When speaking about urinary tract infections, we usually speak about bacterial infections. Fungi (a.k.a yeasts or mold) are different organisms from bacteria and they can cause infections such as thrush in some parts of the body. Fungal infections in the vagina for example are a well-known condition. But can there also be fungal infections in the urinary tract?
Last week I had a look at how hormones affect the urinary tract. Changes in the female hormones oestrogen and progesterone and even the ‘male’ hormone testosterone appear to affect urinary tract symptoms.
Oral contraception affects hormone levels in the body and may therefore also affect urinary tract symptoms.
Other contraception may not affect hormones but may have an impact on the urinary tract in other ways.
Today I would like to take a look at what we know about different forms of contraception and bladder health.
Today I’d like to take a closer look at the role of hormones on bladder health. Hormones have been known for a while to play a role in lower urinary tract symptoms such as UTIs, interstitial cystitis and stress incontinence. Hormones may be the reason why women generally seem to be more prone to bladder problems than men and also why some symptoms may get worse at certain times of the month.
There is new(ish) evidence emerging that recurrent UTIs, also known as chronic cystitis, are not always caused by a reinfection with a new pathogen but rather can be a relapse of the same pathogen.
It turns out that pathogenic bacteria have the ability to invade the cells of the bladder and live there in a dormant sleep-like state.
This is called an ‘intracellular bacterial community’.
In this state, the bacteria remain undetected by standard urine testing and unaffected by antibiotic treatment. They also remain undetected by our own immune system.
Now and again they can leave the cells, causing a relapse of the urinary tract infection.
In last week’s post I talked about the urinary microbiota – the bacterial communities that have recently been discovered to be present in the urinary tract.
We know now that microbes that live in and on our bodies play a crucial role in health and illness. There are friendly and pathogenic microbes (bacteria, fungi etc.) plus opportunistic microbes that can become pathogenic when left unchecked.
When the delicate balance of good vs bad microbes is disturbed we become prone to an array of health conditions and infections. This is called a ‘dysbiosis’.
The so-called GAG layer plays an important role in protecting the bladder lining (epithelium) against anything that enters the bladder.
When this protective layer is disturbed, the sensitive bladder lining is exposed to irritation and attack. From this, sensitivity, pain and other problems can arise.
A damaged GAG layer has been established to play a big role in the pathogenesis of interstitial cystitis.
Overactive bladder (OAB) is not a condition as such but rather a group of urinary symptoms defined by a problem with bladder storage where the bladder muscle (detrusor) contracts too often or spontaneously and involuntarily. It often includes, and is therefore closely related to, incontinence.
There is a reported incidence of OAB ranging between 12-17% in Europe alone and a suggested 1 in 6 people is suffering from symptoms in the UK. The incidence of OAB increases with age but should not be accepted as a normal part of the ageing process.