25 main UTI causes you must know

In order to prevent urinary tract infections, you must know main UTI causes.

Many think that poor hygiene is the main reason for UTI, but this is far from the truth. In most cases, your hygiene habits have little to do with your chances to develop a UTI. Surprisingly, if you are a woman, the secret to a UTI-less life could be in your vagina.

I have grouped all known (to me) UTI causes in 5 main “buckets” to help you to remember what to watch out for. Altogether, there are 25 main reasons why you keep getting your UTIs and how to improve your chances to stay healthy.

Main UTI Causes: #1 Weak Vaginal Flora

Compromised vaginal flora is one of the most overlooked UTI causes

There is a very close link between loss of normal vaginal flora (particularly Lactobacillus species) and increased risk of contracting a UTI.

“Wait for a second!,”- I hear you saying. “If UTIs happen in my bladder, what does my vagina have to do with it?”.

Unfortunately, the important role a healthy vagina plays in protecting you from recurrent urinary tract infections is not a common knowledge. The truth is E.coli bacteria (that cause 90% of all UTIs and live in your poop) travel toward your urethra. But on the way toward your urethra bacteria “make a stop” in your vagina. If your vaginal flora us healthy, the “bad guys” will struggle. However, if vaginal flora is compromised, “the bad guys” will multiply and continue on their way toward your bladder.

A healthy vaginal microbiome has lots of Lactobacillus species. Those tiny good bacteria are on your side. Every day researchers find more and more ways how these beneficial bacteria help our bodies to function and how lack of those bacteria could lead to various misalignments.

For example, Lactobacillus species help to maintain low pH of the genital area, produce hydrogen peroxide, hinder the growth of E. coli, and also help to down-regulate inflammatory reactions caused by E. coli.

In plain words, not only good bacteria make it hard for E. coli bacteria to grow and populate your genitals, but they also reduce inflammation and support healthy pH of your vagina.

However, it is easy to affect the wellbeing of your well-meaning bacteria. Those tiny warriors are kind of fragile and plenty of things can disrupt their ability to grow and protect you.

For example, these are some factors that can affect your vaginal flora and therefore, could be considered risk factors for UTI:

  1. Condoms with spermicide

Most popular spermicide used on condoms is Nonoxynol-9. It is known to disrupt the life of your vaginal bacteria and to suppress their growth.

No wonder, “condoms and UTI” is a popular search phrase. If you can, use condoms without spermicide to avoid this UTI cause.

2. Other Nonoxynol-9 contraceptives

Plenty of other contraceptive products use Nonoxynol-9: contraceptive film, sponges, suppositories, cremes, tablets. You want to avoid these as much as you can. If in doubt, make sure to read the label.

3. Lubricants

I used to get the yeast infection every time after using a lubricant. And no wonder, lubricants could be a contributing factor to cause a UTI as well.

I would advise avoiding lubricants that have Glycerin or Sorbitol on their ingredient list.

4. Antibiotics

Antibiotics are supposed to cure, not cause a UTI, right? That’s true, they will help you to get rid of an acute infection, and in doing so will handicap your own defenses.

You see, when an antibiotic is busy killing E.coli and other bad bacteria that caused your UTI, your good bacteria also suffer. As you can expect, you find yourself in a vicious circle: you need antibiotics to fight an acute bacteria, but after the fight is over you vagina is no longer well protected against pathogenic bacteria that is ever-present.

5. Stress

This factor seems to affect all aspects of our health. Whatever health problem you have, more often than not you can link it to stress. Not only you feel nervous, anxious but your bacteria suffer too.

Apparently, some studies show that stress decreases the number of Lactobacillus species that live and prosper in your body (as reported by Femke Lutgendorff et al. in the June 2008 issue of Current Molecular Medicine). Take a deep breath and make yourself a chamomile tea, go for a walk and count your blessings.

6. Diet

Apparently, your friendly bacteria are picky eaters. Also, they like healthy food and lots of fiber. Oh, and they also need a variety, so drinking lots of psyllium husk won’t be enough. Stuck up on various veggies, fruits, exclude processed food, sugars and add a nice prebiotic blend to your diet (read here more).

7. Lack of estrogen 

Women don’t have it easy: periods, cramps, UTI, babies and then when you think it’s all almost over you are hit by menopause.

Of course, change in your hormones could happen at any age, but chances are higher that you’ll need estrogen supplementation once you grow wiser.

Studies show that when women are given estrogen hormones their vaginal Lactobacillus flora increased and therefore, hormonal changes could be counted as one of important UTI causes.

