What Is a Recurrent UTI, and When Should You See a Specialist?

Urinary tract infections (UTIs) are a common and uncomfortable condition, especially for women. They happen when bacteria enter the urinary tract through the urethra and begin to multiply, often affecting the bladder. This can cause symptoms like a burning sensation when peeing and a sudden, frequent urge to urinate.

Most UTIs clear up quickly with antibiotics. But for some people, the infection keeps coming back — sometimes within weeks. When UTIs happen repeatedly, it’s called recurrent UTI. Some women are more prone to recurrent UTIs due to a combination of factors, including anatomy, hormones, and behaviors.

In this article, we’ll explore why UTIs can return, how recurrent UTIs are treated, and when it might be time to see a specialist for further help.

What are recurrent UTIs?

UTIs are among the most common bacterial infections — about 40% to 60% of women will have at least one in their lifetime.

But for many, a single UTI isn’t the end of the story. Some infections return shortly after treatment, often within weeks or months. This pattern is known as recurrent UTI.

Recurrent UTIs are more common than you might think. More than 1 in 3 women who get a UTI will have another one within a few months.

Clinically, a person is diagnosed with recurrent UTIs if they have:

• three or more UTIs in 1 year, or

• two or more UTIs within 6 months

If that sounds familiar, you're not alone — and there are steps you can take to manage and prevent future infections.

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Symptoms of recurrent UTI

The symptoms of a recurrent UTI are usually the same as a regular UTI — they just keep coming back. Common UTI symptoms include:

• A strong, persistent urge to pee

• A burning feeling when urinating

• Passing small amounts of urine frequently

• Cloudy or strong-smelling urine

• Pelvic pain or pressure, especially in the lower abdomen

• Blood in the urine (in some cases)

If these symptoms return within weeks or months of finishing antibiotics, it could be a sign of a recurrent infection. 

What causes repeated or frequent UTIs?

It’s still not fully understood why some people are more prone to UTIs than others. But research has identified several risk factors that can increase the chances of developing recurrent infections.

You may be more likely to get recurrent UTIs if:

• A close female relative (parent, sibling, or child) also has them.

• You have sex three or more times per week.

• You have multiple or new sexual partners.

• You had your first UTI before age 15.

• You use spermicides for birth control.

• You’re going through the menopause transition.

• You have diabetes.

• You have trouble fully emptying your bladder.

• You take medications that raise the risk of UTIs like certain diabetes medications, older antihistamines like diphenhydramine (Benadryl), opioids, and some antidepressants, like amitriptyline.

Many of these factors either introduce more bacteria into the urinary tract or affect your body’s ability to flush them out. Understanding what could be triggering recurrent infections can help guide prevention and treatment.

How are recurrent UTIs diagnosed?

Recurrent UTIs are diagnosed the same way as a first-time UTI — based on your symptoms and a urine test.

If your symptoms come back within 2 weeks of finishing treatment, it may mean the initial infection wasn’t fully cleared. In this case, you may need to send your urine for a culture test. This identifies the specific bacteria causing the infection and determines which antibiotics are most likely to work.

Imaging tests like X-rays or ultrasounds aren’t usually necessary. But you may need them if you have unusual symptoms or if your primary care provider suspects a physical problem, like a kidney stone or a blockage that’s preventing your bladder from emptying properly.

What is the treatment for recurrent UTIs?

Recurrent UTIs are typically treated the same way as first-time infections — with antibiotics. The exact medication your primary care provider prescribes depends on your health history, the specific bacteria involved, and any previous antibiotic resistance.

Common antibiotics used for recurrent UTIs include:

• Nitrofurantoin (Macrobid)

• Trimethoprim-sulfamethoxazole (Bactrim) 

• Fosfomycin (Monurol)

• Ciprofloxacin (Cipro)

• Cefpodoxime

• Cefuroxime

• Blujepa (gepotidacin) — a newer oral antibiotic approved for uncomplicated UTIs

Most antibiotic treatments last 3 to 7 days, but your primary care provider will tailor the duration to your situation. It’s important to take the full course, even if you start to feel better before you’re done. Don’t save any pills for later or share them with others.

What to expect after starting antibiotics

You should start to feel better within 24 to 48 hours of starting antibiotics for a UTI. But if symptoms aren’t improving after 3 days, or if they get worse at any point, it’s important to follow up with your primary care provider. This could mean the infection hasn’t cleared, the bacteria are resistant, or another condition is causing similar symptoms.

If your infection returns quickly after treatment, your primary care provider may adjust your antibiotics based on urine culture results.

