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Recurrent UTIs in Women: Treatment & Prevention

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Recurrent UTIs in Women: Treatment & Prevention

writtenByWritten by: Andy Wong
Andy Wong

Andy Wong

Andy is the Chief Marketing Officer at PlushCare. He's passionate about advancing healthcare solutions and improving access to care via health technology.

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August 23, 2017 Read Time - 9 minutes

Recurrent UTIs in Women: Causes, Treatment, and Prevention

Urinary tract infections are incredibly common, occurring more often in women than men. Some studies suggest that 1 out of every 2 women will get a urinary tract infection at some point in their lives. Some will even suffer repeat infections for months or years on end. In fact, some studies suggest that 1 in 5 women get a second urinary tract infection, while others have to deal with recurrent UTIs throughout their lives.

As painful and uncomfortable as they are, urinary tract infections are generally not serious, and with prompt, proper treatment, they rarely lead to complications. Left untreated, urinary tract infections can cause some serious problems to your health. Let’s learn more about chronic and recurrent UTIs in women, what causes them, and some tips for preventing and managing them.

What is a Urinary Tract Infection?

Urinary tract infections describe any infection of any part of your urinary system. This includes:

  • Kidneys: A pair of organs lying at about waist level on either side of your spine. The kidneys help to remove waste and extra water from your blood and turn it into urine.
  • Ureters: These comprise two 10-inch tubes that drain urine from the kidneys to the bladder.
  • Bladder: The bladder is an organ that appears as a sac to store urine. Once the urine reaches a certain level in the bladder, you feel the urge to pee.
  • Urethra: The urethra connects the bladder to the outside of the body.

Any part of this system can be infected. Generally, the farther up the tract the infection is, the more serious the UTI. Most UTIs only affect the lower urinary tract, which comprises the bladder and urethra.

Symptoms of a UTI

While not all urinary tract infections cause noticeable signs or symptoms, and many older adults will often ignore symptoms of assume they are caused by something else. You should keep an eye out for:

  • A burning sensation when urinating
  • A constant need to urinate even if very little urine comes out
  • Urine that looks cloudy, red, bright pink, or dark
  • A strong smell in your urine
  • General fatigue or shakiness

Women in particular tend to experience pain in the center of the pelvis and pubic bone. The location of the infection can also cause other varying symptoms.

  • A UTI in the urethra (called urethritis) may also include more burning urination and discharge.
  • In the bladder, a urinary tract infection (called cystitis) can cause pressure in the pelvis, blood in your pee, and general discomfort in your lower abdomen.
  • An infection that has reached the kidneys (known as acute pyelonephritis) often leads to pain in the upper back and flanks, nausea, vomiting, chills, and shaking.

What Causes Urinary Tract Infections in Women?

In the broadest sense, UTIs happen when harmful bacteria enter your urinary tract, making their way up the urethra and spreading throughout the bladder. While the urinary tract has its own built in defenses to keep these bacteria out, they sometimes fail, leading to full blown infections.

In about 90 percent of uncomplicated urinary tract infections, the main infecting bacteria is Escherichia coli, which you may know better as E. coli. Normally found in the colon and around the anus, E. coli is best known for causing food poisoning, but the bacteria may move from the anus to the urethra from improper wiping after using the bathroom or via sexual intercourse.

With recurring or chronic bladder infections, the body may be invaded by a different type or strain of bacteria that is virtually untouchable by antibiotics and the immune system. These can travel back and forth between cells, reinvading your urinary tract and establishing a small colony of bacteria that is resistant to antibiotics.

Chronic infections also come as a result of changing the bacterial makeup in your vagina. These bacteria are sensitive and can be altered through the use of spermicides, antibacterial douches, and the regular use of certain antibiotics. Menopause comes with various fluctuations in a woman’s hormones, which subsequently causes alterations in vaginal bacteria.

Types of Urinary Tract Infections

Many doctors break UTIs into bladder and urethral infections for better understanding.

Bladder infections are almost always caused by E. coli. This bacterium is normally found in the intestines of humans and animals and is otherwise harmless. However, even microscopic bits of feces making it into the urinary tract can lead to bladder infection. This can occur during sex, when switching from anal sex to vaginal sex without cleaning beforehand. However, E. coli can also come from improper wiping and toilet water backsplash.

Urethral infections can also be caused by E. coli, but they may also come as a result of a sexually transmitted infection, including chlamydia, herpes, and gonorrhea. Sexually transmitted infections very rarely cause bladder UTIs.

Urinary Tract Infection Risk Factors in Women

UTIs can happen to basically anyone, but some factors may increase your risk, including:

  • Diabetes, which compromises the immune system, preventing it from fighting off UTIs and other infections
  • Genetic disposition
  • Pregnancy
  • Multiple sclerosis
  • Kidney stones
  • Stroke
  • Spinal cord injury
  • Any condition that affects urine flow
  • Certain abnormalities in the structure of your urinary tract
  • Menopause, which reduces the amount of estrogen and makes the urinary tract more vulnerable to infection
  • Chemotherapy
  • Using a diaphragm, which can push on the urethra and prevent complete emptying of the bladder
  • Using any sort of spermicidal lube, which can kill beneficial bacteria and change the pH balance in the vagina

Treatments for Simple Urinary Tract Infections

Antibiotics are the first line of defense for simple, or single case, infections. The type and dosage depend on the type of bacteria causing the infection and your general health. Some common antibiotics prescribed include:

  • Azithromycin
  • Ceftriaxone
  • Cephalexin
  • Ciprofloxacin
  • Doxycycline
  • Fosfomycin
  • Levofloxacin
  • Nitrofurantoin
  • Trimethoprim
  • Sulfamethoxazole

For post-menopausal women, your doctor may prescribe topical estrogen as a potential option for treatment.