Main UTI causes: #2 Increased number of E. coli

Your E. coli bacteria is the main reason you get UTIs

More than 80-90% (depends on a study) of all UTIs in the world are caused by E. coli bacteria that conveniently resides in your own gut. Therefore, we can speculate that higher E. coli concentration can lead to increased chances of contracting a UTI.

8. Constipation

Constipation is not only unpleasant but also is a symptom of a bigger problem. The thing is, your guts, similar to your vagina, are also populated by various bacteria.

Your body needs bacteria to aid in various important functions such as “breakdown of food products into absorbable nutrients, stimulates the host immune system, prevents the growth of pathogenic bacteria and produces a great variety of biologically important compounds“. E. coli bacteria, when contained in the lower gut are helpful in producing vitamin K, for example.

However, constipation could a sign of an alteration of your microbiome. Some bacteria species reduce their activity, others continue to strive. Unfortunately, the bacteria that continue to grow are mostly the ones that could become pathogenic if they get into your urethra.

Therefore, constipation is a risk factor for UTI because it could increase the number of bad bacteria in your stool. On top of it, constipation might also cause an internal pressure on your bladder, obstructing it and making it more difficult to empty it completely.

Bottom line, eat your veggies and exercise to prevent UTIs caused by constipation.

9. Dehydration 

Unless this is your very first UTI, you must have heard million times that it is important to stay hydrated to prevent urinary tract infections. Why? Well, gone are days when scientists thought that your bladder is sterile. It is not. As everywhere else, there are dozens of various strains of bacteria in your bladder, doing whatever they need to do to keep you healthy.

However, pathogenic bacteria enter your bladder from time to time as well. All those bacteria live their busy lives and multiply.

If there is no fresh urine that washes your bladder walls from time to time, the old urine harbors growing bacteria and this could cause a UTI.

10. Vesicoenteric fistulae

And, in some rare cases, bacteria could be leaking from your gut straight into your bladder. This condition is known as Vesicoenteric fistulae (or enterovesical or intestinovesical fistulae).  This is literally an opening between the bowel and the bladder that could happen as a result of a surgery, accident, cancer, abnormal anatomic development of an embryo.

Main UTI causes: #3 Bladder obstruction

Inability to fully void your bladder is one of the main reasons for UTIs

As described above, if old urine remains in your bladder, it allows bacteria to grow. Anything that causes urine to stay in the bladder for a prolonged period of time can increase your chances to develop a UTI.

Evidently, anyone with an abnormality of the urinary tract that obstructs the flow of urine—a kidney stone or enlarged prostate, for example—is at risk for a UTI.

Therefore, these are five UTI causes related to bladder obstruction:

11. Spinal cord injuries or other nerve damage around the bladder

In this cases, a patient simply does not feel the urge to urinate, leaving urine in the bladder for too long.

12. Kidney and bladder stones

These are not only obstructing normal urine flow, but also damage protective bladder lining allowing for pathogenic bacteria hide and prosper, causing recurrent UTIs.

13. Anatomic abnormalities

Some folks are born with a deformity that could actually make urine to flow “backward” (aka Vesicoureteral reflux (VUR). If your small kid is diagnosed with a recurrent UTI, the doctors would most likely check with ultrasound equipment if his kidneys function well.

14. Bladder and urethra scarring, blood clots

The more infections you experience, the higher are your chances to develop bladder lining abnormalities. Anything but perfectly healthy bladder lining could be a cause for recurring UTIs.

15. Enlarged prostate

The only factor that is unique to guys. The prostate is located in a close proximity to the urethra and if enlarged could make it hard or even impossible to pee. If you can’t pee out your old urine, you are just asking for trouble.

16. Weak bladder muscles

In this case, a patient can’t squeeze his or her bladder muscles strong enough to empty the bladder completely, constantly leaving old urine in the bladder. This as you know by now, could cause a UTI.

Main UTI causes: #4 Bladder flora

Decreased number of good bacteria in your bladder is one of the reasons bad bacteria can grow faster

As we discussed earlier, your bladder is not sterile. Certain microbes, including beneficial ones, exist in the healthy human bladder.

Multiple factors including diet and even your blood type can affect your bladder flora making it more or less prone to urinary tract infections.

These factors include:

17. Certain diseases (for example, diabetes)

If you have diabetes, you are twice as likely to contract a urinary tract infection (UTI). Extra glucose in your urine drives changes in your bladder flora making you more prone to UTIs.

18. Surgeries

 Certain types of surgeries, for example, TransVaginal Mesh can be a risk factor for UTI. Any bladder surgery messes up your natural bladder microbiome and could potentially result in a UTI.

19. Use of instrumentation and catheters

Catheters are known culprit of UTIs. Think of it as a bridge and a hiding place for pathogenic bacteria in your bladder.

