Burning question: Why does my UTI keep coming back?

When you’ve got a urinary tract infection (UTI), it can feel like it’s never going to go away. The pain, the fatigue, the urgent and frequent need to pee—every hour is straight-up misery. What could be worse than that? Well, a recurrent UTI that actually does keep coming back, for starters.

This kind of gynecological Groundhog Day scenario is actually quite common. Research finds that out of the 40 to 60 percent of women who experience at least one UTI in their lifetime, 1 in 4 is likely to have a repeat infection. According to Candice Fraser, MD, of New York City’s Trinity Medical Care, there’s a variety of reasons why a UTI might rear its ugly head again and again. (And, if you’re really unlucky, again.)

“Some people may have structural differences in their urinary tract that make them more susceptible to recurrent or chronic infections,” she explains. Other factors can include certain types of kidney stones that can make a person more susceptible to recurrent or chronic infections, as well as bladder catheters.

Your body’s bacterial balance can also be upset by factors that aren’t directly related to your bladder and urethra. Los Angeles-based OB-GYN Tristan Bickman, MD, notes that other risk factors for a recurrent UTI can include the use of diaphragms and spermicides, douching, and hormonal changes in menopausal women. Another risk factor: GI conditions that result in frequent diarrhea or stool incontinence. “The anus is close in proximity to the urethra, and bacteria can easily be transmitted to the bladder,” Dr. Fraser says.

This is why wiping front to back in the bathroom and peeing right after sex is of the utmost importance. “It flushes out some of the bacteria that may have started to make their way to the bladder,” Fraser explains. 

What to do if you have a recurrent UTI

Let’s say you’re doing all the right things when it comes to preventing UTIs—including drinking plenty of water and cranberry juice, avoiding irritating feminine products, and wearing cotton underwear—but they keep coming back. What else do you possibly do? 

First things first: No matter how experienced you are with UTIs, they should never be left untreated, especially if you are pregnant. When left unchecked, UTIs can lead to other serious health issues, including kidney infection. Your gynecologist or primary care physician will do a urine culture if you are showing the signs of a UTI, and if it comes back positive, you’ll likely be treated with an antibiotic. 

Unfortunately, dealing with this particular malady can be a process. “A UTI may persist if the correct antibiotic isn’t taken or if treatment is stopped too early,” Dr. Fraser says. Dr. Bickman adds that while the average treatment for an “uncomplicated bladder infection” is around a week (with symptoms going away in less than 48 hours), a complicated infection can last for up to 14 days. This means it’s super important to follow your doctor’s instructions, and keep taking your meds even if you start feeling better.

And honestly, sometimes just everyday life can make it easier for you to get a UTI. Payal Bhandari, MD, a physician for UTI prevention company Uqora, says that dehydration, illness, sleep deprivation, and having too much stress can increase the risk of recurrent UTIs. Great. That’s why certain lifestyle tweaks can make a big difference, she says. “When a person is struggling with recurring UTIs, the key is to keep immune defenses up so the bacteria has a harder time reproducing, multiplying, and wreaking havoc,” says Dr. Bhandari.”This includes drinking lots of water, eating nutrient-packed foods and staying physically active.”

If you keep getting treated but are still experiencing frequent UTIs though, you’ll need an evaluation by a urologist or a urogynecologist, Dr. Fraser says. They’ll be able to help find the right medications to prevent infection on a long-term basis—because the only burn you should ever be feeling is the one you get from the gym.

Additional writing and reporting by Kells McPhillips.

How worried should you be about peeing during sex? We asked a doc to weigh in. If it’s happened to you, try this abs move that Hilaria Baldwin swears by for bladder control.