Why does my UTI keep coming back?



Naturopath, Herbalist and Yoga teacher (BA, Dip Nat, Dip Herb)
@NerdyNaturopath
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09 March 2022

Why does my UTI keep coming back?

UTI recurrence is most common in menopausal and post-menopausal women. Other contributing factors of UTI's coming back include not drinking enough water, drinking coffee or alcohol, and eating a lot of sugar. Stress can also play a role, as can hygiene practices, tight underwear and using strongly perfumed shower gel or bubble bath.

What is the most common cause of UTI recurrence?

Recurrent UTIs are defined as having two infections in a period of six months or three infections in a year. Most recurrences are due to a new infection, as opposed to the old infection lingering. Approximately 20% of women who get a UTI will have a recurring infection, and this is most common amongst menopausal and post-menopausal women.

UTIs are much more common in women, due to our shorter urethras. The bacteria causing the infection has a shorter distance to travel to get to the bladder where the infection usually takes hold. During menopause, the drop in hormone levels reduces the production of vaginal mucus which helps to sustain the good bacteria in this area. With less good bacteria around the vaginal and urethral opening, we can be more susceptible to catching a UTI, and to them coming back. If you want to learn more about UTIs in menopause, check out our blog and video on the topic: "UTIs during menopause."

Men do get UTIs as well, and the most common cause is an enlarged prostate, also called Benign Prostatic Hyperplasia (BPH). For enlarged prostate in men, check out our remedy Prostasan.

How can I stop UTI recurrence?

1. Drink more water

Drinking enough water can help prevent a urinary tract infection. Scientific research has found that drinking 1.5 litres of water in addition to normal intake is effective in preventing UTIs. (1) Drinking more water is the number one protocol I give to clients who get recurrent UTIs. By staying hydrated and drinking sufficient amounts of water, many women can avoid recurrent cystitis infections.

Drinking more water, particularly if you don't already drink 1.5-2 litres a day, is always a good idea and will give you a whole host of great side benefits, including better skin and digestion. Keep in mind that if the weather is extra hot, or if you exercise a lot, you will need to drink even more water as well! If you are prone to regular UTIs, why not give it a try!

2. Reduce (or eliminate) alcohol and coffee

Alcohol has the double whammy effect of dehydrating you (see above!) and making your urine more acidic, and thus, more painful! Sorry to be the bearer of bad news, but so does coffee!

Try a sugar-free cranberry mocktail by simply adding some fizzy water to Biotta's cranberry juice if you want a treat on a Friday night; and try a delicious coffee alternative like Bambu.

Giving both coffee and alcohol up altogether will help prevent recurrent UTIs, but even just avoiding them while you have an infection can help.

3. Reduce (or eliminate) added sugars

A diet high in sugar can have harmful effects on your immune system. (2)
 This means that if you have cystitis, eating a lot of sugar can prolong an infection because your immune system won't be able to work as well to fight off the infection. It also means that if you regularly eat a lot of sugar, you are more likely to get recurrent UTIs.

When I talk about sugar, it's not just the sugar in your tea or on your cereal, but hidden in the ingredients of things like yoghurt, pasta sauces and baked beans. It also refers to products made from refined flour, cakes and pastries of course, but also white bread and white pasta.

4. Stress Less

Stress reduces immune function and can make us more prone to getting an infection. (3) https://pubmed.ncbi.nlm.nih.gov/20704904/ Stress can also make the symptoms of cystitis feel worse. Have you ever experienced nervous peeing where you consistently feel like you need to go, just because you are stressed? Stress has a direct effect on the urinary tract and can make you need to pee more often, whilst lowering your pain tolerance during an infection. (4)

Meditation is a proven way to reduce stress levels. (5) If meditation is new to you, try downloading an app like Insight Time or Headspace to help you get started. Even a few minutes a day can help!

Herbal remedies like Passiflora, Valerian, Lemon balm and Avena sativa can be wonderful allies in reducing stress, and can be taken while you have a UTI, or as ongoing remedies if stress is contributing to your UTI.

5. Avoid wearing nylon underwear and tights, and tightly fitting trousers

This is because these can create a warm and moist environment in which bacteria thrive. Instead, wear cotton underwear and loose-fitting clothes.

6. Do not use strongly perfumed bubble bath or shower gel

The chemicals can strip your urinary tract of essential bacteria and weaken the skin. It is also thought that taking showers rather than baths can help in the prevention of recurring infections. Just make sure any soap you do opt for is gentle and natural, without synthetic chemicals.

7. Practice good hygiene

Be careful when inserting tampons, diaphragms or catheters, as these can easily be contaminated and give bacteria a very easy route into your body. Women should also take extra care to wipe from front to back after going to the toilet, to take bacteria away from the urethra. In addition, remember the advice to always go to the toilet after having sex.

8. Antibiotics

Doctors sometimes prescribe low dose antibiotics to be taken over a period of six months for women who get recurrent UTIs. However, long-term antibiotic use can cause a host of side effects. If you are looking for a natural alternative and have a chronic underlying condition such as Multiple Sclerosis, you could book an appointment with a naturopath or herbalist to get some personalised natural support, rather than attempting to treat it yourself. If you are otherwise healthy and simply getting recurrent UTIs, you may want to check out my blog: "How to get rid of a UTI without antibiotics."

9. Herbal remedies

For recurrent cystitis, herbal remedies like Uva-ursi and Echinacea can help the body to get rid of an infection.

To treat UTI's there are two herbs that can help:

Uva-ursi

Uva-ursi, or bearberry, is a traditional herbal remedy for treating UTIs. It's fast-acting and has an antibacterial effect directly in the urinary tract. Unlike antibiotics, it does not trigger thrush. It is not a remedy that should be taken long term, so for recurrent UTIs I recommend having a bottle of Uva-ursi tincture at home to start taking at the first sign of infection.

The antibiotic properties seem to be due to a compound called arbutin; but, as it is a whole plant extract, it has lots of other side benefits too, rather than side effects. It has astringent properties and contains allantoin, which helps to heal inflamed and irritated urinary passages.

It is recommended to take Uva-ursi for one week, and symptoms should improve after just 4 days of use. If symptoms do not improve, it is important to see your doctor.

Echinacea

Echinacea is a great antibacterial and anti-inflammatory herb, which is used to treat many infections. It is well-known as a remedy for colds and flu, but it is also effective in treating urinary tract infections. Its antibacterial properties help to fight the infection, and its anti-inflammatory and immune-supporting properties will help prevent a recurrence.

Echinacea helps to support the immune system, so it can be taken on an ongoing basis to support immunity and prevent infection. If you do start to notice the symptoms of an infection, I recommend taking your Echinacea more regularly. So perhaps you might take it twice a day as prevention and five times a day if you are experiencing any symptoms of an infection.

 


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