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Why Do I Keep Getting UTIs?

A urogynecologist explains why they may be happening, and how to prevent them.

Photo credit: Getty Images

Q:

Why am I getting so many urinary tract infections? Over the past year, I’ve had four! It’s really frustrating because I’m doing all the things I’ve heard you’re supposed to do to prevent them, like emptying my bladder before and after sex, but nothing helps. What am I doing wrong?

Sincerely,

"In UTI Hell"

Dear In UTI Hell:

I’m very sorry you’re dealing with this problem. If you’re having chronic urinary tract infections (UTI), it’s important to have a doctor that you trust and feel comfortable talking to. Make sure you give your doctor a thorough history, which will enable them to uncover the reason for your chronic UTIs.

You’re right that emptying your bladder both before and after sex is one way to help prevent UTIs, but there are many other risk factors. Other common culprits include not showering after a workout and not changing out of a wet bathing suit. Staying in wet or sweaty clothes can make it easier for bacteria to grow and enter your urinary tract.

In addition, if you wear panty liners, make sure you change the pad frequently because the bacteria that collects on the pad could lead to a UTI. And wearing underwear that is too tight can restrict the amount of oxygen that’s getting to your vulva and urethra—making you more likely to get infections.

Even bad habits like waiting a long time when you have to urinate can make you more prone to developing UTIs. This is because when you’re holding your urine in, there’s a suction-like effect where you’re sucking vaginal bacteria into your bladder.

Also, when you don’t urinate as often as you should, your bladder can get stretched out. Over time, especially as you reach menopause, urine can get left behind in your bladder, where it is more likely to collect bacteria. The same thing can happen when you hover over a public toilet seat; the bladder just can’t empty as well as when you sit. That’s why I tell my patients to put paper down on the seat or carry toilet seat covers so that you can sit down and completely relax the pelvic floor muscles when you urinate; this allows your bladder to completely contract and squeeze out all the urine.

It’s also worth considering whether you are having frequent UTIs or if it’s really just one infection that hasn’t been completely treated, because the course of antibiotics wasn’t long enough. Also, if you’re having sex while you are still being treated for an infection, you can get re-infected because intercourse can irritate the base of the bladder and allow new vaginal or rectal bacteria to enter.

Another reason to talk to your doctor is that in very rare cases, frequent UTIs can be a sign of something more serious, such as polyps, kidney stones, or even a tumor in your bladder. Bladder tumors are very­ rare, but it is worth getting checked, if only for peace of mind.

“It’s also worth considering whether you are having frequent UTIs or if it’s really just one infection that hasn’t been completely treated because the course of antibiotics wasn’t long enough.”
Dr. Jill Maura Rabin, Urogynecologist
Dr. Jill Maura Rabin, Urogynecologist | Photo credit: The Well

Next Steps and Useful Resources

Published June 5th, 2018