Healthcare provider discussing fluctuating UTI symptoms with patient via telehealth

Fluctuating UTI Symptoms: Causes & Tips

Medically reviewed on April 4, 2024 by Jillian Foglesong Stabile, MD, FAAFP. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

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It’s very common for women and people assigned female at birth (AFAB) to experience a urinary tract infection at some point within their lifetime. Urinary tract infections (UTIs) occur in 50 to 60 percent of adult women and people AFAB. That said, men and people assigned male at birth (AMAB) can also contract UTIs, although less commonly. [1]

Those with a UTI can experience a variety of uncomfortable symptoms, from painful urination to pain in the pelvis and/or lower back—particularly if the infection migrates to the bladder or kidneys. [2]

Unfortunately, once you’ve contracted a UTI, your risk of getting another increases. Specifically, between 20 to 40 percent of women with a UTI will get another. This is what’s known as a recurrent UTI. [3]

What Is a Recurrent UTI?

A UTI, or cystitis, occurs when harmful bacteria, like E. coli, enter the urethra. Around 75 percent of recurrent urinary tract infections are caused by E. coli. Other infectious bacteria include Enterococcus faecalis, Klebsiella, Proteus mirabilis, or Staphylococcus. [4]

Once harmful bacteria enter the urethra, the immune system triggers an inflammatory response to combat the invader. However, inflammation of the urinary tract can cause [2]:

  • Pain in the abdomen, pelvis, and/or lower back
  • Cloudy and/or smelly urine
  • Incontinence
  • Frequent urination
  • An urge to urinate
  • Bloody urination
  • Painful urination

Learn more about: Can a UTI Cause Bloating?

Recurrent urinary tract infections, defined as two or more infections within the span of six months, are most common in women and people AFAB. [4]

About 26 percent of this population experiences a recurrence of symptoms within six months of their initial treatment. Further, 53 percent of women over the age of 55 and 26 percent of young women reported a recurrence of UTI symptoms within a year of treatment. [4]

If this sounds familiar, you may be wondering, why do my UTI symptoms come and go?

In most cases, recurrent UTIs are entirely new bacterial infections. Other times, the initial bacteria may persist if you fail to complete your antibiotic treatment or the bacteria is resistant to the prescribed antibiotic. The persistence of a bacterial infection may also point to [4]:

  • Abscess – A pocket of pus within the urinary tract or surrounding tissues, which can result from a severe or untreated UTI. Abscesses can cause persistent or recurrent infection symptoms and may require drainage or surgical intervention for resolution.
  • Urinary stones – The formation of mineral deposits in the urinary tract, such as kidney stones or bladder stones, can lead to recurrent UTIs by providing an area for bacterial growth or by causing obstruction. This can impair urinary flow and increase the risk of infection. [5]
  • Prostatitis – Inflammation or infection of the prostate gland, which can be bacterial by nature. Prostatitis can cause recurrent UTI symptoms, particularly in men, and may require specific treatment approaches, including antibiotics or anti-inflammatory medications, depending on the underlying cause. [6]

Additionally, several risk factors may put you at a higher chance of experiencing a urinary tract infection. These include [4]:

  • Any spermicide use within the previous year, primarily if used with a diaphragm
  • Atrophic vaginitis
  • Bladder diverticula
  • Bladder fistula
  • Chronic diarrhea
  • Cystocele
  • Diabetes
  • First UTI before 16 years of age
  • Genetic predisposition
  • A higher frequency of sexual intercourse (more than twice a week can triple your risk)
  • History of five or more UTIs
  • Inadequate fluid intake
  • Incomplete bladder emptying
  • Mother or sister with a history of frequent or multiple UTIs
  • New or multiple sexual partners
  • Short anal to urethral meatus distance
  • Urethral diverticula
  • Urinary incontinence
  • Use of spermicide-coated condoms

Poor hygiene can also put you at a higher risk of contracting another bacterial infection. However, it’s best to implement proper hygiene with a shower—taking baths may also increase your risk of a UTI, as does wiping from back to front and failing to wash your hands properly before washing the vaginal area. [4]

In most cases, however, a recurring UTI is not the fault of poor hygiene. Simply, some women are just more prone to contracting UTIs. [7]

While younger women can experience a heightened risk with increased sex and the use of spermicides, which can kill a healthy bacteria called Lactobacilli, menopausal women may also be susceptible to infections. During this life stage, Lactobacilli naturally decreases, and it can be more difficult to empty the bladder completely, which can allow bacteria to fester and infect the urinary tract. [7]

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How to Treat a UTI Properly

Treating a urinary tract infection properly is crucial to alleviating symptoms, preventing complications and recurrent infections, and eradicating the underlying bacterial infection. To treat your UTI [2,7]:

  • Speak with a healthcare provider – If you suspect you have a UTI, it's essential to seek medical advice promptly. A healthcare provider can confirm the diagnosis through a urinalysis and prescribe appropriate treatment. Namely, an antibiotic.
  • Take your prescribed antibiotics – Antibiotics are the primary treatment for UTIs. The type of antibiotic and duration of treatment depend on factors such as the severity of the infection, the specific bacteria causing it, and any underlying health conditions. It's crucial to complete the full course of the antibiotic treatment, even if symptoms improve before the medication is finished, to ensure that the infection is completely eradicated. It’s typical to use amoxicillin for a UTI, but other common antibiotics used for UTI treatment include:
    • Nitrofurantoin
    • Sulfonamides
    • Amoxicillin
    • Cephalosporins
    • Doxycycline
    • Fosfomycin
    • Quinolones

That said, if you experience many UTIs, it is possible (although not common) for some bacteria to become resistant to antibiotic treatments. In the specific case of treating a recurrent UTI, a healthcare provider may recommend taking a low dose for a minimum of six months, taking antibiotics only after having sex, or using antibiotics when you begin to experience symptoms.

