Frequent UTI Causes: Chronic UTI or Something Else?

Chronic UTI: Why Some Women Struggle with Recurring UTIs

When it comes to your health as a woman, you strive to do all the right things — eat a balanced diet, pursue an active lifestyle, drink plenty of water, and more. And yet you continue to get urinary tract infections every couple of months, despite all of the doctors’ visits, urinary tests, and antibiotic prescriptions.  What’s causing this and what can be done about it? 

You're not alone

According to a research study conducted in May 2020 by Brand Prescriptives among 818 women, over 46% said that they had experienced a UTI in the past year.  That’s significantly higher than any estimates that medical sources have been quoting recently.  And what’s worse, 1 out of every 3 of them reported that they’d had 3 or more UTI’s within the year. This group is often referred to as “chronic” UTI sufferers.  And they are the ones that have the medical community stumped.  Let’s take a look at why this is so.

Common Chronic UTI Symptoms

There are a number of common symptoms frequently experienced by women with a urinary tract infection:

• Burning or stinging sensation during urination
• Strong, persistent urge to urinate
• Passing frequent, small amounts of urine
• Cloudy or foul-smelling urine
• Bloody urine – bright red, pink, or cola-colored
• Pelvic pain
• Pain in the lower back or in the sides under the ribs

There are many possible reasons why women may be experiencing these symptoms over and over again.

When trying to diagnose what’s going on, a urologist will always start by verifying if it really is a UTI by taking a urine specimen, which is sent out to a lab for analysis.  This is very frustrating for women who have lived with this condition for years.  But, to be fair, the “classic” UTI symptoms can represent other problems.  The research shows that are really two categories of chronic sufferers:

1) Women with a UTI problem: the urine specimen showed the presence of bacteria

2) Women with other problems: the urine specimen did not show the presence of bacteria

A brief overview of these two groups, and the possible causes of their symptoms, are discussed below.  You can learn more on several of these topics by clicking on the links provided.

Women with a UTI Problem

The urologist has confirmed that they have an infection.  There are several reasons why this may be happening over and over again.  Some of the causes may be easily addressed, but many others are impossible to diagnose and treat accurately.  Here’s a partial list that continues to expand as we find out more every day on this topic.

1) Lack of hydration: a urologist will explain that the bladder should be constantly replenished with water in order to remain healthy.  They explain that if old urine remains in the bladder too long, it can develop bacteria and a UTI sets in.  The rule of thumb is to drink 6-8 glasses of water each day.  However, many women just don’t like drinking water, or, as they age, avoid drinking water which requires more frequent urination.  This causes a vicious cycle of recurring UTI’s. Read more here.

2) Inaccurate testing: the testing done at an OB/GYN office has been shown to be highly inaccurate, as the equipment that they use to diagnose your UTI in the office is very basic.  The urine cultures done at a urologist’s office will be more sophisticated but are limited to looking at the results in a traditional manner.  New tests are now available which use genetic sequencing to analyze not only bacteria but fungi, parasites, and viruses which may be affecting your health both within and outside of the urinary tract.

3) The wrong antibiotic: as we all know, the typical response to discovering that you have a UTI (again) is to prescribe an antibiotic.   However, it’s possible that the antibiotic that is prescribed is not the correct one.   Certain antibiotics have been proven in clinical trials to be more effective than others in getting rid of certain UTI bacteria.  It’s really important to ask the doctor which bacteria were seen in your urine specimen. You can read our blog on this topic here to see which drugs work best to rid your system of which types of bacteria.

4) Antibiotic resistance: this is the most common cause of chronic UTI’s.  Over the years, many women have probably taken 7 of the 10 most popular antibiotic brand names (Cipro, Bactrim, and Keflex to name a few).  This over-prescribing has led to “antibiotic resistance”, which means that the bacteria have learned how to hide and mutate in your system.  So as soon as the course of antibiotics has been completed, they begin to grow all over again.  This problem has caused scientists to work on new types of antibiotics and also to examine the efficacy of several natural supplement alternatives, such as D-Mannose.

5) Biofilms: these are slimy “sacs” that the bacteria surround themselves with after burrowing into the lining of the bladder.  This protects them against the threat of antibiotics.  It is very difficult to diagnose the presence of biofilms today but researchers and scientists are working on this aggressively because they have identified that this is a significant cause of recurring UTIs.  Read more about the latest research on biofilms.

6) ESBL’s: the two bacteria which are most often the cause of UTIs are Escherichia coli (E. coli) and Klebsiella pneumoniae.  Both are part of a family of germs known as Enterobacteriaceae.  These germs can produce enzymes called extended-spectrum beta-lactamases (ESBLs). ESBL enzymes break down and destroy some commonly used antibiotics, including penicillins and cephalosporins, and make these drugs ineffective for treating infections.  Learn more about how these bacteria are spread and how the medical community is dealing with this enzyme.

Women With Other Problems

The women with ongoing symptoms but no proven UTI is the group that baffles urologists most. This is in part due to the fact that women have a difficult time explaining exactly what they are experiencing; most will start by saying that they have pain “down there”.  This then requires a series of investigations and tests to find out exactly what’s causing these symptoms.  The cause of their symptoms may be simple, complex, or life-threatening and can include:

1) Vaginal Infection: in addition to the typical yeast infection, other types of bacteria may cause a more serious and difficult to treat vaginal infection.  This is typically seen in older women who are experiencing menopause.  The lack of hormones leaves the vaginal canal open to an infection that can cause a similar burning sensation to that of a UTI.  Find out what type of vaginal infections are related to UTI’s.

2) Vulvodynia: This is defined as chronic pain in the vulva, the area on the outside of a woman's genitals. It is usually described as a sensation of burning, stinging, itching, or rawness. It is also defined as pain that lasts more than three months and doesn't have a clear identifiable cause.  Read more on this topic.

3) Interstitial cystitis (IC): is a chronic bladder health issue. It is a feeling of pain and pressure in the bladder area. Along with this pain are lower urinary tract symptoms which have lasted for more than 6 weeks, without having an infection or other clear causes. Identify new methods that urologists are using for IC.

4) Bladder Cancer: the most common symptom of bladder cancer is the presence of blood in the urine (hematuria).  Other symptoms are similar to those of a UTI:

• Pain or burning sensation during urination
• Frequent urination
• Feeling the need to urinate many times throughout the night
• Feeling the need to urinate, but not being able to pass urine
• Lower back pain on 1 side of the body

Read more on questions to ask your urologist about bladder cancer versus UTI symptoms.

New Treatments For Chronic UTIs

The are now new natural alternatives to antibiotics which do not have the harmful side effects and have been proven to work for both UTIs and Interstitial Cystitis.  The combination of Goodbye UTI's Extra Strength Formula and D-Mannose powder are helping women who have suffered from Chronic UTIs for years.  Read more here about how these supplements work together to clear up chronic UTIs for good.