Urinary-yeast infection cycle?

Dear Alice,

I'm really stressed out because I've been getting recurring urinary tract infections coupled with yeast infections for the last six months. I'm not sexually active and I've been to two urologists and a gynecologist — they've all given me medication but the problems always turn up again. Is one problem causing the other? Can these prolonged problems be doing serious damage to my body? Perhaps you can't answer my questions either, but I'm really at my wit's end. What do I do? I'm tired of doctors and embarrassing exams and I can't understand why this is happening if I'm not having sex. Also, I'm a senior and in five weeks I'm out of health insurance — extending my parent's policy is very expensive and not an option. I'm busy trying to set up interviews, finish a thesis, and do a million things — I don't have time to be running around to more doctors' appointments! What insurance options are there for recent graduates?


Desperate for Health Care Options

Dear Desperate for Health Care Options,

While certainly unpleasant, urinary tract infections (UTIs) are very common and aren’t always caused by sexual contact. In fact, about half of people with a vagina report having at least one UTI in their lifetime. Antibiotics are the common treatment for UTIs, but they may affect the bacteria throughout the rest of the body, including the vagina. This may allow yeast infections to proliferate (more on this in a bit). In terms of the long-term effects, recurrent UTIs may have effects on the kidneys if not treated. There are no indications that recurrent yeast infections cause any long-term health effects. As you've been dealing with these issues for some time, it may be worthwhile to pursue what might be a root cause of the infections and their recurrence. As far as insurance options after you graduate, it will depend on where you live, where you work, your prior health history, etc. You might find the Go Ask Alice! Q&A Health insurance options after college, to be helpful. Ready to learn more? Time to jump in!

UTIs occur when bacteria gets into the urinary tract — the body’s urine-producing system that contains the bladder and kidneys. UTIs usually respond well to antibiotics prescribed by a health care provider, such as ampicillin, nitrofurantoin, tetracycline, or sulfonamides. Antibiotics, however, in their effective destruction of bacteria throughout the body, commonly upset the pH balance of the vagina. This imbalance can kill off some of the helpful bacteria as well. Removing this bacteria from the vagina provides yeast, which naturally exists in the vagina in a small amount, with the chance to proliferate. Given how antibiotics work to treat UTIs, it’s possible that having a UTI could increase the odds of getting a yeast infection, especially when the antibiotics aren’t taken according to the prescribed dose. All that said, there are several ways you can reduce your risk of both UTIs and yeast infections.

In understanding the method of prevention, it might be helpful to know about the causes and treatments of both UTIs and yeast infections. The most common type of UTI is a bladder infection (known as cystitis), which is linked to symptoms such as feeling the constant need to pee (even though not much urine is expelled), as well as burning upon urination. Any activity or condition that spreads bacteria into the urinary tract can cause UTIs. Also, certain factors may increase the risk of getting a UTI, which unfortunately, includes previously having one. Though some home remedies may help reduce the discomfort associated with UTIs (more on these in a bit), the only way to eliminate the infection is to take antibiotics as prescribed by a health care provider. In fact, taking anything less than the full dosage may not wipe out the bacteria and could cause one or more recurrences. If bladder infections are left untreated, there’s an increased risk of developing a kidney infection, which is rare, but may be potentially life-threatening. For more information about UTIs, consider checking out Ouch! Burning pee! Is this a urinary tract infection (UTI)? in the Go Ask Alice! archives.

Like UTIs, yeast infections are quite common and aren’t considered sexually transmitted infections. Yeast infections are an overgrowth of yeast in the vagina, which can occur when there’s not enough “good” bacteria to regulate yeast levels. Symptoms of a yeast infection include vaginal itching, thick white discharge (often cottage cheese-like), and, sometimes, a smell similar to baking bread. Moist environments can increase yeast production, so wearing sweaty workout clothes or staying in wet swimsuits for long periods are common culprits. Yeast infections have also been linked to hormone changes due to birth control pills and pregnancy, as well as antibiotics for UTIs. In fact, one study looking at the causes of UTIs found that almost seven percent of patients also had the bacteria associated with yeast infections. To treat a yeast infection, over-the-counter medicines tend to be effective. However, if symptoms don’t go away or if yeast infections continue to occur frequently, it may be wise to visit a health care provider to see if there’s another underlying condition that’s causing your yeast infections.

In between recurrences, there are lots of recommendations for preventing more UTIs and yeast infections:

  • Take antibiotics for UTIs as prescribed by a health care provider. Taking the full dosage for the full number of days can reduce the risk of getting a yeast infection.
  • Increase helpful bacteria through diet or vitamins when taking antibiotics. When starting the antibiotics for the UTI, eating plain yogurt or taking acidophilus (a probiotic) in capsules, liquid, or granule form can help replace your normal bacteria that gets killed by the antibiotics.
  • Drink lots of fluid every day. For an active infection, drink enough to pour out a good stream of urine every hour.
  • Flush out any bacteria in the vagina through urination and hygiene practices. Some methods include urinating frequently (don’t hold a full bladder!), wiping from front to back, washing your genital area with plain water at least once a day, changing sanitary napkins frequently during your period, and urinating within 20 minutes of sexual activity.
  • Reduce moisture in the vagina. Wearing cotton underpants, avoiding tight jeans or clothing that cuts in the crotch, and changing out of wet or sweaty clothes can make it less humid down under.

The reoccurring cycle of UTIs and yeast infections sounds frustrating and downright painful. Though it might take a little more trial and error, a health care provider may be your best resource to advise about the causes and treatments for your situation. And just because you haven’t found a health care provider that you connect with yet doesn’t mean that there isn’t one out there that can help. If you need to take care of gynecological problems in a hurry after you graduate, you might look for a local sexual and reproductive health clinic, such as Planned Parenthood. In many cases, they may have a sliding scale fee or payment plans to help make it more affordable. Good luck!

Last updated Dec 18, 2020
Originally published Mar 19, 1994

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