- Researchers say recurrent uncomplicated urinary tract infections (UTIs) can disrupt a person’s daily life from work to sleep to exercise.
- They say these disruptions can increase medical costs as well as impact wages.
- Experts say good toilet hygiene along with drinking plenty of water can help prevent UTIs.
Uncomplicated urinary tract infections (UTIs) can cause personal, social, and professional complications for women.
That’s according to a study published today in the journal PLOS ONE that suggests recurrent uncomplicated UTIs can impair a woman’s overall quality of life in several significant ways.
Recurrent UTIs are defined as two infections within 6 months or three within 12 months, according to the American Urological Association.
In their study, researchers examined online survey data from 2020 on 375 eligible women over the age of 18 living in the United States.
Of these participants, 43% were categorized as having recurrent uncomplicated UTIs based on self-reported history.
Specifically, the UTIs were found to impair personal and social activities, such as:
- Sleep (for nearly 67% of respondents)
- Sex (nearly 61%)
- Exercise (52%)
- Housework (51%)
- Spending time with friends (nearly 47%)
The data analysis also revealed the UTIs impaired work presenteeism (e.g., showing up to work) and work productivity (eg, how much you accomplish during work hours).
Further, the study authors noted the high health and medical cost of having recurrent uncomplicated UTIs: direct and indirect costs were $1,289 and $515, respectively.
Direct costs can include emergency room visits and antibiotic medication treatment. Indirect costs can be loss of income due to absenteeism.
“This study is an important piece of research because UTIs are super common and burdensome in terms of healthcare cost and absenteeism at work,” said Dr. Maria Sophocles, a gynecologist and medical director of Women’s Healthcare of Princeton, New Jersey.
“We always need more research about UTIs and physicians need a better understanding to streamline and standardize the practice of how we treat them,” Sophocles told Healthline. “This is a great basis for the next study that will actually look at ways to reduce the burden and improve workplace productivity, quality of life, and impairment activities by getting a prescription and testing right the first time.”
Sophocles added that it’s important for a future study to understand the prescribing habits of physicians, how that can alter recommendations, and ensure that they are doing a culture and sensitivity test in addition to a urine report.
“A urine report tells whether or not there is bacteria in the urine, but a culture and sensitivity test actually tests that bacteria against a variety of antibiotics to find which ones will work,” Sophocles said.
She added this will ensure antibiotic medications like Cipro are not overprescribed.
Dr. Courtenay Moore, a urologist at The Ohio State University Wexner Medical Center, suggests this study adds to the conversation on the relationship between UTIs and quality of life.
She told Healthline that the results were not surprising in that many articles have shown a negative effect on a person’s impact on quality of life, including daily activities, general health perception, physical functioning, emotional health, emotional well-being, and social functioning as well as a reduced quality of both intimate and social relationships and self-esteem.
There are some ways to help prevent UTIs.
Sophocles suggests the following:
- Practicing careful toilet hygiene (ie., wiping from front to back) or using a spray bottle of water if needed to clean the urethral area.
- If you get UTIs related to sex, delay peeing after sex. Instead, drink enough water or other liquid until you feel your bladder is somewhat full, and then urinate. This is a more thorough “flushing” of bacteria from the urethra.
- Acidify the urine with 1000 mg per day of vitamin C or a cranberry supplement of your choice.
You may want to consider seeing a doctor if you get more than three UTIs per year, says Sophocles.
Treatment options
If you get recurrent UTIs, Sophocles suggests asking a healthcare provider to prescribe a urinary analgesic such as phenazopyridine to take when you have symptoms.
“It’s available over the counter at lower strengths and prescription at higher strengths,” she adds.
Moore suggests trying over-the-counter supplements that prevent bacteria from adhering to the bladder lining. She says D-mannose and cranberry supplements fit this description.
Increasing fluid intake
At the first signs of a UTI, Moore suggests increasing water intake (perhaps 1 liter per day) as this will “flush the bacteria out.”
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Treating bowel issues
Diagnosing, treating, and preventing future bowel issues is part of reducing the risk for recurrent UTIs.
That’s because bowel issues will increase the risk of urinary tract infection, explains Moore.
“Constipation and diarrhea increase perineal colonization and increase risk of bacteria ascending into the bladder,” she says.
For postmenopausal women
If you are postmenopausal and getting UTIs, Sophocles says it could be due to decreased estrogen because of aging.
“Estrogen is responsible for the good bacteria in the vagina that protect bad bacteria from getting into the bladder,” she says. “When you lose estrogen, good bacteria leave so the opening to the bladder is left unprotected and higher risk of getting a UTI.”
Moore suggests postmenopausal women try a topical vaginal estrogen in combination with probiotics.
“During menopause, estrogen levels decrease causing the vaginal pH to go from an acidic pH to a basic pH,” she explains.
“When this happens, the normal vaginal flora (lactobacillus) dies off allowing enteric organisms (bacteria from the rectum) to colonize the vagina.”
“By treating any bowel issues (which decreases perineal colonization), using topical estrogen (which normalizes vaginal pH) and probiotics (which introduce lactobacillus into the gut) allows for normalization of vagina pH and recolonization with healthy bacteria,” she added.
In women with post-coital UTIs, using a post-coital antibiotic (take an antibiotic immediately after intercourse) can reduce infection risk significantly, said Moore.