Chapter 54: UTIs and Sexism in Medicine

I saw this article last month about the treatment of UTIs (urinary tract infections) and I've been wanting to blog about it for awhile. Both men and women can get UTIs, but it happens more commonly in women and girls because we have shorter urinary tracts that are closer to the rectum than men's, making it easier for bacteria to infect the urinary tract.

UTIs can be very painful, with symptoms including painful and frequent urination, bloody urine, low stomach cramps and feeling the need to urinate despite having just gone.

The study of insurance information cited in the article found that nearly half of all women prescribed anti-biotics for a UTI were given the wrong anti-biotics to treat the infection. Additionally, 3/4 of those women were given anti-biotics longer than medically necessary. Longer treatments that surpassed clinical guidelines were more common in rural than urban areas. Overprescribing antibiotics is a leading cause of the growing problem of antibiotic resistance for many common infections. In the United States, someone dies every 15 minutes from a "super bug" that has become resistant to antibiotics.

"Inappropriate antibiotic prescriptions for uncomplicated urinary tract infections are prevalent and come with serious patient- and society-level consequences," said lead author Anne Mobley Butler, an assistant professor of medicine and surgery at Washington University School of Medicine in St. Louis, in a statement. "Accumulating evidence suggests that patients have better outcomes when we change prescribing from broad-acting to narrow-spectrum antibiotics and from longer to shorter durations," Butler said.

"Promoting optimal antimicrobial use benefits the patient and society by preventing avoidable adverse events, microbiome disruption, and antibiotic-resistant infections," she added.

I had a UTI after my laparoscopy for my endometriosis. It was my first one and I actually ended up at the urgent care because I thought I was dying. The doctor look one look at my lap scars and refused to consider anything else could be causing my abdominal pain except for endometriosis, so he discharged me. My nurse actually pulled me aside on my way out and said that she thought I had a UTI and urine tests indicated that I did, but the doc refused to listen to her. This was Friday night, and I had to wait until Monday to be seen at my primary care doc. She said it was clear that my urine indicated a UTI, so that asshole doctor at the urgent care made me suffer all weekend without meds for no reason.

This is frustrating for several reasons: 1. Left untreated, UTIs can turn into kidney infections, which are very serious. and 2. I have lived with endometriosis for 17 years. I know what it feels like. This pain was different and not at all in the same area as my normal endo pain. It felt different because it was different. But did my doctor ask me that? No.

So part of me can't help but to think that this general unconcerned attitude toward UTIs is so prevalent in the medical community because UTIs are often seen as a "female problem." However, as the study noted above, ineffective treatment not only hurts the patient, which is bad enough, but contributes to societial issues of creating anti-biotic resistent infections. So this "female problem" hurts us all. As a lawyer I have to complete a certain number of contiuning legal education classes a year. I know doctors do too. Perhaps some of them should be required to be women centered medicine to educate doctors on chronic women's health issues so that incorrect treatment doesn't continue.