Why Do I Keep Getting UTIs?

If you feel like you're constantly battling urinary tract infections (UTIs), you're not alone. 

Recurrent UTIs affect millions of women each year and can significantly impact quality of life. While an occasional UTI can be common, frequent infections may be a sign that something else is contributing to the problem. 

Understanding why UTIs happen and how to prevent them is the first step in treatment.

What Is a Recurrent UTI?

A recurrent UTI is generally defined as having two or more culture-proven UTIs within six months or three or more within one year. 

UTIs happen when bacteria enter the urinary tract and multiply. Common symptoms include burning with urination, urinary urgency, frequent urination, pelvic discomfort and sometimes blood in the urine.

Why Do UTIs Keep Coming Back?

Several factors can increase your risk of recurrent infections, including:

• Female anatomy, which allows bacteria easier access to the bladder
• Sexual activity
• Menopause and decreased estrogen levels
• Incomplete bladder emptying
• Kidney stones or urinary tract abnormalities
• Diabetes or weakened immune function
• Use of spermicides or diaphragms
• A history of previous UTIs

What Else Feels Like a UTI?

Sometimes what seems like a recurrent UTI may be a different condition, especially when urine cultures are negative. Overactive bladder, interstitial cystitis (painful bladder syndrome), genitourinary syndrome of menopause and vaginal infections can cause similar symptoms. That’s why it’s important to be evaluated for any underlying conditions.

How Are Recurrent UTIs Evaluated?

If you continue experiencing frequent infections, your health care provider may recommend additional testing to identify the underlying cause. This may include:

• Urine cultures to confirm the type of bacteria causing the infection
• Imaging studies if kidney stones or structural abnormalities are suspected
• Testing to see how well your bladder empties
• Cystoscopy in select cases to examine the inside of the bladder

The goal is to treat not only the infection but also any contributing factors that increase your risk.

Prevention Matters

The good news is that many recurrent UTIs can be prevented. Helpful strategies include:

• Drink plenty of water throughout the day.
• Avoid holding your urine for long periods.
• Urinate after sexual intercourse.
• Practice good perineal hygiene by wiping front to back.
• Avoid irritating feminine hygiene products, such as scented sprays or douches.
• Manage constipation, which can interfere with bladder emptying.
• For postmenopausal women, vaginal estrogen therapy may reduce the risk of recurrent infections when appropriate.

In addition, cranberry products, D-mannose supplements, methenamine, probiotics or preventive antibiotics may also be beneficial for some people. These options should always be discussed with your health care provider.

When Should You See a Specialist?

If you continue to have repeated infections despite treatment, experience blood in your urine, develop fever or flank pain, or your symptoms persist even when urine cultures are negative, it may be time to see a urogynecologist. 

Specialists can evaluate more complex causes of recurrent infections and develop a personalized treatment plan.