UTIs, dryness and incontinence: You don’t just have to ‘live with it’

Burdened by uncomfortable symptoms? There is help available…

Thought urinary symptoms were just a ‘normal part of ageing’? Think again. Whether it’s leaks, urgency, itchiness or down-there dryness, far too many women are shrugging off these frustrating symptoms, writing them off as simply ‘part of being a female’.

But the reality is, these problems shouldn’t be ignored and many are in fact, treatable.

Urinary incontinence, for example, is said to affect between 25 and 45% of women around the world. But, Ms Mittal Patel says that there are now more treatments than ever to help women regain control. 

“Urinary issues aren’t just annoying and embarrassing; they can have a huge impact on your sex life as well. There’s no need to suffer in silence anymore though. At London Gynaecology, we regularly help women who are feeling the strain of urinary symptoms that are affecting their confidence and also intimate moments,” says Ms Mittal Patel, Consultant Obstetrician and Gynaecologist, Urogynaecologist.

There’s no time like now, during this year’s Urology Awareness Month and World Sexual Health Day, to break the stigma, learn what’s normal and understand what can be done to help support your urinary and sexual health.

The causes of urological issues in women

There’s no denying that any odd or unusual symptoms down below can be alarming and often uncomfortable. 

Urinary Tract Infections (UTIs), infections of the urinary system, can cause lower tummy pain, dark/cloudy or bloody urine, high or low temperature and a burn-like feeling when you wee. They’re incredibly common, so much so that half of all UK women have experienced a UTI.

“Women are more likely to contract UTIs as they have a shorter urethra; the tube that carries pee out of the body,” says Ms Patel.

UTIs are usually caused by bacteria entering your urinary tract. Menopause, conditions such as diabetes,incomplete bladder emptying,constipation, pregnancy, sex and not drinking enough water can all increase your risk of UTIs.

Pelvic pain in the lower tummy is also a burden for a lot of women across a range of ages.

“This could be short and sharp or dull and heavy,” says Ms Patel. “Constipation, UTIs and infections can all lead to pain here as can female-specific health issues such as endometriosis or ovarian cysts. In more serious cases pelvic pain could be caused by ovarian cancer or womb cancer, however, if you’re experiencing pain, do keep in mind that both of these are rare.”

Urinary incontinence is another common problem for many females and one which isn’t defined by age.

“Stress incontinence is usually caused by the weakening of the pelvic floor muscles, which are used to stop your weeing. Urge incontinence on the other hand is usually caused by overactivity of the bladder wall which is made up of the detrusor muscles,” adds Ms Patel.

There is also overflow incontinence, which can be caused by an obstruction or blockage in your bladder, preventing it from emptying fully while total incontinence tends to stem from a problem that you were born with, a spinal injury or a fistula; a small hole between the bladder and a nearby area.

Ms Patel explains: “The chances of urinary incontinence are higher in certain groups of people. Women who have been pregnant and undergone a vaginal birth may be more at risk, as are women who are obese or who have a family history of incontinence.”

Age can also contribute to urinary problems, however it’s important to remember that incontinence is not an inevitable part of ageing.

“Leaking, urgency or discomfort may be common, but that doesn’t mean they’re normal,” says Ms Patel.

Menopause can exacerbate urinary incontinence.

“The natural decline in the hormone oestrogen can cause the pelvic floor to weaken. Plus,  it can lead to vaginal dryness, thinning tissues and even recurrent UTIs ” says Ms Patel.

Getting to know your vaginal microbiome

Just like your gut has a community of bacteria that helps with digestion and immunity, your vagina also has its own ecosystem known as the vaginal microbiome. This delicate balance is mostly made up Lactobacillus bacteria, which helps to guard against infections.

“When the vaginal microbiome is disrupted, by lifestyle factors for example or hormonal changes, there is a greater risk of infections such as UTIs,” says Ms Patel.

“We’re still learning a lot about the microbiome, but it’s another important element in protecting yourself from urological issues.”

