3 Common Urinary and Vaginal Pregnancy Problems

A guide to the symptoms, causes, diagnosis and treatments for urinary tract infections such as cystitis, thrush (candidiasis) and stress incontinence.
woman drinking water to help urinary tract infection during pregnancy
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While pregnancy brings many wonderful experiences it also, unfortunately, brings some negative ones too. Some of the most unfortunate possible side-effects of being pregnant are an increased risk for urinary tract infections, painful urination, yeast infections, and stress incontinence.

To help you navigate and understand the symptoms and risk factors related to these health problems, we’ve gathered information from healthcare professionals and put it all together in one go-to place for your reference.

To read more about other pregnancy symptoms, check out: 6 Symptoms of Pregnancy No One Tells You About.

Yeast Infections (Candidiasis)

During pregnancy, increased vaginal discharge is normal. However, if the discharge is creamy and thick and there is soreness and itching in your vaginal area, you may have a bacterial infection.

If you have a vaginal discharge with an odor, you could have trichomoniasis or bacterial vaginosis. According to the CDC, bacterial vaginosis is the most common vaginal infection in women ages 15-44.

While bacterial vaginosis is not an STD, it can increase your chances of getting one. Additionally, having sex increases your chances of getting BV because sex upsets the balance of hormones in the vagina.

BV can lead to preterm delivery or low birth weight if not treated with antibiotics. In addition, you are more prone to yeast during pregnancy, particularly during the third trimester.

Symptoms of Bacterial Vaginosis

  • A thin white or gray vaginal discharge
  • Pain, itching, or burning in the vagina
  • A strong fish-like odor, especially after sex
  • Burning or pain when urinating
  • Itching around the outside the genital area

Causes: A yeast infection is caused by a fungus called Candida albicans. The organism typically exists in small numbers in the intestines and vagina and doesn't cause problems. However, during pregnancy, the environment in the vagina changes, causing an overgrowth of the fungus. If you are under stress, generally feeling unwell, taking antibiotics, or have diabetes, you may be more likely to develop a yeast infection.

What to do: If you think you have a yeast infection, contact your OB-GYN, who can take a vaginal swab to confirm the diagnosis. Yeast infections can be harder to control during pregnancy and may take up to two weeks to cure. Wear cotton underwear and always wipe from front to back after a bowel movement to prevent additional infections.

The American College of Obstetricians and Gynecologists (ACOG) advises that a yeast infection may be treated by either a pill, cream, or gel applied directly to the vagina.

Urinary Tract Infections

During pregnancy, you're more susceptible to urinary tract infections. Most commonly, such infections are confined to the bladder, when they are known as cystitis. You must treat a urinary tract infection in pregnancy quickly because it could turn into a kidney infection, triggering preterm labor.

Sometimes UTIs can be present but cause no symptoms other than frequent urination, which is also a common symptom that begins in the first trimester and lasts throughout pregnancy. A urinary tract infection can only be treated with antibiotics, so it is crucial to call your doctor if you suspect you have one.

Your healthcare provider will perform a urine culture to test if you have a UTI. It is also possible your urine will show asymptomatic bacteriuria which is bacteria not related to a UTI and usually does not require treatment.

Symptoms of a UTI

  • Frequent urination or feeling like you need to go
  • A burning sensation while peeing
  • Cloudy urine
  • Urine that is pink or tinged with blood
  • Strong smelling urine
  • Pelvic pain

Symptoms of a Kidney Infection (pyelonephritis)

  • Blood or pus in your urine
  • Fever
  • Nausea, vomiting, loss of appetite
  • Pain in the abdomen or lower back
  • Fishy smelling urine
  • Cloudy urine
  • Burning feeling while urinating
  • Urgent or frequent urination
  • Fatigue

Causes: Urinary tract infections are caused by bacteria entering the body through the urethra (the outlet from the bladder) and multiplying. Such infections are probably more common during pregnancy because the effect of hormones on the urinary tract slows the passage of urine.

What to do: If you have any symptoms of a urinary tract infection, see your doctor right away. The doctor will take a mid-stream urine sample to identify the type of bacteria causing the infection. Your doctor may prescribe a seven- to ten-day course of antibiotics that are safe for both you and your baby.

To help prevent UTIs, avoid flowery soaps and bubble baths, wear cotton underpants, and always wipe from front to back.

Symptoms usually improve in a few days after the start of treatment.

Because some urinary tract infections are asymptomatic, all pregnant women have urine tests at prenatal doctor's visits, and if bacteria are found, appropriate antibiotics are prescribed.

You will also be tested for group b streptococcus in your third trimester during a routine prenatal visit. GBS is a common bacteria in the genital tract, but some pregnant women can pass this bacteria to their babies during birth. If it is determined you have GBS present your doctor will prescribe antibiotics during labor.

Pregnancy makes you prone to a lot of infections, and treating them isn't always easy. Learn how to deal with infections during pregnancy.

Urostasis and Urosepsis

Urostasis is caused when your enlarged uterus squeezes and presses on your ureters (the ducts from the kidney to the uterus that urine passes through). When urine gets left behind, it causes bacteria to grow, which in turn can cause painful urination during pregnancy.

Urosepsis is a sepsis infection that is a complication caused by a urinary tract infection and could be life-threatening if left untreated.

Symptoms of urosepsis include:

  • Back pain near the kidneys
  • Nausea with or without vomiting
  • Extreme fatigue
  • Reduced urine volume or no urine
  • Trouble breathing or rapid breathing
  • Confusion or brain fog
  • Unusual anxiety levels
  • Changes in heart rate, such as palpitations or a rapid heartbeat
  • Weak pulse
  • High fever or low body temperature
  • Profuse sweating

Stress Incontinence

Stress incontinence is when you unintentionally pass small amounts of urine, particularly when coughing, sneezing, or laughing, and when exercising or lifting heavy objects. Stress incontinence can happen at any time during pregnancy but is most common in the last trimester. It is also likely to continue after pregnancy as well, particularly when your bladder is full.

Causes: The pelvic floor muscles are under additional strain during pregnancy and are also affected by hormonal changes. Therefore any increase in abdominal pressure caused by coughing, sneezing, laughing, or other activities that put these muscles under pressure may result in leakage of a small amount of urine.

What to do: Stress incontinence can be embarrassing and distressing; however, you should mention the problem to your doctor, who will be able to advise you on Kegel exercises, which should help reduce the problem if you practice them regularly.

To help alleviate stress incontinence, try to use the bathroom whenever your bladder feels full. Stress incontinence is more common if this is your second or third pregnancy.

You may want to wear a sanitary pad for additional reassurance.

More: Managing Preexisting Conditions During Pregnancy

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