Frequent, painful and urgent urination: Typical signs you may have a urinary tract infection (UTI). Maybe your pee is cloudy and foul-smelling, too. After a round of antibiotics, you feel better. But then a few months later, the symptoms return. What gives?
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Why do you keep getting these infections? And what does it say about your health?
“The good news is that’s it’s usually nothing too serious, especially if you are a woman,” says urologist Sandip Vasavada, MD. “We see recurrent UTIs in women of all ages,” he says. (Doctors classify UTIs as recurrent if you have three or four infections in one year.)
Older adults also are more prone to recurrent UTIs.
Men can get them too, but it typically means something is blocking urination, such as kidney stones or an enlarged prostate. “And UTIs in men aren’t usually recurrent,” Dr. Vasavada says.
Why are women and older adults more at risk?
E. coli or other bacteria cause UTIs, which are infections in your kidneys, bladder, ureters or urethra. Unfortunately, women are more likely to get them mainly because of their anatomy.
A woman’s urethra is shorter than a man’s and closer to the anus. The urethra is also close to the vagina, which can collect bacteria during sex. So bacteria from both the anus and vagina have easy access to a woman’s urinary tract.
Post-menopausal women are also at higher risk because pH changes in the vagina make it more susceptible to infection.
Both men and women are more likely to get UTIs as they age. Certain medical conditions, such as bladder prolapse in women and enlarged prostate in men, cause incomplete bladder emptying in older adults. Urine that stays in your bladder too long can encourage bacteria to grow.
“Some newer drugs for diabetes can also promote sugar in the urine and create conditions ideal for a UTI,” Dr. Vasavada adds.
Why do UTIs return despite treatment?
There are about a half-dozen oral antibiotics that treat UTIs. Sometimes a doctor will prescribe one drug, then switch to another after a urine culture identifies which bacteria is at work. Adjusting the medication can take time, and recurrent infections may occur in the meantime.
Sometimes a person starts to feel better and decides to stops taking the antibiotic — contrary to the doctor’s instructions — and another infection soon follows. It’s never a good idea to stop taking antibiotics before your dosage is complete.
“But even people who take medication as the doctor prescribes may get recurrent infections,” Dr. Vasavada says.
If you’re a younger woman who is sexually active, your doctor may prescribe an antibiotic to take before and after sexual activity. For post-menopausal women, a vaginal estrogen cream may help reduce infections.
If infections persist, your doctor may test for other health problems in the kidney, bladder or other parts of the urinary system.
Can I prevent recurrent UTIs?
There are steps you can take to help reduce UTIs. The most basic is to drink plenty of fluids. This encourages frequent urination and helps flush out bacteria.
For women, following good hygiene practices is especially important:
- After a bowel movement, wipe from front to back to reduce the chance of moving E. coli bacteria from the rectal area to the urethra.
- Pee immediately before and after sex.
- Don’t douche or use feminine deodorants on your genitals.
- Wear cotton underwear.
For older adults, take care to deal with “retention problems,” which are especially an issue as you age.
“I tell them to double-void — urinate and then go back and urinate again,” Dr. Vasavada says.
What about drinking cranberry juice to fight UTIs?
“That’s one of the most commonly asked questions,” Dr. Vasavada says. “There’s conflicting data. It’s not going to cure an infection, but it could help prevent one, so we don’t discourage it.”
Researchers estimate at least one-quarter of all women experience recurring urinary tract infections (UTIs). You’re diagnosed with recurrent UTIs when you develop two or more of these painful infections within six months.
UTIs cause a host of painful symptoms, and when not promptly treated, the infection can spread to other organs. The medical providers at Urgent Care of Ada, in Ada, Oklahoma, specialize in diagnosing and treating onetime and recurrent UTIs.
Many of our patients wonder why they keep getting UTIs, so we’ve put together this helpful guide explaining UTIs and how we can help.
Understanding UTIs
When any part of your urinary system gets infected, you have a urinary tract infection. Your urinary system includes multiple organs, including your kidneys, bladder, urethra, and ureters. Signs you may have a bladder infection include:
- Frequent urge to urinate, often urgently
- Feeling like you need to urinate after emptying your bladder
- Pain, pressure, or burning sensation when urinating
- Changes in the smell or appearance of your urine (e.g., bloody urine; cloudy urine)
- Pain in your lower back or abdomen
Your intestines naturally have Escherichia coli (E. coli), where it's beneficial to gut health. When E. coli gets into another part of your body through contact with other people, animals, or contaminated foods and water, you can get sick. E. coli in the urinary system causes the large majority (90%) of UTIs.
UTIs are easily treated with antibiotics. However, if you don’t get medical treatment, your UTI can spread to your kidneys. This causes a kidney infection, which is more difficult to treat and can trigger serious complications.
Causes of recurrent UTIs
Women are far more likely to develop UTIs than men because of the shorter distance between their rectum and urethra. And unfortunately, some women are more prone to developing UTIs than others.
Having a close family history of UTIs, like your sister or mother, also increases your risk as do other factors, including:
- Older age (after menopause because of changes in vaginal pH)
- Using some forms of birth control (e.g., diaphragms)
- Having health issues that make you more susceptible to infection
- Taking certain medications (e.g., some antihistamines and decongestants)
- Not urinating after intercourse or engaging in sexual activity
Women who don’t wipe from front to back after using the restroom or who use vaginal douches, scented feminine washes, or scented tampons and pads are also at higher risk of getting recurrent UTIs.
What to do about recurrent UTIs
At Urgent Care of Ada, your provider reviews your medical history, UTI history, and discusses any lifestyle factors that may trigger recurrent infections before creating a customized UTI treatment plan for you.
Though a simple course of antibiotics can clear a UTI, recurring UTIs may require more intervention. For example, taking a low-dose antibiotic for a long period of time (6-24 months) can sometimes help stop recurrent UTIs.
Based on your unique needs, your provider may also recommend taking an antibiotic every time you have sex or engage in sexual activity. If you’re in menopause, vaginal estrogen therapy can help restore the natural pH balance of your vagina and protect you from UTIs.
Your Urgent Care of Ada provider also reviews helpful lifestyle changes that work to prevent recurrent UTIs, such as urinating promptly after sex. Other lifestyle changes that can help include:
- Changing how you get clean: Wiping front to back, taking showers instead of baths, and washing your genitals and anus daily with soap help keep E. coli away from your urinary tract
- Urinate more often: Don’t wait when you get the urge to pee since holding it increases your risk of a UTI
- Stay hydrated: Water helps flush your urinary tract and keeps away harmful bacteria
- Trying cranberry: Some studies show natural compounds in cranberry offer protection against UTIs
Learn more about how we help prevent recurring UTIs by scheduling an appointment over the phone or online at Urgent Care of Ada. If you suspect you have a UTI, get same-day treatment by walking in at our urgent care clinic.
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