7 Common Causes of Recurrent Urinary Tract Infections (UTIs)

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

3. Certain Contraceptives

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

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.

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.

• 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.