Symptoms of the urinary tract infection generally go away within a few days of taking the antibiotics, but you should continue to take the full course of the medication as prescribed by your doctor.

Thankfully, antibiotics should help relieve any pain almost immediately. However, your doctor may also prescribe pain relievers that numb your bladder and urethra, thus reducing any burning during urination. These pain relievers commonly cause your urine to turn red or orange, so don’t be alarmed if your urine does change color even after taking medication.

Treating Frequent or Recurrent UTIs

If you experience more than 3 UTIs in one year, you should consult your doctor about treatment options for chronic UTIs. There are numerous special treatment options for recurring bladder infections, including:

  • Taking low dosages of certain antibiotics over a long term to prevent further infections
  • Single dose antibiotics designed to be taken after sex
  • Antibiotics taken for 1 or 2 days whenever UTI symptoms reappear
  • Vaginal estrogen therapy for postmenopausal women

Your doctor may also recommend at-home urine test kits. You don’t need a prescription for these kits, and they can be used to determine when you need to call your doctor. They can also show you if the antibiotics you’re using have effectively cured the infection.

More severe urinary tract infections may require a stay at the hospital where doctors can administer intravenous antibiotics.

Complications and Long-Term Outlook of Chronic UTIs

Women who suffer lower urinary tract infections rarely have to worry about further complications as long as they get them checked out promptly. Some potential complications include:

  • Kidney damage
  • Increased risk of delivering premature or low birth-weight babies
  • Sepsis, a life-threatening condition wherein bacteria enter the bloodstream

However, these complications are rare and often only occur when your urinary tract infection is left untreated. As uncomfortable and painful as UTIs are, their symptoms tend to go away immediately after treatment.

Keep an eye on your health and seek immediate treatment when you suspect the onset of another infection. The earlier you detect and treat an infection, the less chance of dealing with a more severe long-term problem.

Home Remedies for Chronic UTIs

While antibiotics and professional treatment are the way to go, taking some simple steps at home can help speed your recovery and improve the health of your urinary tract.

  • Drink plenty of water to dilute your urine and promote the flushing away of bacteria.
  • Use a warm heating pad on your abdomen to reduce discomfort and pressure on your bladder.
  • Until your infection is completely cleared up, keep away from drinks that can irritate your bladder. This includes alcohol, coffee, and any sugary drinks containing caffeine or citrus juice. These drinks can only add to your frequent need to urinate.

Cranberry juice tends to be the go-to drink for people suffering from a urinary tract infection. Some studies have found that cranberry products, including juice, tablets, and whole berries, offer properties to help fight infections. The red berry also contains certain tannins that keep E. coli from sticking to the walls of your bladder. However, some studies have also found inconclusive data regarding cranberries’ effectiveness against urinary tract infections.

There’s generally little harm in drinking cranberry juice. If you feel like it’s helping you cope with your UTI, go for it. Just watch the calories. Avoid cranberry juice if you are taking any medications that thin your blood.

Preventing Urinary Tract Infections

Of course, the best thing you can do is to try prevent UTIs from ever happening. While you can’t always zero in on factors that contribute to urinary tract infections, there are plenty of steps you can take to avoid them.

  • Don’t hold your pee. Empty your bladder as soon as you need to go. Don’t rush, but do make sure you’ve completely emptied your bladder.
  • Avoid feminine hygiene sprays, scented bath products, and scented douches, all of which can increase irritation.
  • Wear cotton underwear and loose clothing. Nylon underwear and tight jeans will only trap moisture, promoting potential bacterial growth.
  • In the bathroom, wipe from front to back to prevent bacteria entering your urethra.
  • Wash your genital area after sex.
  • It’s also a good idea to pee immediately after sex. This flushes out any bacteria that may have entered your urethra.
  • Take showers instead of baths.
  • Reconsider your birth control method(s). As effective as diaphragms are, they can potentially contribute to bacterial growth. Unlubricated condoms and spermicidal lubes can cause irritation, increasing the risk of urinary tract infection.
  • If necessary, use lubrication during sex.

If you experience any symptoms of recurring bladder infection, call or book online with PlushCare to set up a phone appointment with a top U.S. doctor today.


PlushCare is dedicated to providing you with accurate and trustworthy health information.

Mayo Clinic. Urinary Tract Infection (UTI). Accessed September 20, 2019 at

Urology Care Foundation. What is a Urinary Tract Infection (UTI) in Adults?. Accessed September 20, 2019 at

Medline Plus. Urinary Tract Infections. Accessed September 20, 2019 at

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