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“Patronised and not believed”: the UK healthcare system is failing to treat women’s UTIs

Written by Amy Beecham

Research by Garmin finds 40% of young women say they have been accused of over-exaggerating symptoms of UTIs.     

While it’s clear that already strained services and a lack of funding contributed to the impact of the pandemic on the healthcare system, health inequality isn’t something that’s unique to Covid-19.

Instead, it’s often the result of commonly misunderstood, misrepresented and mistreated conditions that disproportionately affect women, such as polycystic ovary syndrome (PCOS), endometriosis and urinary tract infections (UTIs).

New research from fitness company Garmin, published by The Independent, found that 40% of young women say they have been accused of over-exaggerating symptoms of UTIs or being “overdramatic” about their wellbeing when seeing a doctor. 45% also said they’ve had their UTI symptoms written off as “part of being a woman”.

According to the Chronic Urinary Tract Infection Campaign (CUTIC),50% of all women will suffer at least one UTI episode in their lifetime, one third of these by the age of 24. 

“Statistics show that UTI is the most common infection seen by GPs,” CUTIC tells Stylist. “In fact, doctors are so familiar with UTIs that they are frequently dismissed as merely a woman’s problem, rooted in the ‘flawed female anatomy’.

“With little training in UTI management, GPs and urologists rely heavily on discredited laboratory tests which miss up to 60% of infections. This means they frequently tell their patients that they don’t have an infection and they should go home and ‘take paracetamol’. These women return to their GP again and again, they are retested using the same ineffective testing protocol, and are again told they are not suffering from an infection.” 

What are the symptoms of UTIs?

According to the Urology Foundation, the most common symptoms include an urgent or persistent need to urinate, a burning sensation when urinating, urine that looks cloudy, dark, bloody or has a strong odour, and pain in the lower stomach or back.

“Living with chronic or recurring UTIs can be distressing and debilitating and can have a significant impact on quality of life affecting self-esteem, work, social and intimate relationships,” a spokesperson for the foundation explains to Stylist.

UTIs are a common yet widely misunderstood medical condition

Why are UTIs so commonly mistreated?

“Many GPs place little importance on women’s symptoms and merely dismiss women as being ‘hysterical,’ or imagining it, when they explain the intense pain they are in,” says CUTIC. “This despite the fact that, in 2019, the British Association of Urological Surgeons agreed publicly that ‘the classic technique and microbiological threshold to diagnose a UTI may be inadequate as it was developed in the 1950s’.”

However, UTIs should not be trivialised. The Sepsis Trust estimates that up to 20% of sepsis cases are caused by UTIs.

“A significant number of women develop life-changing chronic infections,” CUTIC continues. “There are currently no guidelines for treating chronic UTI and GPs fall back on the NICE guidelines for acute UTI which have repeatedly failed these patients. Women are left in debilitating pain and told to ‘live with it’, prescribed anti-depressants, opioids or even referred for psychological therapy.

Current guidance for an uncomplicated UTI is three days of antibiotics. However, CUTIC says that 30% of patients will fail this guideline and potentially develop chronic, embedded bladder infections which can take years to treat. And despite a growing body of evidence, there remains limited understanding or even acknowledgment of this complex and painful condition by the medical community.

“The medical training for UTI diagnosis is inadequate and most doctors are not aware of the complexity of this illness. They are trained to accept the test results and look no further,” CUTIC suggests.

“It is clear from the recent government probe into menopause that women’s health has not been an area of priority. Conditions which primarily affect women are underfunded and under researched – this includes UTIs. Women are frequently patronised and not believed when they describe symptoms relating to UTIs, peri-menopause, menopause and vaginal atrophy. Medical training fails to include proper diagnosis and effective treatment for such conditions. Change is needed now.”

What to do if you have a UTI

“The first port of call is always the GP and if an infection is indicated on the tests, they will probably be given a three day course of antibiotics,” says CUTIC. “However, this will not be enough for 30% of sufferers.

If a woman suspects she has a UTI, but no infection is showing on her test results, she should get a referral to a chronic UTI specialist centre. Unfortunately, there are only a handful of private specialists and only one dedicated NHS specialist centre in the UK.”

“Discuss a referral with your GP if you have three or more UTIs in one calendar year, if you have blood in your urine or have recurrent infections with blood in your urine,” advises the Urology Foundation.

“Many women find it difficult to talk about UTIs or to seek support for what can be a painful and debilitating condition. This shouldn’t be the case. We need to be more confident, open and comfortable talking about UTIs. It is important that women talk to their GP, look at treatment plans and consider what they can do to help reduce their risk in the longer term.”

Images: Getty

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