Women more prone to annoying repeat bladder infections

DEAR DR. DONOHUE: I have repeated urinary tract infections. I am a 68-year-old woman. I have been on trimethoprim (an antibiotic) for a long time, and last week I had another infection. What is your opinion? I am frustrated. — J.

ANSWER: I am taking “urinary tract infection” to mean bladder infection, a most common female problem for two reasons. The female urethra — the tube that drains the bladder — is shorter than the male’s, and bacteria can more easily gain access to the bladder. Secondly, the external opening of the female urethra is in an area where there is an abundant bacterial population.

First off, it must be established that your symptoms — painful, frequent urinations — are truly due to an infection and not something else. High on the list of something elses is interstitial cystitis, a condition that closely resembles a bladder infection but for which antibiotics do nothing.

One way of preventing recurrences is to put a woman on a low dose of daily antibiotics for extended periods of time. During that treatment period, a woman’s urine should be checked, even monthly, to see if there are still bacteria in it. If there are, then the laboratory runs tests on them to determine if they are still susceptible to the antibiotic that the woman is taking. If they aren’t, then a change must be made. This might be your problem.

Or, you might have an anatomic problem like a dropped bladder, something many 68-year-old women have. It is impossible to empty a dropped bladder of all its urine. That creates an environment conducive to bacterial growth and bladder infection. Treatment for this condition is not antibiotics but surgical restoration of the bladder supports.

Cranberry is something that always comes up when bladder infections are discussed. It comes as juice, concentrate, tablets or capsules, and which is best remains to be seen. It does keep bacteria from clinging to the bladder wall, and that helps reduce the incidence of infections.

Urinary tract infections are discussed in the booklet on that subject. To order a copy, write to: Dr. Donohue — No. 1204W, Box 536475, Orlando, FL 32853-6475. Enclose a check or money order (no cash) for $4.50 U.S./$6.50 Canada with the recipient’s printed name and address. Please allow four weeks for delivery.

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DEAR DR. DONOHUE: My niece and her husband have been trying a long time to have a baby. They are in their middle 30s. We think that the problem might be his drinking. He drinks a six- to 12-pack of beer every night. Could alcohol be the reason? My niece’s biological clock is ticking. — L.A.

ANSWER: On the list of causes for male infertility, you will find heavy alcohol drinking. Alcohol in excess can depress the sperm count. Your niece’s husband fits the definition of heavy drinking.