Updated: Apr 6
Anyone who has had the unlucky experience of getting a UTI knows they can be incredibly painful. Feeling like you have to pee minutes after you have just gone. Little knives dancing all over your bladder. Blood appearing in the toilet, if the UTI has gotten serious. Leaving work, the party, canceling any upcoming plans - no matter how fun they were supposed to be. In other words, UTIs totally suck.
When I get a painful UTI, I have to sit on the toilet, sometimes for hours, until I can get my hands on Pyridium, that glorious, sweet little medication that cools my flaming bladder and turns my pee bright orange. On rare occasions, Pyridium has brought little relief, and I’ve had to wait for my antibiotics - typically Macrobid - to start massacring the army of unwelcome bacteria (damn you, e-coli!) that has somehow wormed its way up my urinary tract. Like any well-intentioned antibiotic attack, the Macrobid wipes out the good guys too, taking down the lactobacilli (good bacteria) along with the bad bacteria. What a lot of doctors didn’t take the time to tell me is this: replenishing the good lactobacilli bacteria can be really helpful to avoid getting another UTI right away. Having back-to-back UTIs is common, and this can happen if the good guys haven’t had time to restore their numbers before the bad guys return for a rematch. While I don’t normally take supplements, I do take lactobacilli in the form of a supplement after an infection. I also take d-mannose, a supplement that helps flush bad bacteria out of the body naturally. A balanced, healthy vaginal flora can protect the body against future infections.
For a long time I wondered why I seemed to be particularly susceptible to UTIs. Why mine appeared more painful. Why I experienced them so often, especially in comparison to my friends. What was wrong with my body? Was I too sexually active? (lol, I assure you I was not...) Did I unintentionally anger the she-gods, who then decided to punish me with excruciating bladder pain whenever they felt like it?
It wasn’t until a trip to Spain with my mom that I learned genetics could be responsible. I had gotten a UTI in Seville, and so my mom and I spent the evening going from bar to bar asking if they had cranberry juice to calm my symptoms. Cranberry happened to be one of the few fruits I didn’t know the Spanish name for (arándano). Each bartender I asked said they didn’t have any ‘jugo de arándano’, which was odd because cranberry juice is a typical bar staple. (Later I learned that arándano also means blueberry, so it’s possible the bartenders thought I was asking for blueberry juice.) Finally we found some at one of the nicest hotels in Seville, whose dear bartenders gave me two huge carafes on the house.
While I gulped down cranberry juice, my mom opened up about her own struggles with UTIs. (perhaps no surprise that this somewhat awkward topic of conversation came up between us, but I’m glad it came up – it turned out to be very helpful). Hers were also frequent, to the point where she started taking a prophylactic every time she had sex. Once I knew my mom had grappled with the same issues, I started to do research and found that, indeed, positive family
history is a risk factor for recurrent UTIs . My mom’s experience was also the first time I had heard of antibiotics being used preventatively. While I didn’t go that route myself for many years, the idea stuck with me.
Anyone who knows me well knows that I have dealt with recurrent UTIs for my entire young adult life. My friends are instantly sympathetic when I tell them about a recent episode, as they know how debilitating my UTIs typically are. When someone tells me they have gotten a UTI, I immediately bombard them with all the tips I’ve acquired throughout my history, whether they want to hear or not. I’ve told guys I’ve dated long before entering into a relationship because it tends to come up, one way or another. One guy told me his grandmother experiences them too, and it impressed upon me how common the problem is for women, regardless of age. I hope my female ancestors didn’t suffer as much as I have, because my resources to deal with UTIs are far better than theirs were. I truly don’t know how they managed.
Despite my best efforts at prevention, I got 4 back-to-back infections over several months in 2019. While I still think preventative measures are helpful, they sometimes just aren’t enough. I asked my urologist (doctors who specialize in the urinary tract) whether she thought I should use antibiotics prophylactically, like my mom used to. Now I take a small dose of Macrobid after I have sex. It’s annoying, but it’s far less annoying than having a UTI unexpectedly wreak havoc on a day where I would miss something important.
Feeling like I have control over my UTIs has been liberating. I no longer stress out about sex, and I no longer spend a morning on the toilet, fishing through my medicine cabinet for spare Pyridium while simultaneously trying to make an online doc appointment. While I still deal with bladder pain from time to time when I’m dehydrated (probably because my poor bladder has been through the ringer), I know that a few glasses of water will do the trick.
Bladder health is wealth.
My tips for living pain-free (this has worked for me)
Drink water consistently. If you’re bad at this, consider getting a fitbit or other device that reminds you to do it
Take D-mannose regularly and lactobacillus after any infections
Talk to your doctor about the possibility of using a prophylactic if your recurrent UTIs have gotten really out of hand (i.e. you’ve gotten several UTIs over the course of a few months)
Always pee after sex (but you probably knew that)