What is a UTI?
The term urinary tract infection (UTI) describes the infection of any of the urinary system organ parts – the kidneys, ureters, the urinary bladder and the urethra – caused by microbes, organisms invisible to the human eye. Bacteria are the most frequent cause of UTIs, but sometimes fungi and, rather uncommonly, viruses also take part in the process [1, 2].
UTIs are some of the most frequent infections in humans. A UTI can occur anywhere in your urinary system, but lower urinary tract infections – bladder and urethra – are the most common. But a UTI can also happen anywhere in your upper tract – or your kidneys and ureters. Upper-tract UTIs are less common but usually severe [2, 3].
Women are much more likely than men to get UTIs - adult women are 30 times as likely as men to get a UTI. The female anatomy makes it easier for bacteria from the vagina or rectal areas to enter the urinary tract [1, 4].
What are the Causes of a UTI?
Urinary Tract Infections (UTIs) are the most frequent bacterial infections in humans, with Escherichia coli (E. coli) causing 80-85% of acute episodes of uncomplicated cystitis (inflammation of the bladder) [5, 6, 7]. Similarly, other infective species might be involved in UTIs, including Staphylococcus saprophyticus, Klebsiella pneumoniae, Proteus mirabilis, Enterococcus faecalis and Staphylococcus spp [8, 9].
Sexual activity is a leading cause, but not the only one. Problems with voiding completely when you pee, blockages of the urinary tract like kidney stones or benign enlargement of the prostate, and insertion of a urinary catheter are all associated with UTIs [2, 10, 11].
Long-term antibiotic use can change your normal urinary tract bacteria, leaving you more susceptible to a UTI [10]. Other risk factors include:
- A history of a UTI
- Frequent or long-term use of a urinary catheter
- Muscle weakness
- Paralysis
- Not drinking enough water
- Recent surgery involving your urinary tract or kidneys
- Blockage of the urinary tract (kidney stone or an enlarged prostate)
- Diabetes
- Being uncircumcised
- Faecal incontinence
- Anal intercourse (exposure to more bacteria) [11]
Likewise, specific populations are more prone to UTIs: both young pre-menopausal women and older individuals have a higher risk [2]; anyone who is immobilised for a prolonged period due to surgery or staying in bed. In healthy, naturally fertile, non-elderly women with acute cystitis, recurrence can occur in between 25 and 50% of cases within the same six-month period during which the initial infection is treated [12].
Risk Factors of UTI
Urinary Tract Infections (UTIs) can be influenced by various risk factors.
Perhaps the most essential risk factor is infrequent urination. Peeing is how the body expels urinary tract infections, so retaining urine lets bacteria thrive and increase inside the bladder. It would be best to pee at least every two to three hours [13].
Another is not drinking sufficient amounts of water. This slows the transit of urine through the bladder, boosting the risk of infection [13].
Sexual intercourse, and especially frequent or vigorous intercourse, raises the risk of UTIs, especially among women, who are eight times as likely to acquire a UTI as men [14, 10].
Some health conditions can also make you more likely to get a UTI. These include diabetes, pregnancy and large prostates. Women who are post-menopausal with low estrogen levels are also more likely to have a UTI [13, 2].
Using urinary catheters can also increase UTI risk: the hose transfers bacteria to the bladder more directly [15, 2].
The risk of such surgery exposes a woman to a history of UTI or kidney stones as risk factors since urinary tract irritation from kidney stones could block urine outflow from the urinary tract [13, 2].
Moreover, some demographic factors can put you at higher risk of UTI, including old age, reduced mobility, following surgery or long-term bed rest, and having a compromised immune system [2].
Can a UTI Delay a Period?
Urinary tract infections (UTIs) are commonly dealt with in medical offices. They are ubiquitous in women of reproductive age, particularly those who are sexually active. While UTIs certainly affect your urinary tract, they don’t interfere with your menstrual cycle or the reproductive organs, so they don’t delay your period directly [16].
Interestingly, it may be that your menstrual cycle is affecting the timing of your UTI, not the other way around. This is due to the anti-inflammatory properties of estrogen. When estrogen levels are high, you may be less susceptible to developing a UTI. However, estrogen production lowers around the time of menstruation, which may make you more vulnerable to developing an infection [16].
Other times, the period might be delayed if you have a UTI and a delayed period. High stress levels can affect your cycle just as much as a UTI, according to a 2006 research review and another study in 2015 [16].
If your UTI is bacterial, you’ll be given antibiotics to treat the infection. Usually, antibiotics do not affect the hormones that control ovulation and menstruation. There is one antibiotic (rifampin) that can influence hormonal levels and delay your period [16].
Other health conditions may cause your period to be delayed:
- Hyperthyroidism (an overactive thyroid)
- Polycystic ovarian syndrome
- Primary ovarian insufficiency (also called premature menopause)
- Stress
- Extreme weight loss or gain
- Uncontrolled diabetes [16]
If you’re suffering a UTI and your period is late, you should check in with a doctor to be prescribed antibiotics to clear the infection and to discuss whether treatment options are available for you. If you get recurrent infections, you could also be prescribed prophylactic medications to reduce your risk of future UTIs [16].