Urinary tract infections (UTIs) are one of the most common infections, affecting millions of people every year. In fact, nearly 50–60% of women will experience at least one UTI in their lifetime, according to the National Institutes of Health.
Cara Elmer-Lyon, MD, a urogynecologist at St. Elizabeth Healthcare, explains the science behind these symptoms. “Bacteria make their way up into the bladder and cause symptoms like burning when you pee, pressure and feeling like nothing’s coming out. You constantly feel like you have to pee.”
Despite being so common, UTIs are often misunderstood or left untreated. This can lead to recurrent infections and long-term discomfort. That’s why understanding the condition and seeking timely treatment is so important.
How Can You Recognize Signs of a UTI?
The most common symptoms of a UTI often include:
- A burning sensation when urinating.
- Cloudy or foul-smelling urine.
- Frequent urination with little output.
- Pressure or discomfort in the lower abdomen.
“It’s important to confirm a UTI with a culture, especially if symptoms persist or occur frequently,” says Dr. Elmer-Lyon. “While we may treat one-time UTIs over the phone, recurrent infections need further evaluation.”
How Do You Treat a Urinary Tract Infection?
UTIs are highly treatable, especially when diagnosed early. A diagnosis often involves confirming bacteria in the bladder through a urine culture. “For women who truly have UTI symptoms of an infection, and there’s bacteria on a culture, we will treat those with antibiotics,” says Dr. Elmer-Lyon.
We may need to take additional steps to address recurrent infections. “In women who keep getting infection after infection, we often will conduct a workup to make sure there’s not something in the bladder or the kidneys causing these symptoms or infections,” she explains.
What Causes Recurrent UTIs?
“There are some women who are more prone to frequent UTIs,” Dr. Elmer-Lyon says. “This might result from a genetic predisposition, meaning their genetic makeup makes them more susceptible to infections.” This could involve differences in immune system function, the structure of their urinary tract or how their body naturally fights off bacteria.
Dietary Habits
Diet can contribute to recurrent UTIs by creating conditions in the body that support bacterial growth or irritate the bladder. For example, certain foods and beverages can aggravate the bladder lining or affect urine acidity, creating an environment that promotes bacterial growth. Also, when you don’t drink enough water, you urinate less frequently. This allows bacteria to stay in the urinary tract longer and multiply.
Other Health Conditions
Some women with health conditions like diabetes can have an increased risk of UTIs. Diabetes affects the immune response and causes sugar in the urine. And that feeds bacteria.
“Hormonal changes, particularly during menopause, can weaken the urinary tract lining, making infections more likely,” she said.
When It’s Not a UTI
What if your symptoms continue to last, but tests don’t confirm an infection? “More than half of the time when we get a referral for recurrent UTI, they don’t have a UTI,” she says. “If there’s no bacteria, then the patient thinks, what the heck is going on? Why do I constantly feel like I have a UTI?” According to Dr. Elmer-Lyon, UTI-like symptoms may point to other conditions. These can include:
- Bladder pain syndrome (interstitial cystitis): Chronic bladder inflammation that isn’t caused by bacteria.
- Pelvic floor muscle dysfunction: Tight or spasmed pelvic muscles pressing on the bladder create discomfort and urgency.
Dr. Elmer-Lyon says, “If there’s no bacteria in the culture, we look at other possible causes. Muscle tension or dietary habits can significantly affect bladder health.”
Preventing UTIs and Tips for a Healthy Bladder
Women who experience three or more UTIs in a year may need a long-term prevention plan. “Often, a woman’s bladder has been hit so many times that it’s easier for bacteria to get in. When this happens, we’ll treat it with a low-dose antibiotic for six months to let the bladder heal.”
Lifestyle changes can also help reduce UTI risks. Here are a few recommendations:
- Avoid holding urine for long periods.
- Limit drinks and food that irritate the bladder, such as caffeine or carbonated beverages.
- Practice good hygiene, especially after using the restroom.
- Stay hydrated to flush out bacteria.
Seeking Expert Care
If you’re experiencing recurring UTIs or UTI-like symptoms that won’t go away, it’s essential not to ignore these. “We underestimate how much pelvic muscle function matters,” says Dr. Elmer-Lyon. “With the right diagnosis and treatment, we can identify the cause of the symptoms and break the cycle of infections.”
Schedule a visit with a urogynecologist for a diagnosis and personalized treatment plan.
