Why too many women are prescribed antibiotics for UTIs they don't have

A recent study found that many women treated for recurrent UTIs didn't have UTIs at all. Instead, their symptoms were caused by hormonally driven inflammation and pelvic floor dysfunction. BSIP/Universal Images Group/Getty Images hide caption

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Maria Uloko sees the same scenario in her urology practice in Los Angeles every day: A woman has been diagnosed with recurrent urinary tract infections (which means she's had at least two in six months or three in a year), taken repeated rounds of antibiotics, and feels confused as to why the infections keep coming back.

Then, Uloko tells these patients something that often feels both revelatory and frustrating. "Most of them don't actually have UTIs, even though that's been their diagnosis time and time again," she says. "In fact, millions of women are being treated for UTIs they may not actually have."

Uloko is the co-author of a recent study published in The Journal of Sexual Medicine that backs this up. She and her fellow researchers reviewed the medical records of 253 women with recurrent UTIs and found that just 15% showed evidence of problems that were limited to the bladder or urinary tract. The remaining 85% had signs of hormonally driven inflammation of the vulvar region and 75% had pelvic floor dysfunction.

These conditions produce identical symptoms as UTIs — burning with urination, urgency, frequency, and/or lower abdominal pain — but require different treatment.

"What we found is that in women with recurrent UTIs, the majority didn't have a bladder problem at all; they had a vulvar problem," says Uloko.

Uloko's study provides insights that could help patients with urinary tract symptoms, says Melissa Kaufman , professor and chief of the division of reconstructive urology and pelvic health at Vanderbilt University Medical Center who was not involved in the research. "These findings will accelerate our discipline's investigations into a comprehensive unifying hypothesis to more precisely optimize care," she said via email.