Most women are familiar with the vicious cycle that can result from getting a urinary tract infection (UTI)—the infection is treated with antibiotics, but then a vaginal yeast infection develops.
Once you understand why this occurs and what you can do to prevent the infections, you can break the cycle.
UTIs: Causes and Symptoms
UTIs can develop when bacteria (often, E. Coli from the gastrointestinal tract) get into the bladder through the urethra (the tube through which urine travels when it is excreted). If the bacteria multiply, they can produce inflammation and infection.
“UTI symptoms include painful urination and urinary urgency and frequency, as well as blood in the urine,” explains Tirsit Asfaw, MD, an assistant professor of obstetrics and gynecology at Weill Cornell Medicine.
A woman’s anatomy makes her more susceptible than a man to UTIs because her urethral opening is closer to the anus, and the urethra is shorter, so bacteria don’t have far to travel to reach the bladder.
Strategies to Stop UTIs
Sometimes, it’s possible to identify what’s causing your UTIs and take preventive measures. For many women, it’s sexual intercourse. For some women, it’s exercise, like bike riding.
Preventive measures include using a lubricant during sex and emptying your bladder before exercising and after intercourse. Some women swear by cranberry juice and cranberry supplements, but clinical studies have produced mixed results.
It’s also important to practice good pelvic hygiene. Wash your genital and anal areas regularly, and keep the area dry.
For most women who experience chronic, recurrent UTIs, the most effective prevention method is vaginal estrogen supplementation. Don’t let the word “estrogen” scare you; Dr. Asfaw explains that vaginal estrogen is not the same thing as hormone replacement therapy, and studies have revealed no increased health risks in women using vaginal estrogen.
“When the estrogen level in the pelvic area rises, it helps increase the lactobacilli in the urinary tract and makes it less vulnerable to infection,” she says.
Vaginal estrogen supplementation comes in three forms: creams, pills, and a vaginal ring. Each woman needs to discuss the pros and cons of the various forms with her doctor.
About Antibiotics
The standard course of treatment for a UTI is antibiotics that will kill the bacteria causing the infection. The most common antibiotics used to treat UTIs are Bactrim and Macrobid, which are usually taken for three to seven days.
Dr. Asfaw notes that the antibiotic Cipro should not be used as a first-line treatment for UTIs.
If you experience the classic symptoms of a UTI, especially if you have previously had a UTI, you may be prescribed an antibiotic without having your urine tested for bacteria. However, if you have recurrent UTIs, a urine culture can help your doctor identify the type of bacteria causing the infection so it can be targeted with a specific antibiotic. If you have three or more UTIs in one year, see a urologist or a urogynecologist, who can determine what factors are contributing to the recurrence.
Yeast Overgrowth
If you do take an antibiotic for a UTI (or any other infection), your risk of developing a yeast infection increases.
“The vagina contains lactobacilli, bacteria that keep the vaginal pH in the acidic range and prevent the overgrowth of harmful bacteria, such as E. coli. Antibiotics that treat UTIs may kill the lactobacilli, which may result in overgrowth of other bacteria or fungi, such as yeast,” explains Dr. Asfaw.
To minimize your chances of a yeast infection, consume foods that contain live, active bacteria cultures such as yogurt and kefir and/or take a probiotic supplement while you are taking antibiotics. Also, finish the course of antibiotics as directed, even if your symptoms are gone; if you stop early, the harmful bacteria may survive, and you’ll be at risk of another UTI.
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