Kidney stones are hard deposits made of minerals and salts that form inside your kidneys. They develop when there is a decrease in urine volume or an excess of stone-forming substances in your urine. Small kidney stones may go undetected and be passed out painlessly in the urine. However, larger stones can become stuck in the urinary tract, blocking the flow of urine and causing severe pain or bleeding. About 1 in 11 people in the United States will get a kidney stone at some point in their life. Kidney stones strike men more often than women by a ratio of 2:1, with the first attack most likely to happen after age 40. However, women do get kidney stones, and they can cause a number of complications when they occur.
What are the symptoms of kidney stones in women?
The main symptom of kidney stones is severe pain that begins suddenly when a stone moves in the urinary tract and blocks the flow of urine. The pain often starts in the side and back, below the ribs. It then spreads to the lower abdomen and groin. Other symptoms of kidney stones can include:
- Pain that comes in waves and fluctuates in intensity
- Pain on urination
- Urgent need to urinate
- Cloudy or foul-smelling urine
- Nausea and vomiting
- Restless feeling and inability to find a comfortable position
- Pink, red or brown urine if blood is present
In women, kidney stone pain can often be confused with pain from other conditions such as ovarian cysts, ectopic pregnancy, miscarriage, endometriosis or pelvic inflammatory disease. However, the location, severity, and pattern of coming and going helps distinguish kidney stones from other issues. The pain usually starts suddenly and peaks within an hour without any warning signs. Women may need to see a doctor for an accurate diagnosis, which may involve blood and urine tests as well as imaging scans.
What causes kidney stones in women?
There are several factors that can increase the risk of developing kidney stones in women:
- Family or personal history of kidney stones
- Dehydration from low fluid intake
- High sodium diet
- Obesity
- High animal protein diet
- Certain medications like Lasix (furosemide)
- Underlying conditions such as hyperparathyroidism, kidney infections, renal tubular acidosis, inflammatory bowel disease or urinary tract infections
The most common type of stones in women are calcium oxalate stones. They form when there is too much calcium and oxalates (found in certain foods) in the urine. Other types of stones include uric acid stones, struvite stones and cystine stones. Hormonal changes during pregnancy and menopause can alter the levels of calcium, oxalate and uric acid in urine. So kidney stones tend to occur more frequently during these times. Recurrent UTIs are also a risk factor as they allow bacteria to produce enzymes that increase stone formation.
How are kidney stones diagnosed in women?
To confirm kidney stones as the cause of pain, doctors may recommend:
- Blood tests to assess kidney function and check for signs of infection or other conditions
- Urine test to look for blood, excess minerals and infection
- Imaging tests like CT scan, ultrasound, X-ray or MRI to locate the stone and check for blockages or other issues in the urinary tract
- Previous images may be reviewed if the patient has a history of kidney stones
Based on the stone’s size, location, and other factors, the doctor will decide on appropriate treatment options. Women who pass a kidney stone are advised to retrieve it and bring it for analysis. This helps determine the type of stone to better manage the condition.
How are kidney stones treated in women?
Small stones under 5 mm may pass naturally in the urine without needing intervention. Larger stones often require treatment, which may include:
- Pain Medications – Over-the-counter drugs like ibuprofen or prescription narcotics help manage pain and discomfort until the stone passes.
- Alpha blockers – These relax the ureter muscles and may help larger stones pass.
- Lithotripsy – Shock waves are targeted at stones via a wand placed over the skin to break them into smaller pieces that can pass easily.
- Ureteroscopy – A ureteroscope is passed into the urethra through the bladder to reach the ureter. Tools can capture stones or break them into fragments.
- Percutaneous Nephrolithotripsy – Instruments are inserted directly into the kidney through a small incision in the back to remove or break large stones.
- Surgery – Laparoscopy or open surgery may rarely be needed if other procedures are unsuccessful.
After stone removal, women need to drink plenty of fluids and may be given medication or dietary changes to prevent recurrence. Those with frequent kidney stones may need regular follow up and screening.
How does pregnancy affect kidney stones?
Pregnant women have a higher risk of developing kidney stones compared to non-pregnant women. Reasons include:
- Increased glomerular filtration – More calcium is filtered into the urine during pregnancy.
- Higher levels of estrogen – Increases the likelihood of developing uric acid stones.
- Altered urine composition – Changes occur in urine volume, pH and levels of stone-forming salts.
- Stasis – Occurs when growing uterus compresses ureters. This slows urine flow, allowing stones to linger.
- Hypercalciuria – Urinary calcium increases to support fetal bone development.
- Antacids containing calcium – Taken for heartburn and reflux during pregnancy.
However, some factors during pregnancy can inhibit kidney stone formation like increased hydration and urine citrate. Symptoms of kidney stones like pain and UTIs can be mistaken for normal discomforts of pregnancy. So diagnosis may get delayed, allowing stones to grow larger before treatment. Imaging tests have to be done cautiously during pregnancy to avoid exposing the fetus to radiation. Treatment is aimed at easing symptoms and allowing stones to safely pass until the baby is delivered. Surgery can lead to preterm birth and is avoided unless absolutely necessary.
Effects of kidney stones on pregnancy
Small stones that pass spontaneously usually don’t affect the pregnancy or baby. However, larger stones that block urine flow can lead to:
- Dehydration and electrolyte imbalances
- Infections like pyelonephritis
- Premature labor and delivery
- Preeclampsia
- Chronic kidney disease
- Pain and nausea causingpoor nutrition and weight loss
- Need for stent placement or nephrostomy tube
- Increased risk of C-section delivery
Prompt treatment is key to reduce risks to mother and baby. Women who have had kidney stones during pregnancy may need to be monitored for recurrence in future pregnancies. Staying hydrated, limiting sodium, reducing excess vitamin C intake and preventing UTIs can help lower risks.
Kidney stones during menopause
After menopause, women have an increased likelihood of developing kidney stones. Underlying reasons include:
- Lower estrogen causes osteoporosis and increased calcium in the urine.
- Reduced progesterone alters the balance of salts in urine.
- Lower citrate and increased uric acid in urine after menopause.
- Higher incidence of UTIs due to reduced vaginal estrogen.
- Use of hormone replacement therapy.
- Lifestyle factors like diet high in sodium, oxalates and animal protein.
Kidney stones from low estrogen can be recurrent and difficult to treat. However, the risks can be decreased by:
- Getting enough dietary calcium to prevent bone loss.
- Avoiding high sodium foods.
- Limiting animal proteins.
- Eating more fruits and vegetables high in citrate.
- Drinking plenty of fluids.
- Maintaining a healthy weight.
- Considering topical vaginal estrogen therapy.
Testing urine composition can help guide preventive steps. Medications like thiazide diuretics sometimes need to be adjusted after menopause as they can raise urine calcium. Women with recurrent stones may need specialized diets or medications based on the specific stone type.
Conclusion
Kidney stones can cause excruciating pain when they obstruct urine flow. Women face increased risks during pregnancy and after menopause due to hormonal changes. Small stones can often be managed with observation, pain control and hydration until they pass on their own. However, larger stones usually require interventions like lithotripsy, ureteroscopy or surgery for removal. Preventing recurrences involves dietary and lifestyle modifications. Pregnant women need specialized care to avoid harming the baby. By staying vigilant and seeking prompt treatment, the risks and complications of kidney stones can be minimized in women.