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Urine Infections (I)- Common Reasons Women get them.

Dr Sylvia Kama-Kieghe takes a detailed look at Urine Infections in women- and why they are so common

African lady dressed in casual shorts in front of a railing.

A urinary infection happens when germs enter the urinary tract.

They are also known as urinary tract infections (UTIs).

The urinary tract in a woman is different from that in the man.

This is an important cause for why urine infections happen in women to a greater extent than men.


Female Urinary Tract

Drawing showing the Urinary organs in a woman.

The organs of the female urinary tract are in the abdomen (the area of the body directly under the chest); and the pelvis (the area of the body just above the legs).

From top-down, the organs are the Kidneys, the Ureters, the Bladder and the Urethra.

Kidneys

Learn more about the Kidneys here - but in brief:

Most people have 2 kidneys located in the mid-lower back area covered by the ribs.

It is possible to have a normal life with one kidney.

This can sometimes happen as a congenital defect (i.e. when a person has a medical abnormality from birth).

The Kidney is a hugely important organ.

One of its jobs is to filter materials that arrive in it from the bloodstream and create urine.

The Kidney also regulates blood pressure and rids the body of toxic substances.

Ureters

The ureters are 2 very slim tubes that connect the Kidneys to the Bladder.

This means they travel from the abdomen and into the pelvis.

Their job is to carry the urine from the kidneys into the bladder.

Bladder

The Urinary Bladder is a small organ inside your pelvis.

In women, it sits just at the area above the juncture of the thighs and in front of the womb.

The bladder is a hollow (empty) muscular bag.

It's main job is to receive urine from the kidneys through the ureters and hold it until full. After, urine is released outside the body through the urethra.

When the bladder is full, it sends a message to the brain creating the 'urge' that makes one need to use the toilet.

Urethra

So up to this point, the organs of the Urinary tract have been the same in both men and women.

While both sexes have a urethra, the female urethra is shorter than the male.

In the female, the urethra runs directly from the bladder to open to the outside close to the vaginal opening. This also places the bladder opening close to the anus in ladies.


Recommended Reading:

Reasons for Urine Infections

So how do urinary tract infections (UTIs) develop?

Once germs travel into the bladder (from the urethra), they will multiply. If this continues, they form large quantities that can travel upwards to infect the ureters and kidneys.

The term Lower Urinary Tract Infection is used to describe infections in the Urethra and Bladder; while Upper Urinary Tract Infection is used for infection in the Ureters and Kidneys.

Upper tract infections tend to be worse/more severe than lower tract infections.

Both usually require antibiotics for treatment - in the case of upper tract infections, intravenous antibiotics and hospital admission may be necessary.


Most of the urinary tract from ureter up to the kidneys is usually germ-free so how do germs enter into the bladder?

Some studies indicate a very small amount of germs naturally living in the bladder. Infection can happen when these start to increase and overgrow, overcoming our natural defences.


Graphic drawing of a woman's vulva and perineum
How the Urethral opening is related to the Vagina and Anal openings respectively.

  • Where do the germs come from?
    • The most common source for germs that can infect the bladder are from the woman's own body.
    • Specifically, this is from the anus/back passage where a large number of germs exist coming from within the intestine/bowel.
    • A lot of these germs are 'good' within the bowel, they help in the digestion of food.
    • However, when they enter the sterile urethra and then bladder, they cause infection very quickly.
    • These germs are able to enter the bladder by moving from the anus to the urethral opening because both openings are close together.
    • Poor hygiene practice can encourage this.
    • Wiping from back to front moves the germs around the anus to the urethra opening in the front and this is the common way of developing an infection.
    • The correct thing to do (for example after urinating) is to use a clean tissue or wipe and stroke over the vulva from front to back. Discard the tissue and repeat if needed with a clean one.

  • The next method that germs could access the urethra and bladder is following sexual activity.
    • Germs that cause trouble in the urinary tract could be harmless elsewhere.
    • For example, they could exist on the skin surface without really causing any problems.
    • During sex, these germs may transfer from the partner's skin, or from the woman's skin to the area around the urethra opening which lies very close to the vagina.
    • This way, the germs can travel up into the bladder through the urethra.
    • So we advise women to urinate soon after sexual intercourse to flush out the germs before they can collect and multiply to cause infection.

Thus the nature of the woman's urethra (being a very short tube running from the bladder to the vulva where it opens) makes it easy for the germs to quickly travel into the bladder - compared to the male's.

In the man, the urethra travels from the bladder into the penis before it opens outwards - and is a longer tube.

Can sitting on the toilet cause urinary tract infections?

Theoretically - this is possible (explanation below); but not likely as the urethra is unlikely to be in contact with the toilet seat.

If the toilet seat surface is unclean with faecal matter containing germs, they could travel from the toilet seat to the woman's skin (buttocks, vulva), and from there up through the urethra into the bladder.

However, the germs may not not survive long enough on the seats to manage this making this an unlikely way to develop an infection.

Learn more about toilet seats and what you can catch from them here.


How else can women get UTIs?

  • Holding urine in the bladder for long periods of time.
    • Once the germs enter the bladder or urethra they start to multiply. Flushing the bladder by drinking plenty and going to urinate at regular intervals reduces the risk of multiplication and infection.
    • Hence - Urinate when you feel the urge and try to avoid 'holding it'.
  • By not changing sanitary pads often.
    • Sanitary pads stained with blood are a good source for germs. Blood from the womb needs prompt disposal; as soon as it gets onto the pad and connects with germs from the skin its easy for germ overgrowth to happen.
    • If you do not change promptly, these germs can easily track from the pad and travel into the urethra causing infection.
  • By using female intimate products - Douching; using female deodorant sprays around the vulva, hygiene sprays and soaking in bubble baths.
    • In some women, these products can encourage the growth of germs as they are not sterile and introducing them close to a woman's vulva could lead to germs travelling up the urethra and the bladder.
  • Menopause.
    • Changes in the reproductive tissues because of a reduction in Oestrogen can make it more likely for an infection to happen.
  • Birth Control.
    • This involves devices like diaphragms and spermicidal agents (not sterile) that accompany them.
    • If not properly cleaned, diaphragms can harbour germs that can easily travel from the vagina where they work into the urethra.


Conclusion

These are some of the most common reasons women, in particular, are more likely to develop urine infections.

Avoiding these instances described above can greatly reduce the occurrence of the UTIs.


Read More:

Preventing Women's Toilet Infections

How Men's Urinary Tract Works

Urine Infections - Common Reasons Men Get Them

Common Infections from a Public Toilet- and 8 ways to Avoid Them.

Editing By AskAwayHealth

Disclaimer

All AskAwayHealth articles are written by practising  Medical Practitioners on a wide range of health care conditions to provide evidence-based guidance and to help promote quality health care. The advice in our material is not meant to replace the management of your specific condition by a qualified health care practitioner.
To discuss your condition, please contact a health practitioner or reach us directly through info@askawayhealth.org


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