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.
Overactive bladder symptoms affect one in five women globally, while its prevalence is 28% among those above 60. In India, this burden remains difficult to quantify because many women either ignore symptoms or manage them in isolation, say doctors.
Urinary tract infections show a similar pattern, impacting nearly half of all women at some point in their lives. “About 20-30% 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,” said Dr K Ramesh, senior consultant of Urology at Apollo Hospitals, Chennai.
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 coughs 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,” Dr Ramesh said.
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. 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 than seems reasonable. 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,” Dr Ramesh added.
Dr V V Meera Ragavan,Consultant Urogynaecologist and Robotic Surgeon Apollo Hospitals Chennai said, UTI happens with frequent urination, burning or pain during urination, as well as low-grade abdominal pain in the lower part of the abdomen, sometimes low-grade fever with chills as well. “If you get loin to groin pain, it could be associated with ascending infection up to the kidneys or a stone complicating the urinary infection and it can lead on to sepsis as well. Sometimes blood and urine can also be noticed with urinary tract infection.”
UTI and OAB can have overlapping symptoms, however, overactive bladder is not associated with pain or burning sensation or fever because it is not due to bacterial infection. “Overactive bladder is common in women compared to men and because of the various hormonal and physiological changes,” Dr Meera added.
Women are more prone to overactive bladder because of their weight, pregnancy-related changes, hormone-related changes, especially lack of estrogen deficiency following menopause. The damage to the pelvic floor due to pregnancy and birth trauma also leads to leakage and overactive bladder, Dr Meera said.
Overactive bladder can be prevented by following certain lifestyle practices. Timing washroom visits every two to three hours enables the bladder to hold better, thereby reducing unprovoked over activity and prevents leakage. Avoiding caffeinated drinks, coffee, tea and fizzy beverages also reduce bladder over activity, Dr Meera said.
Reduction of even 5% weight loss can lead to improvement in 70% of these patients. Avoiding excess fluid intake after around 8pm also reduces night time frequency and urgency. “People who snore should get tested to see whether they are obstructing the airway pathway towards the brain, as reduced oxygen supply can be a perpetuating factor for overactive bladder,” added Dr Meera.