I had the pleasure of working with Jessica Zimmer in a hospital in Melbourne. Jess is a nurse completing her Masters in Urological Continence. She has been working in continence and urological nursing for 6 years and is a wealth of knowledge. I asked her some questions about UTIs, as they are so common in women. Males have a longer urethra or urine tube which helps to prevent the movement of bacteria up into the bladder, so they suffer from UTIs much less than women do. Recurrent UTIs are common, and if the infection reaches the kidneys, things can get serious. Also, UTIs may play a role in the start of chronic pelvic pain or painful sex. Have a read to learn some simple steps to decrease your risk of a UTI, and what to do if you get one.
Urinary tract infections (UTI) unfortunately are very common in women. One in two women will have or had one during their lives. Why so many? Women who are pregnant have a one in five chance of getting an UTI! The changes the pregnant body goes through can lead to decreased muscle contractions in the urine tract system. This can lead to increased bacteria growth. Post menopausal women also have an increased risk due to hormonal changes. These hormonal changes result in dry and scratchy vaginas (sometimes diagnosed as atrophic vaginitis). As my mentor once told me, this dryness makes it easier for the bugs to climb up.
So you are not pregnant or menopausal, so why are you getting UTIs?
- Wearing silky underwear to the gym? Not a good idea. Wearing cotton underwear lets our private bits breath better (apparently exercise leggings are designed to be worn with out underwear…. I am not so sure about this one?).
- Do you wear a pad while working out? Change it afterwards! All the sweat has just been absorbed into that pad. A pad (continence pad or menstrual) should only be worn for a maximum 12 hours.
- Are you drinking enough? No, 6 cups of coffee does not count! If we are not drinking enough good fluids (water, milk) our bladder becomes dry and irritated, leading to increased risk of UTI. No one knows how much you should be drinking, I aim for 2L a day of fluid (consisting of 1-2 coffee a day depending how I am feeling, and the rest water) and a touch more if I am exercising.
- How are your bowels? If you are consistently constipated there is higher risk of not emptying our bladder properly, and a higher risk of prolapse if you strain on the toilet. Good bowel health is very important. My moto is ‘a couple of prunes a day will keep your bowels healthy and your skin clear’. Give it a go!
- Not going to the toilet enough to void/urinate is another risk factor. Coming from a nurse who used to work an eight-hour shift with no toilet break; holding on too long can increase your risk of UTI. Believe it or not you are supposed to go to urinate every 3-4 hours during the day. No urine to pass? You are not drinking enough!
- Not urinating post sex? There is no research to support this one, just old wives tales, which say that we should always urinate post intercourse. Between me and you, I make sure I do every time, this is probably just a learnt behaviour I have developed due to my fear of UTI’s (But I believe it works because I have never had one)!
- Wipe from front to back after going to the toilet
What are the symptoms?
Well as one of friends said the other day: she had to pee all day long and it burned. Other symptoms are:
- new urine incontinence
- a feeling of a full bladder even after you have urinated
- change of behaviour (irritability, hallucinations)
- increased body temperature
- smelly urine
There are so many different symptoms, and everyone presents differently. I believe we know our body the best, if there is a change, we need to get it checked out. UTIs can turn very nasty quickly!
Ok so you think you have UTI what to do now?
Go to the GP. Get off Google (you are not a doctor)! I believe a good GP will send your urine away for testing to check what specific antibiotic you will need. As this test can take up to a couple of days to get the results, the GP will do a dipstick (a special stick designed to test urine) into your urine and see if there is any leukocytes and nitrates present. If there is, the GP will most likely give you some antibiotics to take home as well as sending your urine away for testing.
Note: Ural (brought over the counter at the chemist) can help improve symptoms. It helps gets rid of the burning sensation but it will not treat the UTI.
I find that people that suffer from recurrent UTIs have usually not had their urine tested correctly in the first instance, and have therefore had incorrect treatment with the original UTI. Or, once the initial UTI has been treated, suggested lifestyle changes have not been implemented.
Some GPs will tell you to take cranberry tablets to stop UTIs coming back. There is very conflicting research about the efficiency of cranberry reducing UTIs, but I say: can it really hurt to try?
New research is coming out that our bladder has a lot of natural good bacteria growth, just like our bowels. This is very NEW research however. There is also little research about how probiotics help this good growth. If you are into natural remedies, drinking miso soup may help/can’t hurt. Hopefully we get some good research soon to help with further treatment.
Still getting UTI’s after adequate diagnosis and lifestyle changes? Get help! Asked to be referred to a specialist. This needs investigating further!
– the vagina physio