UTIs Across the Lifespan: Why They Happen and How to Stay Ahead of Them

Why UTIs Don’t Have a One-Size-Fits-All Story

For many women, a urinary tract infection feels like a familiar, frustrating part of life. But what most people don’t realize is that UTIs, and the reasons we get them, change over time.

What triggers a UTI in your 20s isn’t the same as what causes one after childbirth, in menopause, or later in life. The microbiome, hormones, and even daily habits all shift with age and so do the risks and symptoms that come with those changes.

“Your UTI story at 25 probably isn’t the same as it will be at 55 and understanding why can help prevent cycles of confusion, misdiagnosis, and frustration.”

Let’s take a closer look at how UTIs evolve across different life stages, what may be driving them, and how you can work with your healthcare provider to get clear answers at any age.

Early Adulthood: When Lifestyle and Microbiome Collide

In your teens and 20s, UTIs often show up during big life changes; new sexual activity, new birth control methods, or even lifestyle shifts like college or work travel.

Several factors make this stage uniquely UTI-prone:

• Increased sexual activity or new partners
• Use of spermicides or types of lubricants (which disrupt the vaginal microbiome)
• Dehydration and holding urine too long
• Overuse of antibiotics for “just-in-case” infections

At this stage, most infections are exposure- or behavior-driven, not related to underlying medical issues. But repeated antibiotic use can start to disrupt the balance of bacteria in the urinary and vaginal microbiomes, setting up a frustrating cycle of irritation and reinfection.

Testing considerations

Traditional urine cultures typically work well for straightforward infections that happen once a year and are caused by E. coli, but they can miss less common organisms like Enterococcus or Ureaplasma. Molecular tests, like PCR, can detect those but they may also find low levels of harmless bacteria that don’t require treatment.

The goal early on isn’t more testing, it’s clear testing. Make sure your provider confirms infection before starting antibiotics, to do this at a minimum a culture test should be run with bacteria identified as the culprit of your symptoms. A urinalysis or dipstick will show signs of inflammation or indicate an infection but it cannot confirm.

After a course of antibiotics, if symptoms come back, consider follow-up and monitor behavior for triggers resulting in symptoms as well as confirm what pathogen was identified with testing. If symptoms persist, recurrent UTIs are defined as two in six months or three in a year, even when culture results are negative it is even more important to explore the next level of testing or investigate behavior modification or urinary tract management options like Uqora.

Pregnancy and Postpartum: Hormones and New Vulnerabilities

Pregnancy

Pregnancy naturally increases UTI risk. Rising progesterone relaxes the urinary tract, allowing urine to sit longer in the bladder creating the perfect environment for bacteria to grow. The immune system also shifts to protect the developing baby, sometimes reducing the body’s usual infection defenses.

That’s why most providers screen for bacteria in the urine during prenatal care. Still, standard cultures can miss some organisms, especially if symptoms appear between checkups. While advanced testing methods like PCR can detect more species, their use in pregnancy should always be guided by a clinician as not every bacterial detection needs treatment, and overtreatment can also cause imbalance.

Postpartum

After childbirth, estrogen levels drop sharply. Add to that tissue healing, pelvic floor strain, and potential nerve sensitivity, and it’s easy to see how postpartum burning or urgency can be confused with a UTI.

In this phase, it’s important to differentiate between infection, irritation, and recovery-related inflammation. If discomfort persists beyond the initial healing period, testing that can check for a broader range of bacteria or confirm that none are present, this will greatly help guide the next step in care.

Perimenopause and Menopause: When Hormones Redefine the Urinary Tract

As estrogen levels decline, the bladder and vaginal tissues thin and lose some of their natural defense mechanisms. The vaginal pH rises, allowing less protective bacteria and more potential pathogens to grow. The result is that UTI-like symptoms become more common even when no active infection is present.

Many women experience burning, frequency, and urgency that mimic UTIs but are actually caused by Genitourinary Syndrome of Menopause (GSM) or vulvar atrophy. In these cases, antibiotics provide temporary relief at best, and sometimes make things worse by further disrupting the microbiome.

