On 16 May, 2026, Seniors Today hosted their weekly Health Live Webinar with a Senior Internal Medicine Specialist, Dr Sonal Kumta who spoke on and answered questions about Urinary Tract Infections in women and its management.
Dr Sonal Kumta is a Senior Consultant Obstetrics and Gynaecology from the Fortis Mulund Hospital, Mumbai. She also heads the preventive health check for women. She is a gold medalist and has completed her DNB board certification. Her surgical expertise includes minimal access surgeries such as laparoscopic hysterectomy, and other ailments including stress urinary incontinence. She is experienced in infertility management including intrauterine insemination (IUI), In vitro fertilisation (IVF) and trained at the reputed fertility centre at Hamburg. Dr Kumta practices high-risk Obstetrics including medical complications related to pregnancy such as Hypertension, Diabetes, Renal disease, Bleeding Disorders.
There is a significant difference in the UTIs in male versus females. And even then, there is also a difference between UTIs in younger and older women.
- Urinary tray infections in women, in the post menopausal category are definitely very important to tackle.
- Post menopause, it is the oestrogen level in your body that declines and that makes the lining of the urethra and the urinary bladder extremely sensitive, making it much easier to get infected.
- In elderly women, apart from the decline in the oestrogen levels, the thirst sensation also declines. Most seniors also do not have enough water worried about having the availability of comfortable and clean washrooms to void their bladder.
- They might also face urgent issues.
- The musculature of the musculoskeletal systems of the entire body becomes weaker with age, including the bladder muscle (detrusor muscle), thus reducing its ability to contract and throw out the urine completely. In effect, even when the woman goes to pass the urine, she may not empty her bladder completely- this is called “post void urine”. Any water that’s remaining inside, stagnating, is an excellent source for frowning organisms and infection. Whenever there is post voidal urine that is left inside, it is likely to get infected much more often.
- The elderly are always facing mobility issues which keeps them from rushing to the bathroom, such as some fracture, etc.
The above mentioned reasons/ causes make the senior women more prone to urinary infections.
The urinary tract consists of the kidneys, ureters (the pipes that carry urine from the kidneys to the bladder), urinary bladder and urethra.
Getting a urinary tract infection in the post menopausal age group is not the patients fault. It is just the physiological changes in your body which are making you more prone to UTIs.
A lot of patients are hesitant in talking about this, and that worsens the situation.
Risk factors for UTIs in women:
- Post menopausal women with oestrogen deficiency
- Diabetes mellitus. Medications for diabetes such as dapaglifozin- throw out glucose in the urine. And glucose is an excellent source of infection
- Chances of vaginal infection due to reduced mobility
- Repeated use of diapers
- Urinary incontinence- this leaves the area wet, and the longer the area remains wet, the higher is the risk of infection in not just the urinary tract but also the vaginal and genitourinary infections.
- Fungal infection/ candidiasis/ thrush
- Not consuming enough water
- Holding urine for a long time
- Improper hygiene practices
If you have complaints such as stress incontinence or you are wetting your panties often, you need to discuss it with your gynaecologist who will help you find a solution.
A lot of elderly women are used to washing their tract every time they pass urine. However, this area is very delicate and cannot be dried instantly. One would have to rub the area to dry it, and that can be very painful.
Thus, as an effect, the wetness remains, predisposing them to infections.
The wiping cannot be from back to front. It has to be from front to back. This is because the anal tract is flooded with organisms such as E. coli and if these organisms enter the urinary tract, they are definitely going to cause an infection.
Symptoms of Urinary infection:
- Burning while passing urine
- Itching
- The feeling of passing urine, right after they have passed urine
- Urine might appear cloudy, it may also have a dark colour or a strong odour
- Lower abdominal pain
- Fever with chills
- Pain in the back/ renal angle pain
In the elderly population, we may sometimes not see the above mentioned typical symptoms. Some of the atypically presenting symptoms can be:
- Sudden confusion/ disorientation
- Easy fatiguability
- Dizziness
In such a situation, Dr Kumta urges the patients and their caregivers to seek medical attention.
Diagnosis is based on:
- Referring to the concerned specialist, in this case a gynaecologist/ urologist
- In case of vaginal/ reproductive tract infection there will be presence of discharge, which could be specific in colour (cheesy white, yellow, etc.), any associated foul odour and intense itching.
- Swab culture
- Urine routine/ microscopy
- Urine culture- helps us know the organism causing the infection and the best antibiotic for the infection.
- Ultrasound of the Kidneys, urinary bladder and pelvic organs.
It is advised that you should give your urine sample before starting any medication/ antibiotic.
In case of infection in the kidneys, a prompt and aggressive treatment is advised.
When giving your urine for routine testing, you should give a “mid stream” sample. The urine is going to touch the vaginal walls and the labia when it comes out and this area is loaded with organisms. This is why, many times even though there is no growth of organisms, the urine report will show the presence of a large amount of bacteria. Thus a mid stream sample is advised- squat on the floor, separate the labia, discard the first and last part of the sample, collect the mid part of the sample which is called “mid clear stream catch”.