Urinary Tract Infection and Osteoporosis in Women

Healthcare professionals usually encounter challenges to address the health conditions facing female patients. In light of the changing nature of today’s society, chronic and acute illnesses among women have become more prevalent. The prevalence of such illnesses is attributable to the unique health issues and conditions that women experience in their day-to-day life. While some of these health conditions affect men too, they are more severe among women. Given the unique health conditions, women experience chronic and acute illnesses that affect their overall health and wellbeing. Some of the chronic and acute health conditions affecting women include urinary tract infections and osteoporosis. This paper examines the management of these two conditions through comparison of common and non-traditional treatment modalities.
Urinary Tract Infection and Osteoporosis
A urinary tract infection is defined as an infection involving organs that create urine and carry it out of the human body (Harvard Health Publishing, 2017). Some of these organs or structures include ureters, bladder, kidneys, and urethra. Urinary tract infections are classified into two i.e. lower tract infections and upper tract infections. Lower tract infections are infections of the bladder that are commonly known as cystitis whereas upper tract infections are infections involving kidneys and ureters. While urinary tract infections affect both men and women, they are more common in women because they have short urethras that enable relatively easy movement of bacteria into the bladder.
On the contrary, osteoporosis is a condition that weakens the bones and enhances the risk of unexpected and sudden fractures. Such fractures emerge because the condition results in increased loss of bone strength and mass. In most cases, this condition progresses without pain or any symptoms. As a result, this condition is considered a silent disease that contributes to mortality and morbidity across the globe. According to Carbone et al. (2015), osteoporosis is a major public health issue, especially for women. Currently, the prevalence rates of osteoporosis among women in the United States is estimated at 10%. Postmenopausal women account for a significant percentage of women suffering from osteoporosis at 9.65% (Tian, 2017). It is estimated that 12.3 million people aged 50 years or more in the United States will suffer from osteoporosis by 2020 (U.S. Preventive Services Task Force, 2018).
It is estimated that the prevalence of urinary tract infections has increased by 70% over the past two decades. This prevalence has occurred across all age groups and racial/ethnic groups, especially in women (Carbone et al., 2015). Currently, at least one-third of adult women are reported to have experienced at least one episode of symptomatic lower tract infection at least once. In addition, between 10%-13% of women in the United States experience a urinary tract infection each year with a lifetime risk of 50% (Eells et al., 2014). As a result, urinary tract infections among women in the United States contribute to more than 6 million outpatient visits and 479,000 hospitalizations each year.
Treatment of these two conditions is critical because of their contributions to morbidity and mortality in the United States and around the world. Urinary tract infections among women not only affect their quality of life, but are linked with societal costs of treatment that exceed $2.46 billion each year (Eells et al., 2014). In addition, recurrent urinary tract infections have become a major problem in clinical practice. On the other hand, osteoporosis is a major contributor of common metabolic diseases and the major cause of mortality and morbidity in the elderly population.
Health Promotion and Screening
Public health professionals recognize the significance of treatment of urinary tract infection and osteoporosis among women. Consequently, the public health sector has adopted various initiatives to help prevent the prevalence of these conditions as well as treatment and management. Health promotion initiatives have involved health education initiatives that seek to educate women on the major risk factors for the condition, its associated complications, and prevention measures. Public health education initiatives toward prevention of osteoporosis include promoting suitable health behaviors and lifestyles among women. These initiatives educate the public on risk factors like age, smoking, body mass index, menopause age, duration of menopause, and educational level (Tian et al., 2017). Women are also educated on lifestyle factors such as alcohol consumption and smoking. Health promotion measures also include screening for the condition since early detection plays a major role in effective prevention and management. The screening is carried out through a bone measurement test known as central or peripheral DXA (dual-energy x-ray absorptiometry), which measure bone mineral density (BMD) (U.S. Preventive Services Task Force, 2018).
For urinary tract infection, health promotion initiatives are centered on educating the public on prevention measures as well as sensitizing women on risk factors. Women receive education on genetic factors and other factors that could influence the development of this condition. Through public health education, women obtain information on correlation between menopause and pregnancy and urinary tract infection. They are also encouraged to adopt suitable health behaviors to prevent the development of a urinary tract infection. Screening for this condition involves the use of an ultrasound exam or cystoscopy.
