Are UTIs more common as we age?
By Board Certified Urologist Dr. Yana Barbalat
Unfortunately, the answer is yes.
Let’s break is down by gender!
UTIs tend to peak at two time periods in a woman’s life. Typically, between
the ages of 18 and 30, and again after the age of 60.
Sexual activity is a common trigger for UTIs, so it makes sense that women
often report their first UTI after becoming sexually active. This is because
there is a transfer and movement of their own vaginal and anal bacteria that
happens with sexual activity. In addition, spermicide use has also been
associated with urinary tract infections. Since the 18-30 year old age group
is most likely to use contraception that contains spermicide (condoms), it
makes sense that this becomes another risk factor for younger women to get
UTIs peak again after the age of 60. This typically happens because vaginal
estrogen levels fall as women age. As vaginal estrogen decreases, so does
the good bacteria called Lactobacillus that thrives in the vagina when
estrogen levels are high. Lactobacillus essentially occupies the vagina and
creates a healthy acidic environment keeping the other bacteria out. Once
Lactobacillus levels decrease, women become more prone to urinary tract
Besides the decrease in Lactobacillus, there are other reasons why older
women tend to get UTIs, also related to estrogen! As estrogen levels fall, the
wall of the vagina become less elastic. Women can develop incomplete
emptying of urine, which can lead to infections. The urethra sometimes
starts to protrude out as well, leaving it vulnerable to the surrounding
bacteria. Previous studies have shown that supplementation with vaginal
estrogen can decrease the amount of UTIs that women get.
In men, UTIs are uncommon until after the age of 60. This is because as men get older, they are more likely to develop incomplete bladder emptying due to enlargement of their prostate. As the prostate grows in men, it creates a narrowing in the urethra and the bladder has to work hard to get the urine out. When some urine remains behind in the bladder, it becomes a medium for the bacteria to grow and thrive in. This is the most common reason for UTIs in older men.
Finally, as men and women get older, they develop other medical issues that
can make them susceptible to UTIs. These include diabetes, neurological
disease, bladder and kidney stones, autoimmune disease and incontinence.
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