Break the Cycle of UTIs and Yeast Infections
Many women are familiar with the vicious cycle that can result from getting a urinary tract infection (UTI)—the infection is treated with antibiotics, but then a vaginal yeast infection devel-ops.
Once you understand why this cycle occurs and what you can do to prevent the infections in the first place, you can break the cycle.
UTI causes
UTIs occur when bacteria (often E. Coli from the gastrointestinal tract) enter the bladder through the urethra (a tube through which urine travels from the bladder when it is excreted) and grow, causing inflammation and infection.
“A UTI will result in symptoms of painful urination and urinary urgency and frequency, as well as blood in the urine,” explains Tirsit Asfaw, MD, an assistant professor of obstetrics and gynecology at Weill Cornell Medical College.
A woman’s anatomy increases her susceptibility to UTIs because the urethral opening is close to the anus, and the urethra is short, so bacteria don’t have far to travel to reach the bladder.
“Postmenopausal women are especially vulnerable to UTIs due to vaginal atro-phy,” says Renuka Tyagi, MD, a urogynecologist at Weill Cornell Medical College. “After menopause, the lining of the vagina is thinner and more delicate, and it’s easier for it to get traumatized during activities such as sexual intercourse and exercise.” That thin-ner vaginal lining also makes it easier for bacteria to move from the vagina to the urinary tract.
CHOOSING YOGURT
Many women opt to eat yogurt that contains live, active cultures of friendly bacteria to keep yeast infections at bay. When choosing yogurt, avoid flavored products with a high sugar content, and check the label to ensure it contains active cultures, which will appear in the ingredient list.
Also, look for the “Live & Active Cultures” seal, developed by the National Yogurt Association to identify products with a high number of bacterial cultures
(100 million per gram).
Preventing UTIs
Dr. Tyagi says it is often possible to identify what’s causing your UTIs and take preventive measures. “For some people, it’s exercise, like bike riding. For many patients, it’s sexual intercourse,” she says.
She recommends reducing irritation to the area by using a lubricant during sex and following these general rules: “Keep yourself hydrated with plenty of water, empty your bladder before exercising and after intercourse, and stay out of wet shorts and bathing suits.”
Another way to prevent a UTI is to increase the concentration of “good” bacteria in your body, which can create an environment that is hostile to the harmful bacteria. These good bac-teria are lactobacilli; they are found in yogurt and in probiotic supplements. Dr. Tyagi recommends that her postmenopausal patients with recurrent UTIs take an oral probiotic each day or that they eat one serving of yogurt daily (see sidebar, “Choosing yogurt”).
If these measures are unsuccessful, you will need further evaluation, preferably by a uro-gynecologist. “In women with recurrent UTIs, there are certain options to help prevent them,” notes Dr. Asfaw. One possibility is taking a long-term course of antibiotics; another is using vaginal estrogen therapy.
About antibiotics
The standard course of treatment for a UTI is antibiotics.
“While some UTIs may resolve on their own, treatment with antibiotics will result in earlier relief from the bothersome symptoms. Generally, it is recommended to treat UTIs with the shortest duration of an appropriate antibiotic regimen,” says Dr. Asfaw.
Dr. Tyagi supports antibiotic use for UTIs, but only under a physician’s supervision. “Too many women self-treat with antibiotics,” she says. “Women should visit their doctor’s office for a urine test that confirms the presence of a bacterial infection before being given a prescription for antibiotics. In general, you should take antibiotics only as needed, because there’s a risk that the bacteria will become antibiotic-resistant,” she says. “Intermittent treatment with antibiotics as needed is the best thing.”
Dr. Asfaw also notes, “Bacteria can sometimes be present in the bladder and not cause an infection; this is particularly true for postmenopausal women. Therefore, if a urine culture comes back positive for bacteria, but the woman has no symptoms of a UTI, she does not need to be treated with antibiotics.”
Preventing yeast infections
If you do take an antibiotic, for a UTI or any other infection, your risk of developing a subsequent yeast infection increases.
“The vagina contains lactobacilli, bacteria that keep the vaginal pH in the acidic range and prevent the overgrowth of harmful bacteria, such as E. coli. When we use antibiotics to treat UTIs, the unintended consequence may be the killing of the good lactobacilli in the vagina, which may result in overgrowth of other bacteria, or fungi, such as yeast,” explains Dr. Asfaw.
To minimize your chances of a yeast infection, consume foods that contain live, active cultures (yogurt, beverages made with yogurt, kefir) and/or take a probiotic supplement while you are taking antibiotics. Also, finish the course of antibiotics as directed, regardless of whether your symptoms are gone; if you stop early, the harmful bacteria may survive, and you’ll be a prime target for another UTI.
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