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What You Really Need to Know About Urinary Tract Infections

We can be more vulnerable to UTIs as we age, but these 6 habit changes can help prevent them.

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Chiara Ghigliazza
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As you get older your bladder weakens and is less stretchy, which can make trips to the bathroom more frequent. Ugh. These changes not only can disrupt your day-to-day life (or slumber) but they also increase your risk for urinary tract infections (UTIs), one of the most common infections in older adults. So here are the facts about UTIs and how to prevent them.

What is a UTI?

Your urinary system includes your kidneys, bladder, ureters (the tubes that carry urine from your kidney to your bladder) and urethra (the tube that carries urine outside your body). UTIs are often caused by bacteria that enter your system (usually your bladder) and trigger an infection (most commonly cystitis). Bacteria can also get into one or both of your kidneys resulting in a more serious infection (pyelonephritis).

Am I at a higher risk of getting a UTI?

Unfortunately, yes. Women get UTIs more often than men — like 30 times more. Blame it on your shorter urethra, which gives germs easier access to your bladder. And as estrogen levels decline with age, vaginal pH increases, leaving you vulnerable to more infections.  

What are the symptoms?

Besides spending a lot of time in the bathroom, common UTI symptoms include:

  • Burning or pain when urinating
  • Feeling like you have to urinate despite having an empty or near-empty bladder
  • Urinating often
  • Urine that appears red or pink, a sign of blood in your urine
  • Pressure or cramping in your groin or lower abdomen

Be aware of symptoms that can indicate a kidney infection, including a fever above 101°F and mental changes or confusion. Kidney infections can lead to serious complications.

It’s also possible to have UTI symptoms but, in fact, have an overactive bladder (a condition where you feel a sudden and urgent need to pee) or painful bladder syndrome (interstitial cystitis), a chronic condition that causes bladder pressure and pelvic pain.

So, if you have symptoms, visit your health care provider for a proper diagnosis.

What can I expect at my appointment and for treatment?

Your provider may ask you to pee in a cup so she can check it for germs and white blood cells, which are signs of infection. If you do have a UTI, this test, along with additional analysis, will help your provider identify the bacteria causing your infection and determine the best antibiotic to help treat it.

If you’re prescribed an antibiotic, take the full course, even if your pain goes away. (Your provider should prescribe antibiotics for “as short a duration as reasonable,” per guidelines from the American Urological Association.) It’s also a good idea to avoid alcohol when taking antibiotics.

So how can I prevent UTIs?

Changing your habits can help.

Practice good hygiene. Wash the skin around your genitals thoroughly with mild soap and water, rinse and pat dry. And wipe from front to back after a bowel movement. These actions are critical to stopping germs from getting into your urethra.

Ditch feminine hygiene products. Your vagina is not meant to smell like peach blossoms. Feminine sprays, powders and wipes can cause vaginal irritation and injury and make your skin more receptive to bacteria, so skip douches and scented products down there. If you have abnormal vaginal odor, talk to your health care provider; it could be a sign of infection.

Stay hydrated. Drink plenty of water to help dilute bacteria and flush it out of your urinary tract. Women who increased the amount of water they drank by 1.5 liters daily had 50 percent fewer episodes of repeated bladder infections and needed fewer antibiotic treatments, according to a 2018 study in the Journal of the American Medical Association Internal Medicine.

Don’t hold it. Empty your bladder when you need to. And don’t go more than three or four hours without urinating. Bacteria grow when urine stays in the bladder too long.

Pee after sex. Bacteria from your partner’s genitals, fingers or sex toys can get into your urethra, so pee after “your performance” to help flush away germs.

Talk to your health care provider. If you have any questions, including those about recurrent infections, ask your provider. For instance, if taking estrogen is not an issue for you, your provider may suggest using an estrogen-containing vaginal cream or ring since it’s been found to help maintain vaginal pH and prevent UTIs, particularly if you’re post-menopausal.

One more note: Clinical studies on the effectiveness of cranberry juice or supplements to prevent UTIs are conflicting, Cleveland Clinic reports. One 2012 review of research, for instance, determined cranberry could not be recommended for prevention. But now, 2019 guidelines from the American Urological Association say health care providers may preventively offer cranberry (including juice and tablet formulations) for women with recurrent UTIs. Still, there can be questions about whether these treatments have enough of the active ingredient and whether these amounts are consistent. Cranberry juices also can be high in sugar. The bottom line: If you’re interested in cranberry, talk to your provider about whether it’s right for you. And know that products high in acid, like cranberry juice, can cause irritation or pain if you have bladder issues like interstitial cystitis.

While getting older comes with changes, knowledge can help you manage them.

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