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Azo not helping: What To Do If Your UTI Is Getting Worse


What To Do If Your UTI Is Getting Worse

Urinary tract infections (UTIs) can be a pesky and painful experience down below. No one wants to be running out of their Zoom call every five minutes to hit the bathroom in discomfort. UTIs can also get even more complicated when some infections end up getting worse instead of better, even with proper treatment. What gives?

UTIs can be persistent and tough to get rid of. And some women are more likely to get them on a recurring basis (thanks, hormones!). (FWIW, one in five women gets a UTI at least once in her life, according to the National Kidney Foundation.)

The key to getting rid of your pee pain comes down to developing a treatment plan of action. And no, self-treating at home isn’t a good idea. The best way to tackle a UTI is through prescribed antibiotics from your doctor, along with a few best at-home practices for relief.

“It’s important to avoid certain activities, to give the area time to heal, flush out bacteria, and not worsen symptoms or cause irritation to the vaginal area,” says Bilal Chugtai, MD, urologist at Weill Cornell Medicine and New York Presbyterian.

If your UTI doesn’t clear up with a standard course of treatment and lifestyle changes (getting to those), it’s possible you’re not dealing with a UTI, and the infection is something worse. Don’t freak out, WH tapped doctors to help you navigate the painful (and sometimes confusing) issue of urinary tract infections. Here’s *everything* you need to know.

First: What is a UTI exactly—and how do you usually treat one?

Essentially a UTI is a bacterial infection that can form in your urethra, bladder, or kidneys, causing unpleasant symptoms like frequent urination, a burning sensation while you pee, pelvic pain, and more.

When UTI symptoms rear their ugly head, trying to treat them yourself will only give the infection more time to spread. The longer you wait to get medical attention, the more you’re putting yourself at risk for more serious health complications.

One in five women gets a UTI at least once in her life, according to the National Kidney Foundation.

“Waiting too long to start treatment can allow the infection to progress from a simple bladder infection treated with three days of oral antibiotics to a complex kidney infection requiring intravenous antibiotics,” says Ekene Enemchukwu, MD, assistant professor of urology at Stanford University School of Medicine.

Dr. Enemchukwu also points out that there’s also the chance you’re actually not dealing with a UTI at all—another reason to always check in with your health care provider about any concerning symptoms. “UTI-like symptoms, in the absence of bacteria, can be caused by other conditions, such as vaginal infections, STDs, kidney stones, severe constipation, and vaginal atrophy,” says Dr. Enemchukwu.

It’s always better to err on the side of caution. Rather than trying the wait-and-see method, make an appointment with your doctor as soon as you notice any telltale signs of a UTI. And even if you’ve had a UTI before and have medication leftover from your last treatment, “there should be no giving of antibiotics without a new assessment,” emphasizes Margaret Mueller, MD, assistant professor of obstetrics and gynecology at Northwestern Feinberg School of Medicine. Instead you should call your provider, come into the office, discuss your symptoms, have a urine culture done, and then be given treatment.

If it’s a typical, mild UTI, here’s what your treatment will look like. These interventions can also make it easier for you to go about your day and sleep with a UTI.

