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Why do I get urinary tract infections all the time?

The question: I'm a 32 female and I get urinary tract infections all the time! I drink lots of water and try to keep healthy, but this is really cramping my style. Any suggestions for why this could be happening and what I can do?

The answer: Urinary tract infections (UTIs) can be uncomfortable and irritating to deal with. You're not alone in your struggle, though, with an estimated 50 per cent of women experiencing a UTI at some point in their life. And those who have had one are at increased risk of having another in the future.

Women are more prone to UTIs than men due to anatomy. The bladder is connected to the outside world through a tube called the urethra. In women, the urethra is shorter than in males, giving bacteria a more direct path into the bladder, which can trigger a UTI.

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In young women, there are a couple of reasons why recurrent UTIs occur. Before jumping to medication, if we can identify these risks and take the simple steps to remedy them, you may be able to avoid recurrent infections.

First, anything that allows bacteria to stay in the bladder will increase your risk. We all know the feeling of holding it in when we're too busy to empty our bladder, or we're out for the day and don't want to use public bathrooms. But by holding urine in the bladder for long periods of time, bacteria can build up and increase the infection risk.

Along the same lines, if you don't drink enough fluids, you won't be able to flush out your bladder and clean out the bacteria. These are simple risks to decrease – just ensure that you empty your bladder regularly and hydrate well to flush out the bacteria. Also, if you feel a UTI coming on, start increasing your fluid intake to halt the progression of the infection.

Any irritation to the urinary tract or vagina can also increase entry of bacteria into the bladder. The most common irritation is from sexual intercourse or exposure to chemicals in lubricants or spermicide. Many of my patients who struggle with recurrent UTIs can see a clear relationship between when they have sex and the onset of UTI symptoms. If this is the case for you, remember to urinate after sex, avoid harsh chemical lubricants and hydrate well.

I'm often asked in my clinic about the efficacy of cranberry juice or tablets in preventing UTIs. There is no evidence that shows cranberries help treat active infections. But there have been some studies that show it may help prevent recurrent UTIs. That being said, the specific amount of juice or tablets needed to prevent infection has not been established, so further studies need to be done.

By recognizing the common triggers, you can take control of the risks that lead to UTIs. If these changes don't help, see your doctor. They may suggest investigations to ensure there isn't an anatomic abnormality in the urinary tract that may be triggering the infections.

It's also important to rule out other conditions that can mimic a UTI, such as sexually transmitted infections. In some cases, your doctor may recommend a preventative dose of antibiotics to be taken one dose after sex (if this is the trigger) or a regular daily dose to prevent recurrence.

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Dr. Sheila Wijayasinghe is the medical director at the Immigrant Womens' Health Centre, works as a staff physician at St. Michael's Hospital in their Family Practice Unit and at Hassle Free Clinic, and established and runs an on-site clinic at Women's Habitat Shelter in Etobicoke.

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