Testing considerations

Urine cultures can under-detect infections if bacteria are present at low levels, while molecular tests like PCR can sometimes over-detect nonpathogenic organisms. With advanced testing a benefit can be that a negative PCR result provides clinician supportive evidence that there are alternative approaches to explore to relieve the symptoms you are experiencing. The key is context and interpreting results in combination with symptoms, hormone history, and tissue health.

If you’re in perimenopause or menopause and symptoms persist despite antibiotics, talk to your provider about whether hormone therapy or vaginal health support may be more appropriate than more antibiotics.

Later Adulthood: The Role of Immunity, Mobility, and Microbiome Stability

As we age, natural changes in immunity and bladder function can make bacterial colonization (bacteria living harmlessly in the bladder) more common, especially in those with mobility challenges or chronic conditions like diabetes.

The tricky part is that older adults don’t always experience “classic” UTI symptoms like burning or pain. Sometimes, the first signs are fatigue, confusion, or sudden incontinence, which can lead to overdiagnosis and overtreatment.

Testing considerations

At this stage, both culture and PCR tests can detect bacteria, but not all detected bacteria require antibiotics. The challenge is distinguishing infection from colonization.

“A positive test doesn’t always mean infection,” Megan notes. “It takes a combination of test results, symptoms, and clinical judgment to make that call.”

Testing can still play a role — but interpretation becomes even more critical.

Across Every Life Stage: The Importance of Context and Clarity

Whether you’re 25 or 75, the same pattern repeats: symptoms, uncertainty, and treatment that may or may not help.

The real lesson across all life stages is that context matters. The same test or symptom can mean different things depending on where you are in your hormonal, reproductive, or immune journey.

No diagnostic test, whether culture or PCR, is perfect. Each has limitations:

• Cultures can miss hard-to-grow or mixed infections.
• Molecular tests (PCR or NGS) can detect bacteria that may not be clinically relevant.

That’s why it’s important to pair testing with symptom tracking, body awareness, and open dialogue with your provider.

“The right test at the right time makes all the difference,” Megan explains. “It’s not about testing more — it’s about testing smarter.”

Advocating for Yourself: Practical Ways to Stay Ahead

No matter your age, you can take proactive steps to understand your body and advocate for better care:

• Ask what type of test is being used — and what it can (and can’t) detect.
• Track your symptoms over time: note when they occur, what triggers them, and what helps.
• Bring test results from prior infections — patterns can reveal whether it’s recurrence or misdiagnosis.
• Discuss contributing factors like hormones, hydration, and sexual activity openly as they’re all part of the picture.

If you’re struggling with recurring symptoms that don’t match your results, consider exploring a test that looks at both urinary and vaginal health, such as MyUTI’s Complete UTI and BV Check Tests. These can help distinguish infection from imbalance, offering clarity for both you and your provider, but they’re most effective when paired with professional interpretation and a holistic plan.

The Bottom Line: Evolving Bodies, Evolving Care

UTIs may be a constant across a woman’s life, but the why behind them isn’t. Hormones, microbiome shifts, and life changes all play a role and understanding those shifts is the key to preventing unnecessary antibiotics, reducing recurrence, and improving comfort.

The most important takeaway? Stay curious about your symptoms. Ask for clarity, not just treatment. And remember: your body changes, but your right to clear, informed care never does.

“The more we understand how our biology evolves, the more confident we become in navigating it at every stage of life.”

This article was developed in collaboration between Uqora and MyUTI to help women understand how UTI risk and urinary health evolve throughout life, and how thoughtful testing and care can adapt along the way. Insights provided by Megan Henken, Co-Founder of MyUTI, an accomplished global marketing leader specializing in the area of women's health, urology and clinical diagnostics. Having personally experienced the impact of frequent UTIs, she is channeling her industry know-how to improve the lives of women & individuals caught in the cycle of frustrating UTIs.

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