There are discomforts that women learn to live with. A sudden need to excuse yourself during meetings. A hesitation before long travel. The quiet, persistent worry of discomfort after urinating. These aren’t dramatic health events. They rarely demand urgent care. Yet over time, they begin to shape how women move through the world. Overactive bladder (OAB) and Urinary Tract Infections (UTIs) are among the most common urological issues affecting women, yet they remain on the fringes of public awareness. In India, where women’s health conversations still struggle for space, these conditions are rarely spoken of, let alone proactively addressed. The silence around them is not cultural alone. It is clinical, structural, and long overdue for disruption.
Current data shows that OAB symptoms affect over one in five women globally, with prevalence rising to 28 percent among those above 60. In India, this burden remains difficult to quantify because many women either ignore symptoms or manage them in isolation. UTIs show a similar pattern, impacting nearly half of all women at some point in their lives. Between 20 and 30 percent go on to develop recurrent infections. These numbers only hint at the wider toll on productivity, emotional well-being, and the quiet erosion of self-confidence that often accompanies chronic discomfort.
What drives these conditions in India?
In India, the interplay of multiple causes makes urinary disorders more complex and more likely to be missed. For OAB, common drivers include age-related changes in bladder muscle and nerve signals, hormonal shifts after menopause, obesity, diabetes, and pelvic floor damage from childbirth. Sedentary lifestyles, constipation, and chronic cough also add pressure on the bladder. In some women, especially younger ones, bladder irritants like caffeine, artificial sweeteners, or acidic foods can worsen symptoms.
UTIs are typically caused by bacteria entering the urinary tract. A shorter urethra makes women more vulnerable, and the risk increases with dehydration, poor genital hygiene, sexual activity without post-coital urination, certain contraceptives, and wiping practices that introduce bacteria. Among postmenopausal women, declining oestrogen alters the vaginal microbiome, weakening its natural defences. In low-resource settings, inadequate sanitation and limited access to toilets raise the risk even further.
The consequences of delay and dismissal
The burden of these conditions is compounded by a lack of awareness and the normalisation of symptoms. Many women delay medical attention or rely on home remedies and over-the-counter antibiotics, which often fail to address the root cause. In the case of UTIs, this can increase the risk of antibiotic resistance. In clinical practice, it is not uncommon for women to seek help only after months or even years of symptoms.
For many, the problem starts with frequency-needing to urinate far more often. Others experience leakage or urgency that disrupts daily life. Those with recurrent UTIs may face a dull pain, burning sensation, or persistent fatigue. Individually, these symptoms might not appear alarming. But their collective impact over time can reshape lifestyle choices, restrict mobility, and contribute to broader health decline.
Treatment is progressing, but gaps remain
The treatment landscape has evolved, but awareness has not kept pace. Newer medications such as beta-3 adrenergic agonists are gradually replacing older drugs, offering better outcomes and fewer side effects. Use of these medications has increased significantly in recent years. For more complex OAB cases, interventions like botulinum toxin injections and sacral neuromodulation are showing promising results. In the case of UTIs, moving from generic antibiotic use to culture-specific treatment is becoming essential, especially given the growing concern around resistance. Antibiotics should only be changed after a urine test confirms the need for a different medication. Medication alone does not close the loop. Pelvic floor exercises, bladder retraining, hydration, and dietary changes are proven to help-but without sustained follow-up, accessible guidance, and patient awareness, they rarely become part of long-term care. These gaps remain common across both public and private healthcare settings.
When two conditions overlap
The link between OAB and UTIs also deserves closer attention. The two conditions often coexist yet are diagnosed and treated in isolation. For postmenopausal women, where age-related changes affect elasticity, flora, and immunity, this combination can quickly spiral into a chronic cycle if left unaddressed.
A call for preventive focus
Ignoring these signs comes at a cost. In older women, urinary issues are tied to a higher risk of falls and hospitalisation. In younger women, they quietly influence work, intimacy, and confidence. And across generations, self-treatment or delayed diagnosis only makes recovery harder.
There is an urgent need to reposition urinary health as part of routine preventive care. This includes asking the right questions during gynaecological consultations, making urological care accessible to women outside metropolitan regions, and creating public health communication that does not reduce urinary discomfort to an embarrassing topic. India’s ageing population and the rise in non-communicable diseases such as diabetes only sharpen the relevance of this conversation. These are not fringe conditions. Their prevalence, impact, and chronic nature demand greater visibility in policy, clinical practice, and everyday health narratives.
Tthe writer Dr Ramesh K, is a senior consultant, Urology at Apollo Hospitals, Chennai