Why Do I Keep Getting UTIs? A Doctor Explains How to Prevent Recurrent UTIs
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Health Concerns

Here’s Why You Might Be Having Frequent UTIs—And How to Prevent Them From Recurring

November 4, 2020

They’re certainly not the first topic of conversation you may want to discuss at a brunch table, but urinary tract infections, or UTIs, especially recurrent UTIs, are more common in sexually active, menopausal, and post-menopausal women than you’d think. It can be easy to confuse UTI symptoms with those of a bacterial or yeast infection or kidney stones, so it’s important to stay tuned in to what’s going on with your body. 

For some people, UTIs recur frequently and may be treated with antibiotics—which can actually cause UTIs to return down the line. Taking frequent doses of antibiotics can have negative implications for your gut health, too. Aside from antibiotics, there are a few more holistic options that can help keep UTIs from coming back. Read on to find out how to banish recurrent UTIs from your system for good. 

What is a UTI, and what are the symptoms?

The most common type of a UTI is simple cystitis, or a bladder infection, caused by bacteria such as E. coli that enter the urethra from the rectal area, says Katherine Nori Janosz, MD, FACP, a board-certified physician at Parsley Health. Typical red flag UTI symptoms include frequency of urination and burning during urination, pain and pressure in the lower abdomen, and occasional vaginal irritation. 

Burning and irritation of the vaginal area can also be symptoms of a vaginal bacterial infection (like bacterial vaginosis, also known as BV) or a yeast infection. If you’re seeing blood in your urine, that can be a symptom of kidney stones or a more serious bladder infection, so that’s something to call your doctor about immediately, Dr. Nori says. More complicated symptoms of a UTI that you should be aware of are a fever (typically above 99.9 degrees), chills, or fatigue, she adds. Certain people, like pregnant women, should be screened for UTIs regularly by their OB-GYN, even if they’re asymptomatic of an infection, Dr. Nori says. Also, anyone who is immunocompromised should report UTI symptoms to their healthcare provider right away. 

What causes recurring UTIs?  

Once you have one UTI, the probability of reinfection is higher. According to the National Kidney Foundation, 20 percent of women who get one UTI will get another. Of that group, 30 percent will get another infection, and 80 percent of the third group will have recurrences. Recurrent UTIs would mean more than two in six months or more than three in one year, says Dr. Nori. “Most of the time, it’s not necessarily that the infection didn’t clear the first time, but that the same type of bacteria has re-infected the bladder,” she says. 

Fighting off infections like a UTI requires a balanced immune system, which means a healthy mix of bacteria in the gut microbiome, as well as in the vaginal microbiome, says Dr. Nori. If you have a compromised immune system to begin with, it can be easier for bacteria, like certain strains of E. coli, to enter the urethra and populate the bladder. “One UTI can increase your risk for recurrent UTIs, because a compromised immune system may allow for lower levels of lactobacilli, a ‘good’ bacteria that can block E. coli’s ability to survive,” explains Dr. Nori.

Regular use of antibiotics can also change the bacterial composition of the gut and vagina, by killing off beneficial bacteria, causing an imbalanced microbiome, or gut dysbiosis, she says. In the gut, dysbiosis may result in unpleasant symptoms such as bloating, gas, constipation, or diarrhea. But, Dr. Nori says, dysbiosis can occur in the vaginal tract too, where it might cause irritation, pain, and discharge, and can also put you at risk for further infections. 

Other sexual health habits can also impact the vaginal microbiome. First of all, sexual intercourse itself can alter the balance of bacteria, says Dr. Nori, and can make it easy for bacteria to enter the urethra. This is why peeing after sex can help prevent UTIs, because it clears the urethra and reduces the risk for bacteria to enter the bladder. Other sexual health products may have a negative effect on the vaginal microbiome, especially those containing spermicides, like lubricants, diaphragms, and condoms. The primary chemical present in spermicides (often used with these products) can reduce the population of lactobacilli, which then allows E. coli to populate, Dr. Nori adds. 

How to prevent UTIs from recurring

If you have frequent recurring UTIs, it’s a good idea to see your primary care physician or a urologist to take a closer look at bladder function. Parsley Health doctors often diagnose UTIs and recommend preventative measures to keep them from coming back, Dr. Nori says. They’ll also work with you to support your immune system through nutrition, sleep, stress management, exercise, and more, which can help fend off UTIs.

There are some natural remedies for UTIs that aren’t necessarily guaranteed to stop a UTI in its tracks, but can prevent further infections from occurring. Here’s what you can do.

Support your microbiome with a probiotic.

Probiotics will help support lactobacilli, which naturally produce hydrogen peroxide, and act like a bactericidal to reduce E.coli,” says Dr. Nori. Also, if you’ve just finished a course of antibiotics, probiotics are going to be helpful to your GI and vaginal tract to repopulate healthy bacteria and balance your immune system, she adds. A recent study found that taking Lactobacillus probiotic supplements (which is also found in foods like most yogurts) could contribute to a healthy vaginal microbiome. 

Hydrate yourself properly. 

Make sure you’re regularly drinking a lot of fluids to avoid bladder infections and kidney stones. 

Pee when you need to pee. 

Holding your urine does not make for a healthy environment for the bladder; it’s important to get to the bathroom as soon as you can when you have the urge to go. The same goes for peeing immediately after intercourse, to ensure that bacteria can’t populate. 

Reach for these key supplements.

One supplement to try is D-mannose, a simple sugar that helps to interfere with the E. coli bacteria naturally, Dr. Nori says. “It can prevent the E. coli from binding to the bladder wall and replicating,” she adds. Cranberry (take a cranberry supplement, not a sugary juice, Dr. Nori says) is a natural UTI remedy you may be familiar with. Studies show that it’s not necessarily a cure-all UTI treatment, but can potentially prevent UTIs from recurring. Cranberry functions similarly to D-mannose in that it can interfere with the harmful E. coli bacteria’s ability to attach itself to the bladder wall, Dr. Nori explains. If you’re considering supplements, it’s best to work with a doctor who can determine the best doses for you and monitor your progress.

Use cotton products when possible.

Wearing cotton underwear will be best to reduce moisture and your risk of bacterial infection. If you menstruate, cotton or organic hygiene products are the best options to reduce irritation to the vaginal microbiome; you should also change the products regularly so that excessive moisture doesn’t build up.  

Keep the area clean. 

This may seem obvious, but be careful about wiping yourself from front to back, so that bacteria from the rectal area can’t enter the urethra or vaginal area. Avoid products like lubricants with spermicides or any chemicals that can alter your pH and therefore the vaginal microbiome.  

Do regular pelvic floor exercises. 

Your pelvic floor muscles could be weakened after giving birth and after menopause as well. Regularly exercising the pelvic floor muscles is key for bladder elasticity and overall bladder health. 

Avoid bladder irritants in your diet. 

The foods you consume can be irritating to the bladder, so it’s best to eat the following in moderation if you’re at risk for recurrent UTIs: foods that are high in sugar, coffee, alcohol, and acidic fruits like lemons, grapefruits, limes, and tomatoes.

Parsley Health is the only medical practice that leverages personalized testing with whole body treatments.

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