  • Explore alternative treatments – If you do experience antibiotic resistance, the infection can make its way up to your kidneys, which can cause severe kidney damage. To mitigate this, your healthcare provider may suggest intravenous (IV) treatment, in which they’ll administer medicine intravenously in your arm.
  • Stay hydrated – Drinking plenty of water helps flush out bacteria from the urinary tract and can likewise help alleviate symptoms like burning during urination. Aim to drink at least eight glasses of water a day, or more if you're experiencing symptoms of dehydration.
  • Manage uncomfortable symptoms – Over-the-counter pain relievers such as ibuprofen or acetaminophen can help relieve discomfort and reduce fever associated with UTIs. Additionally, applying a heating pad to the abdomen can provide temporary relief from pelvic pain or discomfort.
  • Avoid potential irritants – During UTI treatment, it's essential to avoid potential irritants that can exacerbate symptoms or interfere with the healing process. This includes avoiding alcohol, caffeine, spicy foods, and acidic beverages like citrus juices, which can irritate the bladder and exacerbate urinary urgency and frequency.

How To Prevent Recurrent UTIs

Recurrent urinary tract infections can be frustrating and disruptive to daily life, but there are strategies individuals can implement to reduce the likelihood of experiencing multiple infections.

Preventing recurrent UTIs often involves a combination of lifestyle changes, hygiene practices, and sometimes, medical interventions. Firstly, maintaining good hygiene is crucial. This includes practicing proper bathroom hygiene, such as wiping from front to back to prevent the spread of bacteria from the anus to the urethra. [4]

Additionally, ensuring cleanliness of the genital area and washing regularly with mild soap and water can help prevent the introduction of harmful bacteria into the urinary tract. [4]

Staying hydrated is another key factor in preventing recurrent UTIs. Drinking plenty of water helps to flush out bacteria from the urinary tract, reducing the risk of infection. Aim to drink at least eight glasses of water per day, and consider increasing your fluid intake during times when you may be more prone to UTIs, such as after sexual activity or during periods of hormonal changes. [2]

For individuals who experience recurrent UTIs, it may be beneficial to identify and avoid potential triggers. Certain factors, such as sexual activity, use of certain types of birth control, and certain foods or beverages, can increase the risk of UTIs in susceptible individuals. Taking steps to minimize exposure to these triggers can help prevent recurrent infections. [4]

In some cases, healthcare providers may recommend preventive measures such as taking a low dose of antibiotics daily or using vaginal estrogen therapy for postmenopausal women to reduce the risk of recurrent UTIs. However, these interventions are typically reserved for individuals who experience frequent or severe infections and should only be used under the guidance of a healthcare professional. [8]

Finally, it's essential to maintain regular follow-ups with your healthcare provider if you experience recurrent UTIs. Your provider can help monitor your condition, identify any underlying factors contributing to the infections, and adjust your treatment plan as needed to prevent future recurrences.

Consult With an Everlywell Professional for Treatment Options and Peace of Mind

By incorporating these preventive measures into your daily routine and working closely with your healthcare provider, you can reduce the frequency and severity of recurrent UTIs, allowing you to enjoy better urinary tract health and overall well-being.

For a convenient and private healthcare experience, work with Everlywell.

Our virtual care appointments are discreet yet thorough—you’ll simply connect with a licensed healthcare professional from the comfort of your own home to discuss your UTI symptoms and identify the best methods for online UTI treatment and prevention.

Make an appointment today to get started.

Effectiveness of Amoxicillin for UTI Treatment

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  1. Medina M, et al. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol. Published May 2, 2019. Medical Citation URL. Accessed March 11, 2024.
  2. Urinary Tract Infections. Cleveland Clinic. Published April 6, 2023. Medical Citation URL. Accessed March 11, 2024.
  3. Urinary Tract Infections in Adults. Urology Care Foundation. Published November 2022. Medical Citation URL. Accessed February 11, 2024.
  4. Aggarwal N, et al. Recurrent Urinary Tract Infections. StatPearls. Published January 11, 2024. Medical Citation URL. Accessed February 11, 2024.
  5. Ripa F, et al. Association of Kidney Stones and Recurrent UTIs: the Chicken and Egg Situation. A Systematic Review of Literature. Curr Urol Rep. Published July 25, 2022. Medical Citation URL. Accessed February 11, 2024.
  6. Prostatitis: Inflammation of the Prostate. NIH. Published July 2014. Medical Citation URL. Accessed March 11, 2024.
  7. When urinary tract infections keep coming back. Harvard Health Publishing. Published February 2, 2022. Medical Citation URL. Accessed February 11, 2024.
  8. Swatesutipun V. Can recurrent UTIs in women be cured? Review article. Continence Reports. Medical Citation URL. Accessed March 11, 2024.

Jillian Foglesong Stabile, MD, FAAFP is a board-certified Family Physician. Since completing her residency training in 2010, she’s been practicing full-scope family medicine in a rural setting. Dr. Foglesong Stabile’s practice includes caring for patients of all ages for preventative care as well as chronic disease management. She also provides prenatal care and delivers babies. Dr. Foglesong Stabile completed a teaching fellowship in 2020 and teaches the family medicine clerkship for one of her local medical schools. Dr. Foglesong Stabile’s favorite thing about family medicine is the variety of patients she sees in her clinical practice.
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