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The Explainer: Urinary Tract Infections

What they are, why they happen, and how to find relief—fast.

From a burning sensation to a near-constant urge to pee, the symptoms of a urinary tract infection can feel pretty miserable. Even more unfair, these infections return within six months for about 25 to 30% of women who get a UTI. But you can take certain steps to reduce your chances of getting a UTI and preventing reinfection. 

We spoke to gynos to get the scoop on why these uncomfortable infections occur, how to help your body fend them off, and what you can do to put up the best fight when they do happen. 

Related: Everything You Need to Know About Bacterial Vaginosis (a.k.a. BV)

First, why do we get UTIs?

UTIs are usually caused by Escherichia coli, more commonly known as E. coli, a bacterium that lives in the GI tract. (Yes, we’re talking about the same E. coli that causes spinach recalls and prompts major digestive distress.) 

While anyone can get a UTI, they’re more common in women because a female’s urethra (the tube that carries urine out of the body) is shorter and closer to the anus, where E. coli bacteria are common. This is why it’s crucial that women wipe front-to-back, says Alexis May Tran Kimble, D.O., board-certified urogynecologist at The Kimble Center

Vaginal sex can also increase a woman’s risk, as sex can introduce bacteria to the urethra. “If you’re prone to infections, peeing right after you have sex or taking a prophylactic antibiotic can help prevent infections,” says Dr. Kimble. If you notice recurrent infections associated with sex, talk to your doctor to determine the best course of treatment. “UTIs can be more common with any increase in sexual activity,” adds Cynthia Flynn, MD, a board-certified OB/GYN with more than 20 years of experience in women’s health and a doctor at JustAnswer. “UTI symptoms may also start after infection with STDs, so it’s important to be screened if you are at risk.”

Douching, which disrupts the natural balance of bacteria in the vagina, has also been shown to cause UTIs. “We now recognize that a female microbiome exists,” says Dr. Kimble. “This environment provides protective bacteria that can be eradicated with hygiene practices like douching.” Similarly, avoid spermicide as a contraceptive method, as it may alter the delicate pH balance of the vagina and creates an environment where bacteria are more likely to thrive. 

Related: What is Normal Vaginal pH—and When Should You Test Yours?

Research has found that women who get frequent UTIs tend to have depleted levels of Lactobacillus, the predominant microorganism or “good bacteria” in the female urogenital biome. “Chronic UTIs generally refer to a prolonged infection or three or more infections in one year,” says Dr. Flynn. “If untreated, a bladder infection can progress to the kidneys.”

Supplementing with Lactobacillus-containing probiotics has shown promising results in early studies, though researchers are still nailing down the exact strains and dosage that might be most effective. 

What are the signs and symptoms?

While most women complain of a burning sensation when they urinate, there are a number of other symptoms of UTIs that are important to recognize. “UTI symptoms can vary and be mild or severe, depending on the organism or bacteria causing the infection and how long the infection has been present,” says Dr. Flynn.

According to the Cleveland Clinic, UTIs may lead to some of the following:

  • Pain in the side, belly, or pelvic area

  • Pressure in the lower pelvis

  • Frequent or urgent need to urinate, as well as urine leakage (a.k.a. incontinence)

  • Painful urination

  • Blood in the urine

  • Abnormal urine color (cloudy urine) and strong or foul-smelling urine

If you suspect you’re dealing with a UTI, it’s important to make an appointment with your doctor who’ll do a urinalysis—a test that looks for red blood cells, white blood cells, and bacteria in the urine. A urine culture may also be used, which determines the type of bacteria in your urine and can help your doctor decide on the right treatment.

You can test for a UTI at home using test strips, but remember this should be used as a screening test only, says Dr. Flynn. The strips may be positive for blood, leukocytes, and/or nitrites, and you’ll want to see your doctor to confirm your diagnosis.

How to treat—and prevent—UTIs

If you are prone to infections, staying hydrated can really help. Shoot for at least 60 fluid ounces of water a day, and more if you spend time outdoors or exercising. “Increasing fluid helps slough off the superficial inner bladder layer, where bacteria may linger,” says Dr. Kimble. It’s also wise to avoid fluids and foods that can irritate the bladder, including alcohol, citrus juices, caffeine, and spicy foods.

It’s also important to go to the bathroom when you have the urge since urination plays a big role in ridding the body of bacteria. It’s also wise to avoid tight-fitting clothes and wear cotton underwear, as both can help to prevent extra moisture from getting trapped around your urethra and keep bacteria from growing in your urinary tract.

For women with recurring UTIs, it’s important to have a urine culture, says Dr. Flynn. “This will identify the causative bacteria and what the appropriate antibiotic may be,” she says.

Certain supplements can support your healing if you have a UTI. Dr. Kimble recommends the following: 

D-mannose: A sugar normally found in fruits (like cranberry), this supplement was found to be just as effective as an antibiotic for women in one study. It’s thought to work by binding to the bacteria so they can’t attach to the body’s cells in the urinary tract. For prevention, take 2 grams once daily, or 1 gram twice daily; for an active infection, 1.5 grams twice daily for three days, and then once daily for 10 days.

Cranberry capsules: A go-to staple for UTI prevention for years, cranberry also has a number of compounds that bind to the E. coli, preventing bacteria from colonizing in the bladder. While studies on the effectiveness of cranberry juice are mixed, studies have shown that cranberry capsules can significantly reduce women’s chance of getting a UTI. 

Vitamin C: Whether taken via supplements or in your diet, vitamin C is thought to acidify the urine and have a bacteriostatic effect, keeping the bad bacteria from multiplying. 

Related: The Ultimate Guide to Homeopathic Remedies for Women’s Health Issues

Lindsay Galloway is a writer and editor with more than 15 years experience covering health, beauty, travel, and business. Her work has been published in major online news outlets like BBC and The New York Times, as well as print magazines and travel guidebooks. She lives in Boulder, Colorado, where she enjoys local food, walking her dogs—a Shiba Inu and pug—and making fun art in her spare time.
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