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:
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.
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.
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.
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.
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).
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.
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.
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.
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.
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.
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.
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.
- The female urinary microbiota, urinary health, and common urinary disorders
- Probiotic therapy: an immunomodulating approach toward urinary tract infection.
- Urinary Tract Infection in Postmenopausal Women