January 19, 2021/Urinary & Kidney Health

Why UTIs Happen Differently in Men and Women

The ins and outs of urinary tract infections

public lock on bathroom showing urinary incontinance

When you gotta go, you gotta go. But if you need to go all the time — and it kind of burns when you do — it may be a urinary tract infection (UTI).

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But are women or men more likely to develop UTIs? Whose are easier to manage?

According to urologist Petar Bajic, MD, here are the different ways men and women get UTIs and what you can do to prevent and treat them.

What’s a UTI?

Your urinary tract is your body’s drainage system for removing urine. A urinary tract infection (UTI) is an infection in your kidneys, bladder, ureters (the tubes from your kidney to your bladder) or urethra (the tube from your bladder to the outside of your body).

According to Dr. Bajic, men and women differ in both how they get a UTI and how likely they are to get one.

“Women, for example, are far more likely to develop urinary tract infections develop because there’s a shorter distance between the bladder and the outside world. In fact, some women get several infections each year,” he says. “UTIs in men on other other hand are less common, but the infection is typically much more complicated and usually related to prostate enlargement, kidney stones or other conditions.”

What causes a urinary tract infection?

Most UTIs are caused by E. coli and other bacteria from the bowel and bladder that make their way into the urinary tract.

Symptoms of this infection include:

  • Burning when you urinate.
  • Frequent or intense urge to urinate, even if only little comes out.
  • Pain in your lower back or abdomen.
  • Cloudy, dark, bloody or strange-smelling urine.
  • Fever or chills.

How do men get UTIs?

In men the urethral opening is at the end of the penis — a longer distance from the bladder than in women. Secretions from the prostate gland can also kill bacteria, so the frequency of a urinary tract infection is not as high.

But in men, kidney stones and enlarged prostates are common. Both of these can cause a urinary tract infection.

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“When men have an enlarged prostate, residual urine can stay in the bladder and collect bacteria,” Dr. Bajic says. “The enlarged prostate presses on the urethra and blocks urine flow so the bladder doesn’t completely empty. This increases the chances of bacterial growth that can lead to a UTI.”

Dr. Bajic says kidney stones can act as a sponge for bacteria. “Even if the urinary tract infection clears up, the stones can act as a reservoir for bacteria to come back and create another infection,” he adds. “Sometimes the stones need to be removed to prevent infections from returning.”

Acute bacterial prostatitis — a prostate infection — is another less common cause. This can be life threatening if not treated right away.

Men at higher risk include those who:

  • Struggle with kidney stones.
  • Have an enlarged prostate.
  • Have diabetes.
  • Have low immunity.
  • Are uncircumcised.
  • Participate in anal intercourse without condoms.

How men can prevent UTIs

There are things men can do to reduce the chance of getting a UTI. These include:

  • Don’t hold urine for too long. Bacteria grow in it.
  • Drink water to flush your kidneys.
  • Practice good hygiene.
  • Urinate after sex to flush bacteria from the urethra.
  • If you have diabetes, control your blood sugar. High blood sugar can spill into the urine and bacteria thrive on it.

How do women get UTIs?

Women have a more than 50% chance of getting a UTI at some point. This is much more likely than men.

“In women, the urethra is shorter than men’s and is closer to the anus, where stool comes out. It’s also close to the vagina, which can collect bacteria during sex,” Dr. Bajic says. “Because of this positioning bacteria from the anus or vagina have easy access to a woman’s urinary tract making it easier for an infection to occur.”

He also says women who have undergone menopause may have hormone-related changes to their vagina which can predispose them to infections. But this is treatable with prescription creams.

Women at higher risk include those who:

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  • Are pregnant (when there’s more pressure on the urinary tract).
  • Are post-menopausal (when hormones that protect the vagina have depleted).
  • Have pelvic organ prolapse, which makes it harder to empty the bladder.
  • Use certain forms of birth control, such as diaphragms or spermicide.
  • Have diabetes.
  • Have low immunity.

How women can prevent UTIs

Follow the same tips as men, plus do the following:

  • After using the toilet, wipe from front to back to keep bacteria away from your urethra.
  • Talk to your doctor about birth control options. Using lubricated condoms may lead to fewer UTIs.
  • Keep your vagina healthy. Don’t douche. After menopause, consider taking vaginal estrogen.

Complexity, frequency, risk factors and prevention tips may differ by gender, but urinary tract infections are equally uncomfortable for everyone. The better news is that for both men and women most UTIs aren’t serious and don’t cause other problems if you seek medical care right away.

Think you have a UTI?

If you think you have a UTI, Dr. Bajic recommends seeing your doctor for an exam and urine test. If you do have an infection, antibiotics can take care of it.

“Drink lots of fluids to urinate frequently to heal faster. You’ll also need to take care of any underlying issues that led to the infection,” he says.

Should I drink cranberry juice for a UTI?

For those who are wondering, “does drinking cranberry juice really help UTIs go away?” — few studies show any proof.

“Cranberry juice may stop bacteria from clinging to your bladder wall,” Dr. Bajic says. “But because it’s acidic it will aggravate your urge to urinate. You can drink it if you want but cranberry juice doesn’t work on UTIs as well as antibiotics and proper UTI prevention.”

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