Urinary tract infections (UTIs) can be incredibly uncomfortable and frustrating, especially if they keep returning. But what can cause a UTI to keep coming back?

What is a UTI?

UTIs affect the urinary tract, including the bladder (cystitis), urethra (the tube that you pee through) (urethritis) and the kidneys (kidney infection).¹ Most infections involve the lower urinary tract (bladder and urethra)², with kidney infections being more unusual. Common symptoms include:

• strong, frequent need to wee
• painful or burning sensation when urinating
• cloudy, bloody or smelly pee³

Some people are more prone to urinary tract infections, so you might be wondering: what can cause a UTI to come back?

Lifestyle factors that can cause a UTI to keep coming back

Certain lifestyle risk factors can lead to recurrent UTIs. These include:

• using perfumed products around your genitals
• ‘holding on’ to your wee
• not drinking enough water
• not wiping front to back after using the toilet, which may introduce bacteria to your urinary tract
• wearing underwear made from synthetic materials or tight clothes on your bottom half⁴, which mean that the genitals aren’t kept clean and dry⁵
• heavy tampons use⁶
• frequent sexual intercourse⁷
• a new sexual partner⁸
• using a contraceptive diaphragm or condoms with spermicide⁹

Medical factors that might cause a UTI to come back

In addition to the above lifestyle factors, some medical factors might cause recurrent UTIs:

• history of UTIs in pre-menopause or childhood
• family history of UTIs
• vulvovaginal atrophy¹⁰ (thinning, drying and inflammation of the vaginal wall)¹¹
• certain conditions, such as kidney stones, that block the urinary tract
• inability to empty your bladder properly
• diabetes
• a weakened immune system
• an enlarged prostate gland
• a catheter (a tube in your urethra to drain your wee)¹²
• constipation in children – UTIs, recurrent or otherwise, can lead to complications in children, so always see a medical professional if you think your little one has a urinary tract infection¹³
• being pregnant– it’s more common for the UTI to spread to the kidneys during pregnancy and can have complications, so always see a doctor if you think you have a UTI and are pregnant
• bowel incontinence
• menopause (when a woman’s period stops and there are hormonal changes)
• medical procedures involving the urinary tract
• change of bacteria in your vagina (all vulvas naturally contain beneficial bacteria to prevent illness) caused by heavy antibiotic use¹⁴
• female anatomy – women have shorter urethras that are closer to the anus (bottom), making it easier for bacteria to get through
• urinary tract abnormalities¹⁵     

Complications and how to prevent UTIs from coming back

Recurrent UTIs, defined in women as two or more within six months or four or more within a year, can lead to complications.¹⁶ These include:

• a kidney infection
• abscesses on the kidneys
• impaired kidney function
• kidney failure
• urosepsis¹⁷(sepsis in the kidneys)¹⁸

It is therefore incredibly important that you speak to your healthcare provider if you suspect you’re experiencing recurrent UTIs. In the meantime, you could try these steps to prevent UTIs from coming back:

• take D-mannose or cranberry tablets (in women under 65)
• drink plenty of water
• wee as soon as possible after sex¹⁹
• swap to sanitary towels if you have a UTI during your period and make sure you change them regularly²⁰
• various lifestyle changes, including avoiding caffeine and alcohol²¹, and upping your Vitamin C intake²²
• avoid swimming in the sea²³ and make sure to rinse well after swimming in a pool (as chlorine can irritate the urinary tract)²⁴

You could also consider using continence products to manage your symptoms if you are experiencing leaks. Try iD’s range of dermatologist-approved, comfortable and discreet pads and pants

With these explanations and tips, we hope you understand what can cause a UTI to come back and how to prevent them.

Sources

¹ “Urinary tract infections (UTIs)”, NHS, 18 November 2020, Source: https://www.nhs.uk/conditions/urinary-tract-infections-uti/
² “Urinary tract infection (UTI)”, Mayo Clinic Staff, n.d., Source: https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
³ “What to know about urinary tract infections”, James McIntosh, 6 November 2018, Source: https://www.medicalnewstoday.com/articles/189953
⁴ “Urinary tract infections in adults”, NHS, 12 December 2017, Source: https://www.nhs.uk/conditions/urinary-tract-infection-adults/pages/introduction.aspx/amp/#causes
⁵ “Urinary tract infections (UTIs)”, NHS, 18 November 2020, Source: https://www.nhs.uk/conditions/urinary-tract-infections-utis/
⁶ “What to know about urinary tract infections”, James McIntosh, 6 November 2018, Source: https://www.medicalnewstoday.com/articles/189953
⁷ “Risk factors and predisposing conditions for urinary tract infection”, Oscar Storme, José Tirán Saucedo, Arturo Garcia-Mora, Manuel Dehesa-Dávila, and Kurt G. Naber, 2 May 2019, Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502981/
⁸ “Urinary tract infection (UTI)”, Mayo Clinic Staff, n.d., Source: https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
⁹ “Urinary tract infections (UTIs)”, NHS, 18 November 2020, Source: https://www.nhs.uk/conditions/urinary-tract-infections-utis/
¹⁰ “Risk factors and predisposing conditions for urinary tract infection”, Oscar Storme, José Tirán Saucedo, Arturo Garcia-Mora, Manuel Dehesa-Dávila, and Kurt G. Naber, 2 May 2019, Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6502981/
¹¹ “Vaginal atrophy”, Mayo Clinic Staff, n.d., Source: https://www.mayoclinic.org/diseases-conditions/vaginal-atrophy/symptoms-causes/syc-20352288
¹² “Urinary tract infections in adults”, NHS, 12 December 2017, Source: https://www.nhs.uk/conditions/urinary-tract-infection-adults/pages/introduction.aspx/amp/#causes
¹³ “Urinary tract infections (UTIs)”, NHS, 18 November 2020, Source: https://www.nhs.uk/conditions/urinary-tract-infections-utis/
¹⁴ “What to know about urinary tract infections”, James McIntosh, 6 November 2018, Source: https://www.medicalnewstoday.com/articles/189953
¹⁵ “Urinary tract infection (UTI)”, Mayo Clinic Staff, n.d., Source: https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447
¹⁶ Ibid
¹⁷ “What are the complications?”, NICE, June 2021, Source: https://cks.nice.org.uk/topics/urinary-tract-infection-lower-women/background-information/complications/
¹⁸ “What Is Urosepsis?”, Dan Brennan, 7 June 2021, Source: https://www.webmd.com/a-to-z-guides/what-is-urosepsis