Diagnostic Tests
The prevalence of osteoporosis and urinary tract infections among women has contributed to the development and use of different diagnostic/screening tools. The diagnosis of urinary tract infections involves the use of an ultrasound exam, a computed tomography scan of the urinary system and kidneys and cystoscopy (Harvard Health Publishing, 2017). These tests are carried out to identify bacterial growth in the individual’s urinary system. The bacterial growth is in turn used as the premise for diagnosis of the condition. In addition, diagnosis involves blood tests that examine blood culture, especially for an individual with symptoms of an upper tract infection.
On the other hand, screening for osteoporosis involves the use of a bone measurement test known as central DXA and other tests like quantitative ultrasound and peripheral DXA. Central DXA measures bone mineral density at the hip and lumbar spine while peripheral DXA examines bone mineral density at the heel and lower forearm (U.S. Preventive Services Task Force, 2018). On the other hand, quantitative ultrasound is used to measure peripheral sites in order to determine the risk of fractures.
Common Treatment or Management Modalities
As the prevalence of osteoporosis and urinary tract infections continue to increase among women, there are some common treatment or management modalities used for these conditions. According to a publication by Harvard Health Publishing (2017), one of the common treatment or management modalities for urinary tract infections in this population is antibiotics. Healthcare providers tend to prescribe antibiotics for lower tract infections and upper tract infections depending on the results of laboratory testing. Uncomplicated lower tract infections in women are treated with a three-day antibiotics therapy. However, for pregnant women and those with other complications like diabetes, antibiotics are prescribed for a slightly longer period of time. For upper tract infections antibiotics are administered for period of 10-14 days. When hospitalized for severe upper tract infections, women are treated using antibiotics which are administered intravenously.
The treatment/management of osteoporosis involves the use of multiple drug therapies approved by the United States Food and Drug Administration. Some of the most commonly used drug therapies include raloxifene, estrogen, parathyroid hormone, and bisphosphonates. However, the decision on which therapies to administer is influenced by the patient’s clinical situation and trade-offs between the advantages and disadvantages of the drugs (U.S. Preventive Services Task Force, 2018). To help balance these trade-offs, healthcare providers educate the patient on how to lessen adverse impacts of the drug therapies through strategies like taking drugs with a full glass of water. The other treatment/management approach used for osteoporosis in women is hormone replacement therapy, which is carried out due to lack of estrogens after menopause (Khadilkar & Mandlik, 2015). This therapy entails the use of estrogens to increase lumbar spine and femoral neck bone mineral density. Additionally, treatment/management of osteoporosis in women involves the use of dietary supplements, particularly calcium and vitamin D (Carbone et al., 2015). These supplements are regarded as first-line therapy for the condition since they help prevent bone loss and osteoporotic fractures (Khadilkar & Mandlik, 2015).
Patient Education and Follow-up Needs
Patient education plays an important role in enhancing the effectiveness of treatment or management approaches used for osteoporosis and urinary tract infections. Patient education and follow-up are essential toward addressing patient needs and ensuring adherence with therapy and medication. Additionally, patient education and follow-up helps to assess the effectiveness of the recommended treatment approaches and need for any changes in the recommended treatment or management modalities.
Patient education needs for both osteoporosis and urinary tract infections are centered on medication adherence. Since drug therapies are the most commonly employed treatment or management modalities for the two conditions, ensuring medication adherence is critical toward enhancing patient outcomes and overall health. Medication adherence needs are critical when the prescribed drug therapies are for a longer period of time. Secondly, patient education and follow-up needs for two conditions also relate to lifestyle factors. The effectiveness of the treatment regimen for osteoporosis and urinary tract infections is affected by lifestyle factors, especially health-related behaviors. Therefore, health providers provide patient education and conduct follow-up to determine whether the patient has adopted desired health behaviors to enhance the effectiveness of the treatment regimen. For osteoporosis, patient education needs also include information on how to prevent the adverse effects of drug therapies. For urinary tract infections, follow-up is needed to prevent recurrent UTIs, which are a common problem in clinical practice (Eells et al., 2014).
Health Screening and Promotion Needs for Osteoporosis
One of the health screening and promotion needs for women across the lifespan in relation to osteoporosis is prevention measures. A critical aspect toward preventing the prevalence of this chronic illness is educating the public on prevention measures. In this regard, women across the lifespan should be educated on risk factors that contribute to the development of this condition and how to avoid these risk factors. Prevention measures help to lessen chances of development of the condition and play an important role in lessening its associated complications and morbidity and mortality. The need for prevention is not only for postmenopausal women, but also critical for young women. Postmenopausal women need to learn prevention measures for osteoporosis since they are at increased risks of developing the condition and account for a significant portion of women suffering from the condition. On the other hand, younger women also need to learn prevention measures because the condition not only occurs after menopause. Younger women should learn prevention measures as part of health promotion because osteoporosis is prevalent across the lifespan. Some risk factors contributing to the development of this condition are not related to menopause such as pregnancy and lifestyle factors like alcohol consumption. Therefore, by learning these factors, younger women engage in appropriate health-related behaviors, which lessens their likelihood to develop the condition.
