even when your bladder is empty (urgency).

Other symptoms might include:

• Pelvic pain and pressure in the lower abdomen or groin area.
• Urine that appears cola-colored or is tinged red or pink.
• Urine that appears cloudy.
• Strong-smelling urine.

Any person can get a UTI, but you’re most likely to experience a UTI if you have a vagina. That’s because the urethra in women and AFAB is shorter, which makes it easier for bacteria to enter the urinary tract and travel to the bladder, and because the urethra is closer to the rectum, where E. coli bacteria tend to colonize. So the greatest risk factor for getting a UTI is beyond your control: being a woman or AFAB.

Other important risk factors for UTIs:

• Sexual activity, including self-pleasure and pleasure at the hands of a partner. (Remember, dirty fingers and sex toys can introduce bacteria into your urinary tract and cause infection.)
• Not wiping from front to back
• A previous UTI.
• Pregnancy.
• Age (older women get twice as many UTIs as their younger counterparts).
• Certain types of birth control, especially diaphragms and spermicidal agents.
• Menopause.
• Blockages or structural problems in the urinary tract, such as kidney stones.
• A suppressed immune system. (Diabetes and other chronic diseases can impair the body’s natural ability to fight infections.)

How to treat a UTI (and When Should I See a Doctor?)

While you might be tempted to “tough it out” when experiencing early UTIsymptoms, it’s important to seek medical attention and treatment as soon as possible. (And Tia’s team of clinical experts are here to help—our UTI appointment include testing (a quick and easy urine analysis), a personalized treatment plan, and expert guidance for preventing future infections.)

Uncomplicated UTIs are generally treated with a short course (3-7 days) of oral antibiotics, such as trimethoprim and sulfamethoxazole/TMP-SMX (Bactrim), Fosfomycin (Monurol), Nitrofurantoin (Macrobid), or Ciprofloxacin (Cipro).

It is also important to recognize symptoms that might indicate that a UTI has spread to the kidneys, since this type of infection requires more urgent attention and treatment. If you experience more severe symptoms, like fever, chills, lower back/flank pain, or nausea and vomiting, seek urgent medical care. Simple UTIs are rarely dangerous, but pyelonephritis can cause kidney damage and often requires hospitalization and IV antibiotics.

Unfortunately, 20-40% of women will experience recurrent UTIs, which is roughly defined as having two infections within six months or three infections within a year. If you have frequent UTIs, your healthcare provider may recommend taking a longer course of antibiotics—six months or more—or taking a single dose of antibiotics after sex if your UTIs are related to sexual activity.

It’s worth mentioning here that even a simple UTI might not be so simple to recognize or treat in certain populations:

• Older women (65+) are twice as likely to experience UTIs, and left untreated, UTIs in this patient population can cause sepsis, a dangerous blood infection. Since symptoms in older women can often be confused with other illnesses, including delirium or sudden confusion, it’s especially important for older women or their caregivers to seek medical attention at the first signs of a UTI.
• Perimenopausal, menopausal, or postmenopausal women are also more likely to get UTIs. Why? During perimenopause, the ovaries produce less estrogen and progesterone, hormones that play an important role in urogenital, reproductive, and sexual health. These fluctuations in hormone levels change the lining of the vagina and bladder, reducing natural defense mechanisms against UTIs. If you’re in perimenopause, menopause, or postmenopause, your care provider might recommend starting topical vaginal estrogen therapy to reduce your chances of getting UTIs. It is a safe strategy that can be highly effective in preventing UTIs.
• Pregnancy can also make a woman more prone to UTIs. Thankfully, there are several antibiotics that are safe and effective to use while pregnant, including Nitrofurantoin and Cephalexin.

Home Remedies for UTIs

While antibiotics remain the gold standard for treating UTIs, many women are naturally curious about home remedies that might help prevent infections or relieve the pain and discomfort associated with them.

• Phenazopyridine hydrochloride (like Azo) might relieve symptoms related to pain, burning, itching, and urgency. But don’t fret if your urine turns a bright reddish-orange color! This common side effect is harmless (if somewhat wild to witness), but it can stain clothing and bedding.
• Methenamine and sodium salicylate work in unison to slow bacterial growth along the urinary tract and, in theory, might help lessen the burden of disease and symptoms. However, check warning labels carefully, as this home remedy is contraindicated in people who are allergic to aspirin, on a low-sodium diet, or taking anticoagulants.
• You can also take NSAIDS (aspirin, ibuprofen, naproxen) and acetaminophen (Tylenol) as directed for general relief from UTI symptoms.
• Drinking plenty of water, avoiding drinks that can irritate your bladder (alcohol, coffee, soft drinks), using a heating pad, wearing loose-fitting clothing, and resting (yeah, right!) are also commonly recommended strategies for finding some pain relief and comfort from UTIs.

That said, while home remedies are generally safe and well-tolerated, they likely won’t treat the underlying infection or offer more than temporary relief. As always, it is best practice to contact your healthcare provider with questions or concerns about your health. Better to ask a professional rather than to seek armchair medical advice online or from a bestie…unless your bestie happens to be a board-certified primary care physician or OB/GYN!

How to prevent future UTIs

If it is true that “an ounce of prevention is worth a pound of cure”, then this age-old adage definitely applies to UTIs. Thankfully, there are many common sense steps women and AFAB can take to prevent a UTI before it ever takes hold.

• Stay hydrated. Drink plenty of clear liquids, especially water. Urinating more frequently flushes bacteria from the urinary tract.
• Practice proper hygiene. Always wipe from front to back after urinating or having a bowel movement.
• Urinate after having sex.
• Avoid irritating feminine products, including douches, deodorant sprays, and powders.
• Switch birth control methods. Diaphragms and condoms treated with spermicide can promote bacterial growth. And remember: if you use lubricant, make sure it’s water-based.
• Try drinking cranberry juice or taking probiotics. Studies are conflicting, but evidence suggests that antioxidants in cranberries may prevent bacteria from sticking to the walls of the urinary tract. Additionally, probiotics might help support the body’s natural defense mechanisms.
• Change clothing. Loose-fitting clothing and cotton underwear prevent moisture from building up around your urethra.
• If you are perimenopausal, menopausal, or postmenopausal, consider consulting your physician and starting topical vaginal estrogen therapy.

UTIs are an uncomfortable fact of life for many women and AFAB. Thankfully, most UTIs are uncomplicated bladder infections that are easily diagnosed with a urine test and treated with a short course of oral antibiotics. Symptoms usually include pain or discomfort while urinating, urinary frequency, and/or urinary urgency, but lower abdominal pain, changes in urine color or odor, and flu-like symptoms are also commonplace. Additionally, there are several simple lifestyle measures everyone can take to decrease the risk of experiencing UTIs, including staying hydrated, practicing proper hygiene, and urinating after sex.

Even if few people think much about urinary health before a problem arises, urogenital, sexual, and reproductive health deserves to be talked about, honored, and celebrated without shame or embarrassment alongside all other healthcare topics. Tia gives you permission to start that conversation. And to keep talking.