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2023 Jun

UTIs As You Age

Why it’s important to recognize common and uncommon symptoms and get treatment fast.

Many women have experienced urinary tract infections at some time in their lives. UTIs are common and over half of all women will have at least one in their lifetime. Essentially, a UTI is an infection of the urinary tract that can include the kidneys, ureters, bladder, and urethra. The most prevalent location is the bladder. Some women are at higher risk to develop a UTI, including women who are sexually active, use certain types of birth control, are pregnant, have diabetes, use a catheter, have a kidney stone or other blockage, and women who have gone through menopause.

In fact, UTIs are the most common type of bacterial infection in older adults over age 65 and can have more severe consequences in seniors. After menopause, some women are more vulnerable to UTIs as the muscles in the bladder and pelvic floor weaken causing urine retention or incontinence. Additionally, as women age they may have a less robust immune system to naturally fight off infections. Some older women may have other urinary problems, such as incontinence or over-active bladder, that may mask any typical UTI symptoms.

Another common issue with UTIs in advanced ages is the phenomenon of delirium or confusion. Often times, symptoms like delirium, confusion, agitation, hallucinations, and restlessness may be the only symptoms exhibited. These symptoms are many times the first clue that someone may be suffering from a urinary tract infection.

Of course, not all UTIs in the elderly present is this manner. The most common symptoms include frequent urination and burning sensation or pain while urinating. Cloudy or bloody urine or urine with a strong odor may also be a sign of a UTI. More advanced infection may be accompanied by fever, nausea, vomiting, chills, and pain in back or pelvic area.

If you have any of these symptoms, it’s important to be seen by your healthcare provider to determine whether you have a UTI. A urinalysis will show the presence of bacteria in the urine, and cultures of the type of bacteria present will confirm what is the best course of antibiotic to treat the UTI.

Many times a rapid test in the office will give an immediate confirmation of infection, and your provider may prescribe the most common type of medication that covers the most common types of bacteria. In most instances, antibiotics will begin to alleviate symptom in short order. but it is imperative to take the full course of recommended medications to ensure the infection is fully eliminated.

Left untreated, UTIs can worsen quickly and infection can spread into the kidneys and even into the blood stream, a condition called sepsis. While not common in younger people, sepsis in the elderly can be fatal is left untreated.

To avoid the risk of developing a UTI and the possible complications, there are steps you can take to prevent one. These include drinking plenty of fluids throughout the day. If you are drinking enough fluid you should be emptying your bladder at least every 4 hours. Urinate before and after sexual intercourse. Avoid douching or feminine hygiene products like washes, sprays, and powders. Wear cotton-crotch undergarments and avoid tight fitting pants that trap moisture.

An additional prevention measure may include consulting with your healthcare provider to determine if an older patient may benefit from low-dose estrogen to change the bacteria that surrounds the urethra.

Timothy Hardy

Dr. Timothy Hardy, M.D., FCOG, FPMRS, has been practicing medicine in the community for many years. He received his medical degree from Eastern Virginia Medical School and founded his own practice, Atlantic OB, in 1990, where he has been providing women with exceptional care ever since. For information, call 757-463-1234 or visit


Give Your Child a Healthy Start to the School Year

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Help ensure your child enters the new school year healthy and without delay with these tips from the Virginia Department of Health.