Key takeaways
Chronic stress can weaken the immune system, increasing the likelihood of developing UTIs.
Stress-related behaviors, such as neglecting hydration and hygiene, smoking, drinking coffee, and consuming alcohol, can elevate the risk of infection.
Stress can trigger urinary symptoms that mimic a UTI but may not necessarily indicate a bacterial infection. Stress management can help prevent UTIs and other health issues.
If you’ve ever had a urinary tract infection (UTI), you know how fast you can go from feeling perfectly fine to downright miserable. UTIs are a common but brutal women’s health issue, causing symptoms such as a sharp burning sensation that tortures you every time you pee, an urgent need to urinate, or constant pelvic pain.
A UTI occurs when bacteria enter the urinary system and travel to the kidneys, bladder, ureters, and urethra. As the bacteria spread and multiply, the urinary tract becomes inflamed and infected, says Carly Ross, MD, a board-certified OB-GYN at Cooper University HealthCare in New Jersey and advisor to Winx Health. “The majority of the time, the bacteria in question is E. coli, which typically lives harmlessly in the intestinal tract but becomes an irritant if it reaches the urinary tract,” explains Dr. Ross.
UTIs are commonly triggered by improper wiping, staying in a wet bathing suit too long, or excess moisture. Still, risk factors such as sexual activity and sexual intercourse, certain types of birth control (diaphragms, cervical caps, and spermicides), not urinating when you need to, and menopause affect their onset. Even stress can play a contributing role in the development of UTIs.
Can stress cause a UTI?
Stress doesn’t directly cause UTIs, says Kecia Gaither, MD, a board-certified OB-GYN maternal-medicine physician and Director of Perinatal Services/Maternal-Fetal Medicine at NYC Health + Hospitals/Lincoln in the Bronx. However, she says that it can trigger abnormally elevated levels of cortisol, which has a significant impact on immune function.
During periods of high stress, the nervous system releases cortisol, an adrenal hormone that regulates the body’s fight-or-flight response. While cortisol can be advantageous in the short term by providing you with extra energy, prolonged exposure to elevated cortisol levels from chronic stress can impair the immune response, leaving the body more vulnerable to viral and bacterial infections.
Moreover, psychological stress often leads to behaviors that can put you at higher risk of a UTI, like drinking coffee, consuming alcohol, and smoking, says Faina Gelman-Nisanov, MD, FACOG, a board-certified OB-GYN at North Jersey Gynecology in Oradell, New Jersey. Individuals exposed to ongoing stressors may also overlook essential hygiene practices, reduce their fluid intake, or postpone urination, all of which can create an environment conducive to infection.
RELATED: What causes UTI? | UTI Symptoms
Stress-related urinary symptoms
Under stress, people may encounter a variety of urinary symptoms that mimic a UTI, such as increased urgency or frequency of urination, says Dr. Gaither. These stress-induced urinary symptoms can be particularly intense for those who already have health conditions like overactive bladder or interstitial cystitis (IC), both of which are sensitive to emotional and psychological changes, says Dr. Ross.
Overactive bladder is a condition causing you to experience a sudden and intense urge to pee, explains Dr. Ross. She says that stress tends to heighten muscle tension, including excluding those in the bladder and pelvic floor, which can worsen these symptoms.
Interstitial cystitis (bladder pain syndrome) is a chronic condition that causes lower urinary tract symptoms (affecting the urethra and bladder) like pain, pressure, and frequent/urgent urination, says Dr. Ross. She emphasizes that there are many questions about this condition’s root cause; however, it may be attributed to inflammation of the bladder wall, abnormalities in the bladder lining, and, in some cases, autoimmune abnormalities. Stress can aggravate IC symptoms such as inflammation and irritation. What’s more, Dr. Ross points out that pain tolerance is typically lower when you’re stressed, further heightening the chronic pain associated with this condition.
It is crucial to differentiate between stress-related urinary symptoms and bacterial UTIs, as they are not the same. While stress can amplify feelings of urinary discomfort, a bacterial UTI generally presents with distinct signs, including painful urination, cloudy or strong-smelling urine, and an overall sense of urgency. If left untreated, a UTI can cause fever, nausea, vomiting, and pain in the area of the kidneys.
RELATED: How long does a UTI last?
Managing stress to prevent UTIs
Dr. Gaither says that embracing lifestyle modifications that promote overall health and wellness can effectively combat high stress levels. They include:
- Eating a balanced diet full of lean proteins, whole grains, fruits and vegetables
- Staying hydrated, as drinking ample amounts of water helps flush out the urinary tract, reducing the likelihood of infection
- Prioritizing probiotics to support a healthy microbiome, strengthening the immune system
- Incorporating regular physical activity into your daily routine
- Getting adequate sleep (seven to nine hours)
- Engaging in relaxation techniques such as mindfulness, meditation, or yoga
- Seeing a therapist for mental health support
While some studies indicate that unsweetened cranberry juice may reduce the ability of bacteria to adhere to the walls of the urinary tract, it’s not recommended if you have interstitial cystitis. That’s because cranberry juice is acidic, and acidic foods and drinks can significantly worsen IC symptoms.
If UTI symptoms become severe, or you are experiencing pain with urination, blood in the urine, back pain, urinary incontinence, or fever, consult a healthcare professional for medical advice as it may have turned into a kidney infection, advises Dr. Gelman-Nisanov. They can provide potential treatment options or additional preventive strategies.
RELATED: Home remedies for UTI symptoms and treatment
The bottom line
Though it’s not a direct cause of UTIs, stress can affect urinary health and exacerbate conditions like overactive bladder and interstitial cystitis. Stress can contribute to a weakened immune system, making you much more susceptible to bacterial infections like UTIs. Addressing both physical and psychological sources of stress is vital to maintaining urinary well-being and preventing infections.
Sources
- Urinary tract infections, Office on Women’s Health (2021)
- Urinary tract infections, UCSF Health
- Cortisol, Cleveland Clinic (2021)
- Evidence for the impact of diet, fluid intake, caffeine, alcohol and tobacco on lower urinary tract symptoms: A systematic review, Journal of Urology (2018)
- Overactive bladder, Mayo Clinic (2024)
- Interstitial cystitis, National Kidney Foundation (2024)
- How sleep works, National Heart, Lung, and Blood Institute (2022)
- Probiotics mechanism of action on immune cells and beneficial effects on human health, Cells (2023)