Secondly, early screening is a vital health promotion and screening need for osteoporosis in women across the lifespan. Early detection play an important role in enhancing the health of women with this condition through promoting the use of a suitable management modality. There are numerous benefits associated with early detection of the condition, especially reduction of the risk of developing hip fractures (U.S. Preventive Services Task Force, 2018).
Traditional vs. Non-traditional Treatment Options
Traditional treatment option for urinary tract infections in women has involved the use of antibiotics while non-traditional treatment options include complementary and alternative medicine. Traditional and non-traditional treatment options for this condition are similar in the sense that they involve the use of some form of medication. While traditional treatment mostly entails use of antibiotics, complementary and alternative medicine include use of homeopathic products (Baars et al., 2019). In addition traditional and non-traditional treatment options focus on enhancing the health of the patient. However, these conditions differ with respect to drug resistance as there is evidence of increased resistance to antibiotics by the primary cause of uncomplicated urinary tract infections in women. On the contrary, homeopathic products in non-traditional treatment options face minimal resistance from this causative agent. Secondly, traditional treatment options focus on fighting the primary causative agent of UTIs while non-traditional methods provide additional benefits. Non-traditional methods like rhythmic lifestyle, mediation programs, mindfulness, and sauna visits help support general physiological recovery, which enhances overall recovery and helps to avoid recurrent UTIs (Baars et al., 2019).
For osteoporosis, traditional treatment (drug therapies) and non-traditional treatment (complementary and alternative medicine) focuses on reducing bone fracture and enhancing bone strength. However, these approaches differ in the sense that traditional treatment options use medication while nontraditional options promote management of the condition without using medication. Secondly, clinical and evidence-based practice exist to support the effectiveness of traditional options while there is no clinically significant evidence on the effectiveness of non-traditional treatment options for osteoporosis.
Collaboration with other Clinicians
Given the complexities associated with the two conditions, collaboration between members of the healthcare team is essential for best practice. Collaboration would entail identifying specific tasks and responsibilities to support patient care measures, establishing effective communication mechanisms, delegating roles, and demonstrating shared responsibility.
In conclusion, urinary tract infections and osteoporosis are some of the major health issues affecting women in the modern healthcare setting. These conditions are among the major causes of morbidity and mortality in women in the United States and globally. Given their prevalence and associated complications, their prevention, treatment and management has become critical in the modern healthcare setting. These measures play an important role toward health promotion. Traditional and non-traditional treatment options have been developed and are utilized in the management of urinary tract infections and osteoporosis to help improve patient outcomes and overall wellbeing.
References
Baars et al. (2019, February 3). The Contribution of Complementary and Alternative Medicine to Reduce Antibiotic Use: A Narrative Review of Health Concepts, Prevention, and Treatment Strategies. Evidence-based Complementary and Alternative Medicine, 1-29. doi: 10.1155/2019/5365608
Carbone et al. (2015, November). Urinary Tract Stones and Osteoporosis: Findings From the Women’s Health Initiative. Journal of Bone and Mineral Research, 30(11), 2096-2102.
Eells, S.J., Bharadwa, K., McKinnell, J.A. & Miller, L.G. (2014, January 15). Recurrent Urinary Tract Infections Among Women: Comparative Effectiveness of 5 Prevention and Management Strategies Using a Markov Chain Monte Carlo Model. Clinical Infectious Diseases, 58(2), 147-160.
Harvard Health Publishing. (2017, May). Urinary Tract Infection in Women. Retrieved from Harvard Medical School website: https://www.health.harvard.edu/a_to_z/urinary-tract-infection-in-women-a-to-z
Khadilkar, A. & Mandlik, R.M. (2015). Epidemiology and Treatment of Osteoporosis in Women: An Indian Perspective. International Journal of Women’s Health, 7, 841-850.
Tian et al. (2017, October). Prevalence of Osteoporosis and Related Lifestyle and Metabolic Factors of Postmenopausal Women and Elderl Men. Medicine, 96(43), doi: 10.1097/MD.0000000000008294
U.S. Preventive Services Task Force. (2018, June 26). Screening for Osteoporosis to Prevent Fractures – U.S. Preventive Services Task Force Recommendation Statement. JAMA, 319(24), 2521-2531.