Caring for your vaginal microbiome can involve avoiding harsh soaps, wearing breathable underwear, eating a balanced diet and even taking probiotics (good bacteria) targeted to supporting the microbiome.

How symptoms can affect your sexual health

Urinary issues don’t just make your day-to-day life uncomfortable. They can spill over into your intimate life too. 

UTIs and vaginal dryness can often make sex painful or uncomfortable, stripping away the pleasure from something that should be enjoyable and turning it into a source of stress. 

Ms Patel explains: “This can slowly chip away at a woman’s confidence, leaving them feeling self-conscious about their bodies or worried about triggering discomfort. It can also put strain on a relationship which can then lead to more stress.”

Research by Innovo has found that 23% of women have less sex because of their bladder weakness with one in 10 saying that it’s ruined their sex life completely and 30% admitting that menopause has impacted their sex life due to the accompanying incontinence.

“At London Gynaecology, our experts are on hand to offer advice and necessary treatments,” says Ms Patel.

When to see a urogynaecologist and the treatment options available

Ultimately, if you’ve been suffering from any urinary-based symptoms and they’re affecting your day to day life, then you must seek help.  When these symptoms linger, it’s a signal to seek medical advice. 

A urogynaecologist- a gynaecologist who specialises in diagnosing and treating female pelvic floor disorder – will help you to uncover the underlying cause and offer solutions.

At London Gynaecology, treatments are always personalised and tailored to your needs.

“Incontinence may be treated by assessing your fluid and caffeine intake; it may require losing weight, retraining your bladder  and/or it may be helped by pelvic floor training to help strengthen the pelvic floor muscles,” says Ms Patel.

We may also recommend certain medications or treatment, depending on your situation. 

Meanwhile, UTIs can be treated with a short course of antibiotics along with self-care advice to help reduce pain. If you suffer from recurrent UTIs, defined as having two UTIs in six months or three within 12 months, you may require different antibiotics and/or tablets to stop the infection from returning. 

If you’re in perimenopause or post menopause, a vaginal oestrogen treatment (in the form of a cream, gel, tablet or pessary) might also be recommended to help reduce vaginal dryness.

Ms Patel adds: “Remember, you don’t just have to ‘live with it’. You should be able to live comfortably and enjoy a happy sex life, without pain or the burden of ongoing urinary symptoms.”

“Peeing with a UTI was so painful – like razor blades”

Dr Chiara Board, scientist, women’s health advocate and founder of P. Happi, experienced recurrent UTI’s for decades.

“I got my first UTI from sex in 2011, when I was a student. I developed a really bad burning sensation, I was peeing all the time and it was super painful, like razor blades. I also had blood in my urine as well. 

Since that first UTI, I have had about 40 to 50 more.”

Sex was a really common trigger for Chiara as was taking baths. 

“I’d worry when I would go on trips or long journeys and I’d get stuck somewhere without being able to go to the toilet. I spent a lot of sleepless nights in hospital or A&E, feeling alone and a burden to others.”

Although some clinicians were helpful and understanding; others seemed annoyed and dismissive. So, frustrated with the lack of answers and concerned about antibiotic resistance and its side effects, Chiara began searching for effective, more sustainable microbiome solutions, exploring how its balance could influence infection risk and support women’s long-term health.She later went on to set up her own women’s health start-up.

I haven’t had a UTI for a long time. Keeping my microbiome protected, trying to stop bacteria from entering my intimate area and allowing the good lactobacilli in my urovaginal microbiome to thrive, has made a big impact. Generally, I just try to be healthy and ensure I feel protected and hydrated; whether that’s drinking plenty of water, peeing after sex or finding products and routines that help me take care of my intimate microbiome.”

Chiara’s story is a reminder of how women’s lived experiences can drive change. It’s inspiring to see patients taking challenges like recurrent UTIs and using them to push innovation and awareness in women’s health. But everyone’s story is different. At London Gynaecology, we share this commitment – our specialists take an individualised, evidence-based approach to urinary health, ensuring every woman receives care tailored to her needs.