Urinary tract infections (UTIs) are among the most common bacterial infections, affecting millions yearly. While anyone can develop one, they tend to affect women far more often than men. In fact, women may get UTIs up to 30 times more often than men, but when men do get them, the infections tend to be more complex. But why does this occur? Here, we'll talk about how UTIs differ in men and women and when to see a doctor.
Anatomy and Biological Differences and How They Impact UTIs
A urinary tract infection (UTI) is an infection that can occur anywhere in your kidneys, bladder, ureters, or urethra. Bacteria, most commonly E. coli, cause it. But why do women get more UTIs than men? One of the biggest reasons is anatomical differences regarding the urethra.
Urethral Length
The urethra is the tube that carries urine from the bladder out of the body. In women, the urethra is significantly shorter; about 1.5 inches (4 centimeters) long, compared to 8 to 9 inches (20 to 23 centimeters) in men. This shorter distance means bacteria have a much shorter path to travel from outside the body into the bladder, increasing the risk of infection.
Urethral Location
The location of the urethra is also why women get UTIs more often. In women, the urethral opening is very close to the anus and vagina. Because of this proximity, it's easier for bacteria to travel into the urinary tract, especially if wiping back to front or after sexual activity.
Prostate Gland
Men have an extra line of defense: the prostate gland. It produces antibacterial secretions that may help reduce the risk of UTIs. However, this doesn’t make men immune; they're just less prone. And, when men do get UTIs, they’re often linked to other health concerns.
Prevalence and Risk Factors of Getting UTIs
Urinary tract infections are significantly more common in women than in men. An estimated 50% to 60% of women will experience at least one UTI in their lifetime, and many will have recurrent infections.
Several factors can increase a woman’s risk for developing a UTI, including:
- Pregnancy
- Menopause (decreased estrogen levels)
- Low vaginal estrogen
- Certain forms of birth control
- Pelvic organ prolapse
- Diabetes
- High blood sugar
- Weakened immune system
UTIs in men are less common, affecting only about 12% of men during their lifetime. However, when UTIs do occur in men, they are more likely to be considered complicated and linked to underlying health conditions or anatomical abnormalities.
Risk factors for UTIs in men include:
- History of kidney stones
- Enlarged prostate
- Uncircumsized
- Diabetes
- High blood sugar
- Low immunity
- Anal intercourse without condoms
UTI Symptoms in Men vs. Women
Regardless of gender, UTIs often cause a standard set of symptoms that signal inflammation or infection in the urinary tract. These may include:
- Burning or pain during urination
- Frequent urge to urinate, often with little urine passed
- Increased urgency or pressure in the lower abdomen
- Cloudy, dark, or foul-smelling urine
- Lower abdominal discomfort
However, the symptoms of a UTI tend to be more acute and noticeable in women. Due to urethral length and location, UTIs in women come on quickly and strongly, often associated with a sudden onset of burning and even discomfort in the lower abdomen or back.
In men, the UTI symptoms can be more subtle, especially during the early stages. They may also be similar to signs of other conditions, since UTIs are typically associated with underlying conditions like kidney stones and an enlarged prostate. In these instances, symptoms can appear as:
- Pelvic or perineal discomfort (pain between the scrotum and anus)
- Low urine flow or hesitancy, especially if prostate enlargement is involved
- A feeling of incomplete bladder emptying
If the UTI spreads to the prostate, it can cause acute bacterial prostatitis, a serious condition that can be life-threatening if not promptly treated. Symptoms of this include:
- Fever and chills
- Pelvic or lower back pain
- Painful ejaculation
- Difficulty urinating or urinary retention
If you experience any of these symptoms or any other worrisome changes in bathroom habits, schedule an appointment with your urologist.
Gender-Specific UTI Complications
Potential complications and long-term concerns can also differ significantly based on gender. Women are more likely to get recurrent urinary tract infections, particularly those who are sexually active, postmenopausal, or have a history of prior infections.
Women are also at a higher risk of complications if they're pregnant. Untreated UTIs during this time can lead to pyelonephritis (kidney infection) and can cause complications for the pregnancy, such as:
- Preterm labor
- Low birth weight
- High blood pressure or preeclampsia
- Hospitalization
In men, UTIs are usually complicated by default since they're associated with underlying conditions like urinary obstruction, benign prostatic hyperplasia (BPH), or bladder dysfunction. This can make treatment more challenging and may require a more intensive course of antibiotics. UTIs in men may also spread to the prostate or the epididymis, both of which require prompt treatment.
What to Do if You Think You Have a UTI
If you get a UTI, don’t wait it out; early diagnosis and treatment are key to avoiding complications. And drinking cranberry juice isn't a cure. Your doctor or urologist will run diagnostic tests such as a urinalysis or a urine culture to check for the presence of bacteria, and that may be all that's done.
However, men may need additional tests to ensure that there are no other underlying conditions at play. Your doctor may also recommend a digital rectal exam (DRE) or imaging tests to rule out abnormalities and blockages.
Are UTIs Treated Differently Based on Gender?
Treatment for UTIs can also vary based on gender, severity, and whether the infection is associated with other conditions.
Women who have uncomplicated infections typically receive short-course antibiotics (about 3–5 days). For women with recurrent UTIs, treatment may include:
- Postcoital antibiotics
- Vaginal estrogen in postmenopausal women
- Probiotics or other lifestyle changes (e.g., increased hydration, avoiding known irritants)
Men typically require longer courses of antibiotics, especially if the prostate is involved. This can range from 7 to 14 days, depending on severity. If prostatitis is confirmed, additional or alternative antibiotics may be used, and follow-up testing is necessary to ensure the infection clears.
Can You Prevent a Urinary Tract Infection?
Luckily, there are a few things you can do to help prevent a UTI. There are general guidelines that are recommended for everyone, along with a few gender-specific prevention tips. When it comes to general guidelines, these are some of the best things you can do:
- Drink plenty of water to help flush bacteria from the urinary tract.
- Practice good hygiene (e.g., regular bathing, changing underwear daily).
- Urinate after sex to help clear any bacteria introduced during intercourse.
- Avoid holding in urine for long periods.
Women should also make sure that they wipe front to back after using the bathroom to help avoid spreading bacteria from the anus to the opening of the urethra. Irritating feminine hygiene products like douches or scented products can also disrupt the natural flora and contribute to causing an infection. Women can also talk to their doctor about changing birth control methods if the current options are linked to recurrent infections.
Men should make sure to take care of their prostate health and stay up to date on screenings with their doctor. It's also important to recognize potential problems and see your doctor when they occur. Ignoring things like a slow urine flow or incomplete emptying can make it far more likely to get a UTI, so it's better to see your doctor. Men should also avoid holding in urine, especially if there are prostate issues, and always make sure to empty the bladder completely. If engaging in anal sex, using protection and thoroughly cleaning the area afterard can help reduce exposure to fecal bacteria.
When to See a Doctor
Understanding how urinary tract infections differ in men and women is key to recognizing symptoms early, getting the proper treatment, and taking steps to prevent future infections. While women are more prone to UTIs due to anatomical factors, men often experience more complicated cases that may require further medical evaluation. Regardless of gender, staying informed and proactive about urinary health can make a big difference in your overall well-being.
At Byram Healthcare, we’re committed to supporting your urological health with a wide range of urology supplies and discreet home delivery. Talk to your doctor to learn more about which urology products can help, and order online at Byram today.
