Elizabeth, a 35-year-old working mother and graduate student, has experienced three urinary tract infections (UTIs) in the past six months. When she started to have symptoms -- including the frequent urge to urinate -- Elizabeth set up a video visit with her physician; She told the doctor that she was "99.9% sure it's another UTI."
But, Elizabeth continued, she had been using prevention techniques that she found online -- like drinking cranberry juice. She wanted to know what else she could do to keep this from happening again.
Recurrent UTIs are when a woman has had two or more UTIs within six months, or three or more UTIs within a year. Having repeat infections is common: More than 80% of women who have one UTI will have another during their life.
And after a UTI, women can experience a relapse, which is a resurgence of the infection within two weeks of the original symptoms. More commonly, women can also experience reinfection, when a second UTI is caused by a completely new infection more than two weeks later.
Why do some people get more UTIs than others?
Risk factors that make UTIs more likely
- Being female
- Having a shorter distance from the anus to urethra (the opening where urine exits the body)
- Having a history of UTIs (especially in the past 12 months)
- Having a maternal history of UTIs
- Urinary tract abnormalities (such as kidney stones)
- For females, having passed menopause (due to changes to the microorganisms in the vaginal area)
- Having diabetes
- Having new sexual partners in the past year
- Having recent or frequent sexual intercourse
- Not urinating before or after sexual intercourse
- Using spermicide or spermicide-coated condoms
- Using a diaphragm
- Wearing non-cotton underwear
Bacteria are normally found both inside and outside the human body. But a UTI can develop when bacteria from the gut or skin travel up the urethra to the bladder where they multiply, causing an infection, explained Randall Stafford, MD, PhD. E. coli, regularly found in the gut, is the most common bacteria that causes UTIs.
Some women are more likely to get UTIs no matter what they do. However, some of the most powerful prevention techniques are actually very simple.
What can Elizabeth do to prevent her UTIs from recurring?
What to do -- to prevent UTIs
- Drink plenty of water to flush out bacteria
- Urinate every two to three hours
- Urinate before and after sexual intercourse
- Wipe front to back after urinating or defecating
- Manage diabetes
There are also things Elizabeth can avoid to reduce her chances of getting sick.
What not to do -- to prevent UTIs
- Don't use vaginal deodorants or douches
- Don't use diaphragms, spermicide or unlubricated condoms
- Don't hold urine in for long periods of time
- Don't remain in wet clothes or swimsuits
- Don't wear non-cotton underwear
As Elizabeth and millions of other women like her know, UTIs can be painful and inconvenient.
"The best way to deal with a UTI is to prevent it from happening in the first place," said Kim Chiang, MD, a Stanford primary care physician.
In addition to incorporating the do's and don't of UTI prevention into your life, make sure to ask your doctor or health care provider about other prevention techniques, especially if you have recurrent UTIs.
This is the second post in the series Understanding UTIs. The goal of this seven-part series is to provide easy-to-understand, scientifically grounded information about UTIs. Patients referenced are composites, compiled from actual patient experiences.
Joanna Langner is a graduate student in Community Health and Prevention Research at Stanford who is interested in health disparities and women's health. She wrote this series with the support of Randall Stafford, MD, PhD, professor of medicine and director of the Program on Prevention Outcomes and Practices, and Kim Chiang, MD, clinical assistant professor of medicine.
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