Facts about urinary tract infections in people with a vagina
The length of the urethra is shorter in people with a vagina. It is closer to the anus and vagina where bacteria are. This makes it is easy for bacteria to get in the bladder and cause a urinary tract infection (UTI).
You can get UTIs at any age, but there are times in life when they are more common. In puberty, they happen more often because of hormone changes. In young people, they may be due to the start of sexual activity. They are also more common after menopause.
Some people have a higher risk of getting a UTI, including people who have:
- High blood sugars
- Kidney stones
- Catheters that stay in all the time
Signs of UTI
- Pain or burning when peeing
- Pee that is cloudy
- Pee that smells bad
- Pressure in the lower stomach
- A need to pee often
- Blood in the pee
- A low fever
Most UTIs are not serious. Some cause kidney infections. Signs of this are sharp upper back pain and fever.
The most common care for a UTI is three to seven days of antibiotics.
See a provider if you think you have a UTI. You will need to give urine for testing. This test looks for signs of infection in your pee. The test may be done in a lab. It can also be done with a dipstick in the office. It is quick and easy.
Things that can affect the office test are:
- Hydration
- Medicines
- Vaginal infections
- Menstruation
Urine tests from a lab tell your care team the kind of bacteria causing the UTI. This helps them know which antibiotics are best to treat it. It takes 48 to 72 hours to get these results.
Using too many antibiotics can lead to health problems and drug resistance. Other medicine can help with bladder pain while waiting for the results.
A catheterized urine sample may be needed for people with frequent UTIs or vague signs. This helps to be sure normal vaginal bacteria do not affect the test.
Some people get test results that show bacteria but do not have signs of a UTI. This is common in older adults. A person with bacteria in their pee but no signs does not need to be treated. Only people with bacteria and signs of a UTI should be treated.
More tests may be needed for people who:
- Have a high risk for bladder cancer
- Have bowel disease
- Do not respond when treated
Your care team will work with you to decide which tests you need, such as:
- Pelvic exam to check the support of and health of the lining of the vagina
- Catheterized urine sample
- Vaginal wipe to check for yeast and bacteria
- Ultrasound or X-ray of kidneys and bladder to check for stones, blocks, or masses
- Cystoscopy to check the lining of the bladder
UTIs after menopause often happen because of low estrogen levels. This changes the vaginal climate to make it easy for bacteria to grow. Hormone therapy can help people with UTIs that start or get worse after menopause.
Other options are:
- Wipe from front to back.
- Use a new piece of toilet paper with each wipe.
- Pee right away after sex.
- Drink 8 to 10 glasses of water each day.
- Use the bathroom every two to three hours.
- Get routine health exams.
- Change pads or incontinence briefs often.
Cranberry, probiotics, and D-mannose may help prevent UTIs. Studies on cranberry pills and other supplements do not show a clear benefit, though. D-mannose can prevent bacteria from attaching to tissues.
Read about the pros and cons of each product to decide if they are right for you.
Vaginal estrogen therapy: This can help people with infections that start or get worse during or after menopause.
Self-start antibiotics: These may help people who have UTIs more than two to four times a year.
Post-sex antibiotics: This is a single, low-dose antibiotic to be taken after sex. It can help with UTIs that start after sex.
Low-dose daily antibiotic suppression: This treats UTIs that do not go away with a short course of antibiotics. It can help the bladder and bacterial flora reset. It can be used for three to six months.
Hiprex® (methenamine): This helps people with frequent UTIs. The medicine reacts to acid in the pee and makes it hard for bacteria to grow.