Kidney stones are often thought of as a condition that affects men. And while it is true that men have historically been more likely to develop them, this perception can leave women unaware of their own risk – and less likely to recognise the symptoms when a stone does occur.
The reality is that women do get kidney stones, and the gap between male and female incidence is narrowing. Understanding why they develop, how they may present differently in women, and what can be done to prevent them is important for anyone with concerns about their kidney health.
How common are kidney stones in women?
Around one in ten people will experience a kidney stone at some point in their lifetime, and women make up a significant proportion of that figure. Historically, men were roughly twice as likely as women to develop stones, but research over recent decades has shown that female incidence has been rising steadily – particularly among younger women.
This shift is largely attributed to changes in diet, rising obesity rates, and the growing prevalence of type 2 diabetes and metabolic syndrome, all of which are risk factors for stone formation that affect women and men equally.
Women between the ages of 30 and 60 are most commonly affected, although stones can develop at any age. Postmenopausal women face a particularly notable increase in risk, for reasons closely tied to hormonal changes – discussed in more detail below.
Why do women develop kidney stones?
Kidney stones form when certain minerals and salts in the urine become so concentrated that they crystallise. The same underlying mechanisms apply in women as in men – inadequate hydration, a diet high in salt or oxalate-rich foods, and an imbalance in stone-promoting versus stone-preventing compounds in the urine can all contribute.
However, there are a number of factors that influence kidney stone risk specifically in women.
The role of oestrogen
One of the most important protective factors for women before menopause is oestrogen. The hormone helps maintain higher urinary citrate levels – and citrate is a natural inhibitor of stone formation, as it binds to calcium in the urine and prevents crystals from forming. It also keeps urine less acidic, which reduces the risk of uric acid stones.
After the menopause, oestrogen levels fall significantly. As a result, urinary citrate tends to decline and the risk of kidney stone formation increases. This is why postmenopausal women experience stones at rates approaching those seen in men of a similar age.
Urinary tract infections (UTIs)
Women are substantially more likely to develop urinary tract infections than men, due to the shorter length of the urethra. This matters in the context of kidney stones because certain bacteria – particularly those that produce the enzyme urease – create conditions in the urinary tract that encourage the formation of struvite stones, also known as infection stones.
Struvite stones can grow rapidly and to a significant size, sometimes causing few symptoms until they are well established. Managing recurrent UTIs effectively is therefore not just important for infection control – it can also reduce the risk of this specific type of stone.
Pregnancy
Pregnancy brings unique physiological changes that can affect the risk of kidney stones. The kidneys filter more blood during pregnancy, which increases the amount of calcium excreted in the urine. At the same time, the growing uterus can compress the ureters, slowing the drainage of urine from the kidneys and creating conditions more favourable to crystal formation.
Kidney stones during pregnancy are relatively uncommon, but they are the most frequent non-obstetric cause of hospitalisation in pregnant women. The symptoms – particularly flank or side pain – can also be difficult to distinguish from other pregnancy-related discomforts, making a specialist assessment important if kidney stones are suspected.
How do symptoms present in women?
The hallmark symptom of a kidney stone is renal colic – a severe, cramping pain that typically starts in the flank (the side of the body, beneath the ribs) and radiates towards the lower abdomen or groin. This pain is caused by a stone moving through the ureter, the narrow tube that connects the kidney to the bladder.
Other symptoms include:
- Blood in the urine, which may appear pink, red, or brown
- A burning sensation or pain when urinating
- A persistent urge to urinate, or passing urine more frequently than usual
- Nausea and vomiting, often accompanying severe pain
- Fever and chills, which may suggest an associated kidney infection
In women, the pain pattern of a kidney stone can occasionally be confused with gynaecological conditions – including ovarian cysts, endometriosis, or pelvic inflammatory disease – particularly when the pain is felt in the lower abdomen or pelvis.
This means that in some cases, a kidney stone diagnosis may take longer to reach, which underlines the importance of thorough investigation when symptoms are not fully explained.
If you have a fever alongside kidney pain, seek urgent medical attention. A blocked, infected kidney is a serious complication that requires prompt treatment.
Are there any differences in stone types between men and women?
The most common type of kidney stone – calcium oxalate – affects both men and women in roughly similar proportions. However, women are more susceptible to struvite stones, given their higher rates of UTIs. Uric acid stones, more commonly associated with high-protein diets and gout, are seen more often in men, though they are not exclusive to them.
How are kidney stones in women treated?
Treatment depends on the size and location of the stone, the severity of symptoms, and whether there is any sign of obstruction or infection. The options available to women are the same as those available to men:
- Conservative management: Small stones (typically under 5mm) may pass on their own with adequate fluid intake and pain relief
- Ureteroscopy and holmium laser fragmentation: A minimally invasive procedure performed under general anaesthetic, where a small telescope is passed into the urinary tract to locate and break up the stone with a laser
- Extracorporeal shock wave lithotripsy (ESWL): A non-invasive treatment that uses focused shock waves to fragment the stone from outside the body
- Percutaneous nephrolithotomy (PCNL): Reserved for larger or more complex stones, involving a small incision to access the kidney directly
In pregnant women, treatment decisions are made with particular care to avoid radiation exposure and anaesthetic risk, and a specialist team approach is essential.
Reducing your risk
The preventive measures for kidney stones are broadly the same for women as for men, though there are a few considerations worth highlighting:
- Stay well hydrated. Aiming for two to three litres of water daily is one of the most effective preventive steps, helping to keep urine dilute and reducing the chance of crystal formation.
- Eat a balanced diet. Reducing salt, moderating animal protein, and being mindful of high-oxalate foods – such as spinach, nuts, and chocolate – can all lower risk.
- Treat UTIs promptly. Getting urinary infections treated quickly and thoroughly reduces the risk of struvite stone formation.
- Speak to your GP about the menopause. If you are postmenopausal and have experienced a kidney stone, it is worth discussing whether your hormonal status is a contributing factor as part of your overall management plan.
When to see a specialist
Any episode of severe flank or abdominal pain, blood in the urine, or a fever alongside urinary symptoms warrants prompt medical assessment. If you have had a kidney stone previously, the risk of recurrence is real – and a specialist can carry out the investigations needed to understand why stones are forming and how to prevent them.
At Urocare London, Consultant Urologist Mr Maneesh Ghei provides expert assessment and treatment for kidney stones in both men and women. With access to the full range of diagnostic tools and treatment options, he can create a management plan tailored to your specific circumstances.
