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6 Reasons Why You Keep Getting a UTI


UTIs are one of the most common bacterial infections in women, accounting for nearly 25% of all infections and leading to more than a million emergency room visits every year.

The only thing worse than getting a UTI is getting a recurring UTI. Recurrences usually occur within 3 months of infection, and 80% of recurring UTIs are reinfections. Post-menopausal women have higher rates of re-infection.

At Interlude our mission is to dramatically reduce the instances of infection by providing unprecedented access to education, prevention, and support for women in their post-menopausal years. By understanding the reasons why UTIs may happen more frequently as you get older, you can take action to prevent them.

So why would a UTI keep coming back? How do you stop recurring UTIs? Or why does it still feel like you have a UTI even when your doctor says you don’t? In this article, we'll explore six reasons why your UTI won't go away and what you can do about it.

1. You’re going through menopause

Estrogen plays an important role in maintaining the health of the urinary tract in women. But when estrogen levels decline in menopause, there can be uncomfortable consequences.

It doesn’t happen to everyone, but 50%-80% of women post-menopause can develop a chronic and lifelong condition called the genitourinary syndrome of menopause (GSM). Symptoms include:

  • Urinary tract infections
  • Urinary urgency
  • Urinary frequency
  • Dysuria
  • Burning
  • Painful sex
  • Vaginal dryness

If you’re in menopause and experiencing UTIs that won’t go away, Interlude’s medical team may prescribe vaginal estradiol. This well-studied and effective treatment can help prevent and reverse GSM symptoms, including UTIs.

2. The skin around your urethra is inflamed

If you are going through menopause, it can be tricky to identify why you feel UTI symptoms.

For example, a burning feeling when peeing can be a sign of a UTI. But it can also mean that the skin around the urethra is irritated and inflamed. (This could explain why you might feel like you have a UTI when your doctor says you don’t.)

The bottom line is that when estrogen levels decline in menopause, you can experience both UTIs and irritation that feels like a UTI.

The good news is that treatment with a preventative option like vaginal estradiol can address the root cause so that you can be comfortable and infection-free.

3. Your vaginal pH is high

Lactobacilli are a type of bacteria that naturally live in the vagina and maintain a healthy vaginal pH. Lactobacilli produce lactic acid, which helps maintain an acidic pH level that discourages the growth of harmful bacteria.

Lactobacilli thrive on estrogen. But as you enter menopause, estrogen levels decrease, and this can lead to a decrease in the number of lactobacilli. As a result, the vaginal pH becomes less acidic, which creates an environment that is more favorable for the growth of harmful bacteria that can cause UTIs.

How to test your vaginal pH levels

It’s useful, effective, and inexpensive to test your vaginal pH. You can buy vaginal pH test strips at the drugstore, perform a simple test at home, and get results in minutes.

An elevated vaginal pH in the 5.0 to 6.5 range suggests an infection like bacterial vaginosis (BV) or decreased estrogen levels. Further testing can help rule out BV and, as a result, establish menopause as the cause of your symptoms.

4. There’s an increased presence of E. Coli around your urethra

Escherichia coli (E. coli) is a type of bacteria that naturally lives in the intestines and is normally harmless. However, when E. coli bacteria are present around the urethra (the tube that carries urine from the bladder out of the body), they can cause UTIs.

After menopause, the lining of the urethra and the bladder can become thinner and drier, making it easier for otherwise harmless bacteria like E. Coli to enter and infect the urinary tract.

If you’re noticing that the skin around your urethra and vagina is thin and dry, vaginal estradiol can help restore the health of the skin.

5. You have pelvic prolapse

Remember how there can be uncomfortable consequences when estrogen levels decline in menopause? In numerous studies, menopause has been associated with pelvic prolapse (which can also lead to UTIs).

Pelvic prolapse is when the pelvic organs, such as the uterus, bladder, or rectum, descend or bulge into the vaginal wall due to weakened or damaged pelvic muscles and tissues.

The reason pelvic prolapse can cause UTIs is that the bladder, which stores urine, is supported by the pelvic floor muscles and connective tissues. When these structures weaken, the bladder may not be able to empty completely, creating a stagnant pool of urine in the bladder. Bacteria can then grow in this urine, leading to a UTI.

Additionally, the prolapsed organs can put pressure on the urethra, making it harder to fully empty the bladder. This can also contribute to the growth of bacteria in the bladder, increasing the risk of UTIs.

Can you fix pelvic prolapse?

Post-menopausal women with symptoms of pelvic organ prolapse may benefit from non-surgical options to help strengthen and support the pelvic organs:

  • Vaginal estradiol - prescribed as a cream, suppository, or ring
  • Vaginal pessaries - plastic or silicone devices that support the vagina
  • Pelvic floor exercises (Kegel exercises)

6. You have an underlying health condition

Several underlying health conditions can increase the risk of developing urinary tract infections (UTIs). Here are some examples:

  • Diabetes: High blood sugar levels can weaken the immune system, making it harder for the body to fight off bacterial infections, including UTIs.
  • Kidney stones: These small, hard deposits of minerals and salts can cause blockages in the urinary tract, making it harder to empty the bladder completely and increasing the risk of UTIs.
  • Weakened immune system: People with weakened immune systems, such as those who are undergoing chemotherapy, are more susceptible to infections, including UTIs.
  • Neurological disorders: Conditions that affect the nerves that control the bladder, such as multiple sclerosis or spinal cord injuries, can make it harder to empty the bladder fully, increasing the risk of UTIs.

Get preventative care for UTIs through Interlude

Menopause symptoms like UTIs can be difficult and frustrating to treat. But that’s only because many doctors aren’t trained in menopause.

Interlude is a 100% online telemedicine service for vaginal and urinary health after menopause. We offer an easy online consult, preventative treatment, and ongoing support for less than the cost of a standard co-pay.