Getting a urinary tract infection (UTI) may seem like a matter of bad luck, but there are sneaky causes that you can sidestep or mitigate. If you were assigned female at birth, your anatomy — namely, a relatively short urethra — naturally puts you at an increased risk. However, specific habits and health conditions can also raise your chances of developing an infection. Here are seven surprising things that put you at a greater risk of a UTI.
1. Holding Your Pee
While occasionally delaying a bathroom trip is normal, consistently holding urine or failing to empty the bladder completely (urinary retention) can lead to high levels of residual urine. This sets the stage for bacteria to build up, leading to inflammation of the bladder or a urethral infection, says Jill Maura Rabin, MD, a professor and vice chair of education and development, obstetrics, and gynecology at Northwell Health in Manhasset, New York, and author of Mind Over Bladder. Habitually ignoring the urge to urinate can also overstretch and weaken the bladder muscles over time, making it even harder to fully empty the bladder. “It’s better to empty the bladder completely to let it fill up again completely,” she says.
2. Bicycling Regularly
An older study found that people assigned female at birth who commuted to work by bike or frequently cycled for exercise were more likely to report a history of UTIs than noncyclists. While shorter urethras play a role, prolonged bicycling, motorcycling, and horseback riding may increase the risk of bladder infections. The compression and friction from the bike seat can irritate the pelvic area and push bacteria closer to the urethra. Additionally, padded cycling shorts can trap sweat and moisture, creating an ideal breeding ground for bacteria. “The compression with cycling could be contaminating the urethra,” says Thomas W. Gaither, MD, the study’s lead author and an assistant professor of urology at the University of California in San Francisco. To mitigate this risk, Dr. Gaither recommends drinking plenty of water before and after cycling.
3. Taking Certain Drugs
Some medications — including antihistamines, antipsychotic drugs, decongestants, and anticholinergic drugs — can cause urine retention. Many of these drugs work by blocking specific nerve signals, which inadvertently relaxes the bladder muscles and makes it difficult for them to contract and fully expel urine. Recent research also shows that common blood pressure medications, specifically calcium channel blockers such as amlodipine, can similarly inhibit bladder smooth muscle contraction, leading to urinary retention. Furthermore, immunosuppressive drugs (such as prednisone or tacrolimus) are strongly associated with urinary tract infections because they reduce the body’s natural immune defenses against invading bacteria. That doesn’t mean you should stop taking these medications, Dr. Rabin says. Just be aware of the added risk, drink plenty of water, and try to empty your bladder completely when you urinate to reduce the risk of infection.
4. Wiping the Wrong Way
There’s a reason your mother taught you to wipe from front to back after using the bathroom: Going in the opposite direction can help bacteria travel from the anus to the urethra and into the bladder, Dr. Rabin says. In fact, a recent cross-sectional study found that roughly 44 percent of people assigned female at birth wipe by reaching from the front between the legs. Researchers note that this wiping style is associated with an increased risk of UTIs, particularly among people ages 40 to 59.
5. Going Through Perimenopause or Menopause
As estrogen levels drop with age, individuals going through midlife transitions often experience thinning and drying of the tissues in the vagina and bladder. This hormonal shift also directly impacts the area’s natural defenses. Estrogen normally supports the growth of protective lactobacilli (good bacteria) that keep infection-causing pathogens in check, but menopause causes these helpful bacteria to naturally decline.
At the same time, pelvic nerves and muscles may not function as well. Bladder contractions tend to become less forceful with age, which can cause difficulty emptying the bladder fully, Rabin says. These changes can, in turn, foster bacterial growth, increasing the risk of UTIs.
6. Having Diabetes
Urinary tract infections are the most common bacterial infection seen in people living with diabetes. A recent study found that nearly 40 percent of individuals with the condition have experienced a UTI, and those assigned female at birth face a significantly higher risk. Adding insult to misery, UTIs tend to be more common, more severe, and harder to treat in people with type 2 diabetes. This is partly because high blood sugar causes excess sugar to be excreted in the urine, which encourages bacterial growth. A weakened immune system and impaired bladder emptying due to diabetes-related nerve damage can also leave urine in the bladder for too long, promoting infection.
7. Wearing Little Lingerie
Wearing a thong, a teddy, or string-bikini underwear may make you feel sexy, but it can trap bacteria in the vaginal area and compress the sensitive tissue there, making you more susceptible to vaginal infections and UTIs. “There are only a couple of inches of space between the openings to the urethra, the vagina, and the rectum,” Rabin notes. “Tight underwear can act as a superhighway for bacteria from the anus to travel to the vaginal area.”
