UTIs occur when bacteria from the skin or rectum travel to the opening of the urethra, the tube that carries urine from the bladder out of the body. Bacteria that enter the urinary tract can cause inflammation that leads to uncomfortable UTI symptoms, such as an intense urge to urinate and pain or burning when you pee. Anyone can develop a UTI, but they’re more common in women, who have shorter urethras that are closer to the anus, enabling bacteria to reach the urinary tract more freely.
Understanding what’s behind these chronic infections is key to managing and preventing them. Here are some of the most common causes of recurrent UTIs:
1. Loss of Estrogen
Estrogen levels drop during perimenopause and menopause. Surgical removal of the ovaries and certain cancer treatments can also cause lower estrogen levels.
“Postmenopausal individuals may benefit from topical vaginal estrogen,” says Gina M. Badalato, MD, a urologist and associate professor of urology at NewYork-Presbyterian/Columbia University Irving Medical Center in New York City. This comes in cream, tablet, or ring form and can help restore levels of good bacteria and strengthen vaginal tissue to help prevent recurrent UTIs.
2. Sex
You can help prevent UTIs when you have sex by:
- Peeing before and immediately after sex
- Drinking plenty of water to help flush out bacteria
- Keeping the genital area clean to prevent bacteria buildup
You may also want to ask your doctor if they recommend taking a single dose of an antibiotic after sex, as research suggests it may prevent a UTI.
3. Certain Contraceptives
Spermicides and diaphragms are birth control methods that can increase the risk of UTIs.
Spermicides come as creams, gels, suppositories, and spermicide-coated condoms. They kill sperm but can also destroy beneficial bacteria in the vagina that help fight infections. Diaphragms can put pressure on the urethra, making it difficult to fully empty the bladder. If you use spermicide or a diaphragm, ask your doctor if switching birth control methods may help prevent recurrent UTIs.
4. Urinary Retention
Urinary retention is when your bladder doesn’t empty completely when you urinate. Urine that remains in your bladder can create an environment for bacteria to grow, increasing the risk of a UTI. “Often-overlooked causes of UTIs include urinary conditions impacting bladder function — both the storage and emptying of the bladder,” says Dr. Badalato.
Treatment for urinary retention depends on what’s causing the condition but may include medication, a catheter to drain the bladder, or surgery. If you have difficulty fully emptying your bladder, talk with your doctor to determine the underlying cause and discuss treatment options.
5. Obstructive Uropathy
Obstructive uropathy occurs when urine is blocked from flowing through the urinary tract, causing it to back up into the kidneys. Bacteria can grow and multiply in the pooled urine and cause a UTI.
This condition may be caused by structural problems or blockages in the urinary tract due to kidney stones, bladder stones, scar tissue in the urethra, or certain cancers, such as bladder, colon, and ovarian.
If you have symptoms of obstructive uropathy, such as difficulty peeing, fever, lower back pain, nausea, or vomiting, see your doctor to identify and treat the underlying cause.
6. A Weakened Immune System
Managing any underlying conditions and practicing healthy hygiene and lifestyle habits can help reduce the risk of UTIs if you have a weakened immune system.
7. Lifestyle Habits
Some habits, such as not drinking enough water, holding in urine for too long, or wearing tight pants, can increase the likelihood of developing a UTI.
These lifestyle changes can help reduce the risk:
- Drink plenty of water to help flush bacteria out of the bladder.
- Urinate regularly — at least every four hours.
- Wipe from front to back after going to the bathroom, and make sure your hands are clean before wiping.
- Use gentle, fragrance-free liquid soap to wash your genitals.
- Opt for showers, or limit baths to less than 30 minutes.
- Wear breathable cotton underwear and loose-fitting pants.
- Change out of sweaty exercise clothes as soon as you’re done working out.
- Ask your doctor if cranberry or vitamin C supplements may help.
Get to the Bottom of Recurrent UTIs
Recurrent UTIs can be frustrating and uncomfortable, but there are strategies to help prevent them and treatments that can help ease symptoms.
If UTI symptoms keep coming back, talk to your doctor. They can help determine the cause and develop a management and treatment plan to help you feel your best.
The Takeaway
- Urinary tract infections occur when bacteria from the skin or rectum travel to the urinary tract and enter the bladder.
- Common contributors to UTIs include certain contraceptives, estrogen loss, sexual activity, underlying conditions that affect bladder function or weaken the immune system, and urinary retention.
- Working with a doctor to identify and address the cause of recurrent UTIs can help reduce your risk of future infections and improve your quality of life.
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