Urinary Tract Infection is common in females. This is due to the close proximity of all the three orifices, urethra, vagina and anus, also the shorter length of the female urethra. More than 50% of the women will have at least, one UTI in their lifetime. 30-40% of UTI reoccur in 6 months. Signs and Symptoms are frequent urination, urgency, blood and pus in the urine, cramps in the lower abdomen, fever with chills, strong smelling urine, pain during urination, nausea and vomiting, back pain, pain in the flanks. The common organisms responsible for UTI are E. Coli, Staphylococcus, Pseudomonas, Klebsiella, Chlamydia, Enterococcus.
Causes of UTI, sexual intercourse, during which E. Coli from the anal area can get pushed into the urethra, and then into the bladder causing Cystitis. Diabetes, Pregnancy, use of irritative contraceptive agents like diaphragm or burning with the use of condoms, heavy use of antibiotics, use of birth control pills, urinary tract problems like stones, polyps tumors, in menopausal women where the estrogen is very less, leading to the dryness of the vagina and decrease the capacity of the bladder there by causing recurrent UTI.
Investigations asked for are, urine routine, microscopy, urine culture sensitivity, ultrasound on abdomen and pelvis.
Management is drink plenty of fluids, drink cranberry juice which inhibits the E. coli from adhering to the bladder. Take tablets containing cranberry and hibiscus extracts. Pro-biotic supplements which maintain the gastric tunnel track and immunity. Antibiotics are given based on the culture sensitivity. In post menopausal or peri-menopausal women, local estrogen creams are given to apply to the vagina or HRT is given to prevent urogenital syndrome.
Precautions to take care are urinate before and after the intercourse, drink plenty of fluids, use pH maintained feminine washes, take probiotics, wash from front to back after using the washroom because washing in the reverse directions can cause the bacteria to enter from the perineum into the urethral region.
Regarding the causes for delayed menses in a 28 day cycle when there is no penetrative intercourse, there can not be pregnancy as there is no deposition of sperms in and around the vagina. So, other causes of delayed periods have to be looked into. They are stress, lack of sleep, altering the reproductive hormones, short illness on antibiotics, painkillers, people on anti-depressants, anti-psychotic agents, PCOD, overweight, hormonal imbalances, intake of emergency contraceptive pills, new jobs or exercises, excess eating of cheese or drinking wine, vigorous athletic exercises or training, miscalculation of periods, breastfeeding mothers, anorexia, eating disorders, thyroid disorders, pro-lactate disorders, pituitary problems, menopause and puberty. Last, but not least, always do a urine pregnancy test and meet a gynecologist.