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What to do for recurrent UTI?

This Premium Q&A, reviewed and published, features a real conversation between an iCliniq user and a physician.

Patient's Query

Hi doctor,

I am in menopause and have had bad issues with my hormones and my bladder. I am 51 years old. Is this something you can help?

Answered by Dr. Divakara P

Hi,

Welcome to icliniq.com.

Yes, definitely, I can help you. Kindly elaborate and let me know your problems.

Patient's Query

Thank you doctor,

For over a year now, I have been having issues with menopause hormones and bladder. I am getting recurrent UTIs for at least once a month. My gynecologist does put me on estrogen cream vaginally. I have been on it for the past six months. Initially, it seemed to help a little, so I was using it for two times a week. But, now she just increased it to thrice daily. She also told me to take a low dose antibiotic Macrobid after intercourse. But, I am still getting UTIs. I went to a urologist about two years ago and said that everything was fine. But, I did not go through entire test as she hurt me pretty bad with the catheter. I have vaginal atrophy and I was very irritated and dry down there and it almost killed me when she did it. I do not have children. My obstetrician is using her knowledge to the deep I guess. Currently, I am having UTI and on the Macrobid twice a day. It seems like it is not working and I have a low grade fever of 97.1 degrees Fahrenheit. Please give some advice. What shall I do now?

Answered by Dr. Divakara P

Hi,

Welcome back to icliniq.com.

I went through your query and I can understand your concern.

  1. Recurrent urinary tract infections are quite common during and after menopause. But, if properly treated, it should get resolved.
  2. Most likely rather than treating for the hormonal issues, proper focus has to be given on treating UTI.
  3. I recommend you to stop taking Macrobid and get a urine culture test after five days. You can take an alkalizer syrup (Syrup Citralka - Sodium hydrogen citrate) for symptomatic relief.
  4. Once you get the urine culture report, you can be started on proper antibiotic therapy as indicated by the culture report. This antibiotic therapy has to be given for at least three weeks and then a repeat urine culture has to be done to check if UTI has been eradicated or not.

Patient's Query

Thank you doctor,

My obstetrician did not ask me to get a urine culture. I just visited a urologist before. Should I visit an endocrinologist? Or whom shall I meet to help me and do it right? My doctor said that the UTIs are due to low estrogen levels and prescribed me estrogen cream. But, that did not help my UTI.

Answered by Dr. Divakara P

Hi,

Welcome back to icliniq.com.

  1. Your doctor is right. UTI is due to low estrogen levels causing dryness. But, treatment with hormonal cream or pills will just normalize the hormone levels, but it will not cure the UTI.
  2. In your case, UTI is persistent or recurrent because of improper and inadequate treatment of UTI and not just menopause and hormone issue.
  3. So, you can either ask your doctor only for prescribing urine culture sensitivity test or you can meet a physician or internist or infectious disease specialist for this problem.
Answered byDr. Divakara P
Medically reviewed byiCliniq medical review team
Published At November 25, 2017
Reviewed AtFebruary 15, 2024

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Divakara P
Dr. Divakara P

Internal Medicine

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