20. Antibiotics

Similar to how antibiotics affect your vaginal microbiome, they influence the bacterial composition of your bladder as well.

Main UTI causes: #5 Activities that transfer bacteria

Your hygiene routines can pose greater UTI risk

I’m sure, if you are an adult, you are wiping “from front to back”. And only once, with one piece of paper. Should we even talk about it? Nonetheless, if you ever go to a physician’s office you are destined to hear it again.

Besides wiping, there are other activities that can help your E. coli bacteria to “get a lift” from your anus towards your urethra and will increase the chances of contracting a UTI.

21. Bad hygiene

Take your shower, do not sleep in the same underwear that you wear all day. Oh, and, of course, wipe from front to back.

22. Sex

If your vaginal flora is compromised, E. coli can grow in your vagina. Next time when you have sex, they’ll get much closer to your urethra, greatly increasing your chances of a UTI. Sex on its own doesn’t cause a UTI, but it’s a major risk factor if your vaginal flora is compromised.

23. Thongs

A narrow piece of material will pick up more bacteria and then slide back and forth while you move. While studies did not find conclusive evidence, many doctors recommend to opt out for simple cotton panties instead of thongs.

24. Feminine menstrual products

Just remember to change them regularly or they could become a breeding ground for pathogenic bacteria.

25. Anal play

On its own, anal sex or finger anal play would not cause a UTI. To be safe, use a condom and discard it right away. Do not use the same condom for vaginal penetration.

Am I missing anything? Leave me a comment below and share your thoughts.

Next: read how to prevent UTI by making changes to your diet.






  1. Hi Anastasia,

    Admirations for writing the article!

    One serious and dificult to treat cause for frequent UTIs can be a fistula.

    An enterovesical fistula, also known as a vesicoenteric, intestinovesical fistula or apendicovesical fistula, occurs between the bowel and the bladder or the intestines and the bladder or the apendix and the bladder. In such cases bacteria leaks from the bowels in to the bladder and contaminates it regularly causing frequent UTIs. In such cases taking antibiotics stops the UTI for the duration of the treatment but it returns few days after the treatment stops.

  2. Hi! Great site, very informative.

    There IS one possible cause that you missed which might explain certain UTI symptoms that do not show up at “proper” UTIs.

    Drum roll…that is…Lyme Disease. One of the first places the Borellia bacteria colonize in any organism they infect is the bladder. This is because they go into an encysted form that can easily pass out into the environment via urination. They then get ingested by the next link in the chain needed to keep the cycle going, making its way through the various hosts and vectors.

    You have to hand it to the little guys — it is really a most ingenious way to keep replicating themselves!

    For years I had urge incontinence that had shades of UTIs, but nothing ever came up as confirmed. Once I got treatment for the Lyme underway (alternative only as I’d had it for far too long misdiagnosed as other stuff for antibiotics to work on me) that long-standing problem resolved.

    Lyme often affects the neurological system, so you can also have some of that kind of issue at work, too. (Lyme is frequently misdiagnosed as Parkinson’s, MS, and Alzheimers, among others.)

    I post this in case others might be frustrated and wondering how in the world to stop having UTI symptoms that defy classification. There may be an underlying cause.

    Just be aware — much of the info out there on Lyme is outdated, misinformed, or sometimes just plain dead wrong, especially on the CDC site. (It took the CDC seventeen years and some pretty heavy pressure to “revise” their numbers to ten TIMES the amount they declared was accurate, and that, too, is underestimating according to the field experts.)

    To anyone reading this and wondering how to find out if you may have Lyme, I’d start with Stephen Harrod Buhner’s book, Healing Lyme, the 2015 edition. For a well rounded work that explains the antibiotics arena of Lyme well, plus supplements, diet, and exercise support, check out The Lyme Disease Solution, by Kenneth Singleton. Both are good.

    And if you need to get you doctor to test you for Lyme, you may have to insist they use the Igenex Lab in Palo Alto, CA, or one of the other Lyme and Tick Borne Disease specialized labs. Their accuracy is about 80% vs. 49% for the common lab tests. (Ummm…Just flip a coin??)

    A last tidbit: there is a tremendous amount of controversy over whether Lyme is “chronic.” I hold with the minority who says it is not. It is a minority, but there are some pretty learned voices in it. YOU get to choose which voices to believe, and belief is a powerful thing!

    Apologies if this hijacked your comment section. I hope it helps!

    • Hahah :)) best hijacking ever!

      Thank you for taking the time to write it up and share your experience. I will look into this further and edit the post to reflect info about this case. Perhaps even a separate post since seems like a certain group of folks could really benefit from this. Super happy for you and good job heal-lieving yourself 🙂
      Linking Healing Lyme and
      The lyme disease solution book


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