Recurrent UTI: Causes, Tests, Treatment & Prevention

Got multiple UTIs in a year? You're not alone — some people get them again and again. Recurrent UTI usually means two or more infections in six months or three or more in a year. This page gives clear, useful steps you can try and what to expect from your doctor.

Why UTIs keep coming back

There are a few common reasons. Bacteria can be reintroduced from sexual activity, from bowel bacteria near the urethra, or from using spermicides. After menopause, lower estrogen changes vaginal flora, letting bad bacteria stick around. Other causes include incomplete bladder emptying (from constipation or certain medical problems), kidney stones, diabetes, and sometimes an untreated or resistant bug.

Not all repeat problems are the same. Sometimes it’s reinfection — a new bacteria each time. Other times it’s persistence — the same bacteria surviving low-dose or short antibiotics. Your doctor will want to figure out which is happening because that changes treatment.

Tests and smart treatment choices

Always get a urine culture when you have symptoms. Cultures identify the exact bacteria and which antibiotics will work. Avoid guessing or saving old antibiotics; that can fuel resistance. If infections are simple and respond well, you might just get a standard course of antibiotics. If they return, options include a longer targeted course, a low-dose antibiotic taken daily for months, or a single dose after sex if your UTIs are linked to sex.

For postmenopausal people, topical vaginal estrogen often cuts recurrences by restoring healthy Lactobacillus in the vagina. Probiotics with Lactobacillus crispatus show promise, but evidence varies. D-mannose is a sugar supplement some people use; it may help prevent E. coli from sticking to the bladder, though studies are mixed. Cranberry products have modest benefit for some but are not a cure.

If infections are severe, occur in men, happen during pregnancy, or don’t respond to treatment, your doctor may order imaging (ultrasound or CT) or refer you to a urologist for cystoscopy. Those tests look for stones, anatomic issues, or other problems that keep infections coming.

Simple habits help a lot. Drink enough water to keep urine pale, pee after sex, avoid spermicides, wipe front to back, wear breathable cotton underwear, and avoid irritating soaps or douches. Treat constipation and manage blood sugar if you have diabetes.

If you’re tired of repeat infections, ask your clinician for a clear plan: culture results, targeted antibiotic, prevention options (postcoital dose, daily low-dose, or vaginal estrogen), and when to get imaging. Don’t self-treat with leftover meds. Recurrent UTIs are frustrating, but with the right tests and a tailored plan you can reduce how often they come back.