Other prescription options

In some cases, medical professionals might recommend a preventive medication to reduce the chance of another infection. One option is methenamine hippurate — a nonantibiotic prescription that helps keep the bladder environment less friendly to bacteria, making it harder for infections to take hold. It’s sometimes used for people with frequent UTIs who want to avoid repeated courses of antibiotics.

Managing symptoms at home

While antibiotics treat the infection, supportive care can ease your discomfort:

• Over-the-counter (OTC) pain relief, like acetaminophen or ibuprofen, can reduce pain and fever

• Phenazopyridine (Azo or similar) is an OTC medication that can help relieve UTI symptoms. But it won’t treat the infection. 

• Heating pads placed over the lower abdomen can ease bladder cramps and pelvic pain

• Staying well hydrated helps flush bacteria from your system

If you’re dealing with frequent or recurrent UTIs, your primary care provider may also recommend preventive strategies, which we’ll cover in the next section.

What should you do if UTI symptoms don’t go away after antibiotics?

If you’ve finished a course of antibiotics but still have symptoms — like burning, urgency, or pelvic discomfort — it’s important to check back in with your doctor’s office. There are a few possible reasons the infection may not have cleared:

• Antibiotic resistance: The bacteria causing your UTI may not respond to the antibiotic you were prescribed.

• A different type of infection: While most UTIs are caused by bacteria, other germs — like fungi or viruses — can sometimes be the culprit.

• Another condition entirely: Some conditions, like sexually transmitted infections (STIs) or interstitial cystitis, can mimic UTI symptoms.

Depending on your situation, your primary care provider may recommend:

• Another urine culture to identify the exact cause of your symptoms

• A longer course or different type of antibiotic

• Additional testing to rule out other causes for your symptoms

Don’t wait it out — ongoing symptoms should always be evaluated, especially if they persist or worsen after treatment.

What is the difference between chronic and recurrent UTIs?

Chronic UTI means there are ongoing symptoms despite treatment. This is unlike recurrent UTIs where the symptoms go away between infections.

In cases of chronic UTI, the infection may not fully clear, and symptoms like urgency, burning, or bladder discomfort linger. Experts believe this can happen when bacteria remain in the urinary tract, even if they don't show up on standard urine culture tests. So if you have other signs of infection, your primary care provider may treat your ongoing UTI symptoms.

How do you prevent recurrent UTIs?

If you have frequent UTIs, your primary care provider may talk to you about preventive antibiotics, also called antibiotic prophylaxis. This could involve:

• Taking a low-dose antibiotic daily

• Taking an antibiotic after sex, if UTIs are triggered by sexual activity

• Taking an antibiotic only at the first sign of symptoms

But, it’s not clear how long antibiotic prophylaxis should go on. And, taking antibiotics for a long time can increase the risk of side effects and antibiotic resistance, so it’s not right for everyone. 

Other ways to lower your risk

In addition to antibiotics, there are lifestyle habits and therapies that may help prevent UTIs:

• Drink plenty of water throughout the day to flush out bacteria.

• Urinate soon after sex to help clear the urethra.

• Wipe from front to back after using the bathroom.

• Use nonspermicidal contraception, like condoms without spermicide.

• Consider vaginal estrogen therapy if you’re in or past menopause — this can help maintain healthy vaginal tissue and lower the risk of UTIs.

What about cranberry and probiotics?

There’s no guaranteed way to prevent UTIs, but some people find benefit from:

• Cranberry products, such as juice, tablets, or dried cranberries, which may help prevent bacteria from sticking to the bladder wall

• Probiotics, especially Lactobacillus, taken by mouth or as intravaginal suppositories, which may help restore healthy vaginal flora

While the evidence for these approaches isn’t strong, they’re generally safe to try, especially if you’re looking for options beyond antibiotics.

When should you see a specialist for recurrent UTIs?

You don’t always need to see a specialist for recurrent UTIs. But in certain situations you might need further testing or referral to a urologist or urogynecologist, especially if you:

• Continue to have UTI symptoms after treatment and your urine culture shows no bacteria

• Have blood in your urine after finishing a course of antibiotics

• Have had more than one kidney infection

• Have a history of kidney stones

• Have had surgery involving your urinary or genital tract

• Struggle to fully empty your bladder 

• Experience incontinence

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Written by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Edited by:

Sophie Vergnaud, MD

Sophie Vergnaud, MD, is the Senior Medical Director for GoodRx Health. An experienced and dedicated pulmonologist and hospitalist, she spent a decade practicing and teaching clinical medicine at academic hospitals throughout London before transitioning to a career in health education and health technology.

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