Why Women Get UTIs More Often: Causes, Prevention and When to See a Doctor

Urinary tract infections (UTIs) are one of the most common bacterial infections, accounting for millions of healthcare visits per year in the U.S. alone. Recent research shows that infection prevalence is rising, with recurrent infections driving some of the increase.

A 2025 study of adult visits to emergency departments between 2016 and 2023 found that UTIs were among the most frequent infectious diagnoses. An earlier study reported that the UTI incidence in the U.S. had increased by more than 50% between 1998 and 2011, with about 400,000 hospitalizations and an estimated cost of $2.8 billion in one year alone.

Why are women more likely to develop UTIs?

 “They’re more predisposed to the infection,” says Raveen Syan, M.D., a urologist with the University of Miami Health System. “And there is not just one cause. It’s multifactorial.”

Biology plays an important part. For one, women have fewer anatomical barriers than men to protect them from bacteria. They have a shorter urethra (4 cm) compared to the male urethra (18-20 cm) This means that pathogens such as E. coli can make it through the urinary tube more quickly, increasing the probability that the bacteria will take hold before being flushed out.

Women’s urethral opening is also much closer to the anus, which makes the chances of fecal transfer more likely. This is why bowel habits and wiping directions are drilled into girls from a young age. What’s more, some people may be more prone to infection due to differences in the epithelial lining of the female urethra that “makes it easier for the bacteria to attach,” Dr. Syan adds. “It’s an environment (moist and warm) that helps bacterial growth.” The male urethral opening, on the other hand, is less hospitable to bacteria.

But it’s not just female anatomy that raises the risk of UTIs in women.

Does menopause increase the risk of UTIs?

Hormonal changes can make for a hospitable environment for UTI development.

Estrogen, Dr. Syan says, is vital in keeping the vaginal and urethral epithelium thick and strong. But when that important hormone drops because of perimenopause or menopause that protective tissue grows thinner and more fragile. Less estrogen also changes the vaginal pH, making it less acidic and more welcoming to harmful bacteria and yeast.

In fact, several published analyses have revealed that postmenopausal women experienced up to 4 times more UTIs than premenopausal women. Vaginal estrogen therapy, however, reduced recurring infection by up to 75%, underscoring estrogen’s crucial role in driving risk.

But an aging population is not necessarily to blame for the worrisome rise in UTIs, particularly recurrent cases. “The big issue is antibiotic overtreatment,” Dr. Syan says. In other words, urologists, gynecologists and family physicians are encountering more treatment-resistant cases. Large U.S. health‑system studies show that roughly 15 to 20% of women with an initial UTI will experience a second bout within a year, often with increasingly antibiotic‑resistant bacteria the second (and third) time around.

Dr. Syan says it’s important to consult your clinician to determine the difference between a persistent infection (one that doesn’t go away) and a recurrent infection. “If you’re experiencing 3 or more [infections] in 12 months, or more than 2 in 6 months, there is something else going on and you need to get it checked.”

The increase in treatment-resistant UTIs have led to updated treatment recommendations.

Asymptomatic infections should be left alone. “We now recommend against treating them,” she adds. This change in clinical guidelines is a direct result of rising antibiotic resistance in UTI pathogens, particularly E. coli.

Urinary tract infections are not inevitable, and there are plenty of lifestyle habits Dr. Syan recommends both women and men practice:

Be aware of UTI symptoms and seek help for an infection.

Common signs include:

• cloudy, bloody or discolored urine
• pain, burning or stinging when you pee
• frequent need to urinate
• cramping or pain in your pelvis, strong-smelling urine
• fatigue and/or fever

Drink plenty of water.

She recommends about two liters (about eight 8-ounce glasses) a day.

Don’t hold in your pee for long periods of time.

Dr. Syan sees this in school‑aged girls but also in professionals (teachers and nurses), and women who avoid public bathrooms. When you hold urine for long periods, bacteria have more time to multiply. Also, holding it in reduces the natural flushing that helps keep the tract clean. “Listen to your body,” she says.

Take a cranberry supplement.

They don’t treat UTIs, but they can help prevent them. An active compound in cranberries, A-type proanthocyanidins (PACs), can prevent E. coli bacteria from sticking to the urinary tract walls.

Ask your clinician about D-mannose, an over-the-counter medication.

It is not a first line of treatment, but it can prevent recurrent infections. It works by attaching itself to E. coli bacteria and preventing them from sticking onto the urinary tract walls.

 Consider Hipprex, an antibacterial medication that is not an antibiotic.

Prescribed only after an active infection has been cleared, it serves as a long-term prevention therapy to stop chronic, recurring UTIs.

“If you suspect an infection,” she adds, “make sure you visit your doctor and ask for a urine test. It’s the only way to confirm if bacteria are actually present and know if the symptoms are not caused by other issues.”

Written by Ana Veciana-Suarez. Reviewed by Raveen Syan, M.D.

Tags: Dr. Raveen Syan, how to prevent UTIs, menopause and UTIs, recurrent UTIs