  • Taking a prescribed oral antibiotic. Being on an antibiotic for three, seven, or 10 days is generally going to be your first line of defense. It’s likely that you’ll start to feel better after one or two days of taking your meds, that doesn’t mean the antibiotics have finished their job. If you stop your treatment too soon, the bacteria can build defenses against the meds, rendering the meds useless.
  • Drinking tons of water. Those dreadful bathroom visits may make you think twice about chugging a glass of water, but “water is essential for all bodily functions,” says Carolyn DeLucia, MD, of VSPOT Medi SPA. “If we are dehydrated, then the bacteria can fester in the bladder. When we are well-hydrated, we urinate regularly, and the water cleans the walls [of the urinary tract] easily.” Not drinking enough water can also prevent your medication from getting where it needs to go: “Antibiotics have to have good penetration into the kidneys and bladder,” adds Vandana Bhide, MD, board-certified internist and pediatrician at the Mayo Clinic. “Drinking a lot of water will help deliver the antibiotic to the urinary tract. It also flushes the kidneys and bladder, and it prevents dehydration and kidney stones.” Aim to drink half of your weight in ounces each day.
  • Avoiding foods that could irritate your bladder. Avoid foods and drinks that are known to rub the bladder the wrong way, including coffee, alcohol, caffeinated sodas, acidic fruits, spicy foods, and artificial sweeteners. “Exposing yourself to these irritants in the midst of a UTI isn’t particularly harmful or dangerous,” says David Kaufman, MD, of Central Park Urology in New York City, “it just makes you feel worse, like putting salt in a wound.”
  • Taking lots of bathroom breaks. If you have the urge to go but hold it in instead, you could be setting up your urinary tract for problems. When you retain your urine, you’re causing your body to hang onto all those germs that are floating around in your bladder—the opposite of what you should do if you’re hoping for a quick recovery. “Emptying out the bladder flushes out the bacteria that’s been introduced there,” says Dr. Bhide.
  • Pausing on sex. Doing it while you have a UTI isn’t exactly advised. “Most women with symptomatic UTIs avoid sexual activity because it’s too uncomfortable,” notes Dr. Enemchukwu. “It can also theoretically push bacteria from the vagina back into the bladder, causing a new infection. ” So, it’s generally best to refrain from sexual activity during an active infection. Adds Dr. Kaufman, “I usually allow the patient to decide when she is ready for sex—it’s typically not a big problem once she starts antibiotic treatment.”

Sooo…what happens if a UTI gets worse?

There are a few reasons why your UTI might not improve, the first being that you stop taking your antibiotics. “Survivor bacteria that have been exposed to a short course of antibiotics will evolve to resist that antibiotic,” explains Dr. Kaufman. That means the infection will no longer respond to the medication, making it much tougher to get rid of the UTI.

UTI getting worse even with antibiotics? It’s also an unfortunate fact that some women are more prone to UTIs than others. For example, women that are postmenopausal or around the time of perimenopause will experience a decrease in estrogen, which affects the type of bacteria that exists in the vagina, Dr. Mueller says. “When those ‘good’ bacteria are depleted, because that estrogen is no longer circulating, that can allow for vulnerability of the vagina and the lower urinary tract to let in what we call ‘bad’ bacteria, like E. coli, or [other] things that cause urinary tract infections,” she explains.

If you have more than two UTIs in six months or three in one year, docs will typically recommend you get a cystoscopy or CT scan to look inside the bladder and make sure there’s nothing there that shouldn’t be there (think: kidney stones).

That brings us to another reason your UTI could be getting worse: It might *not* be a standard UTI and is actually a more serious kidney infection that requires emergency care. This can occur when bladder infections are left untreated, Dr. Mueller says.

Symptoms of a more severe kidney infection can include:

  • Blood in urine
  • High fever
  • Chills
  • Flank pain
  • Nausea
  • Vomiting
  • Sepsis

How do you know if you’re dealing with a standard UTI or severe kidney infection?

Both are technically forms of UTIs. A standard UTI, though, typically just means you’re dealing with cystitis, or inflammation of the bladder. That inflammation causes those typical UTI symptoms like painful or burning urination and urgent or frequent urination, explains Dr. Mueller.

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But a kidney infection, also known as pyelonephritis, is caused by the same bacteria and oftentimes results from an untreated bladder infection. These symptoms are typically much more severe.

When should you seek medical attention for a UTI?

Always, Dr. Mueller says. Self-treatment is not a great idea. And while popular over-the-counter relief products like Azo do exist, they’re not recommended as treatment on their own. “[OTC products] can help with some of the symptoms,” Dr. Mueller explains, “but they have has no antibacterial properties.” Going to your doc for a prescribed antibiotic is your best bet, along with adding in those lifestyle best practices mentioned earlier.

And if there’s any indication that you’re experiencing a kidney infection, like blood in your urine or pain around your torso, head to the emergency room ASAP for urgent care. This will likely require hospitalization and intravenous antibiotics.

Alexis Jones

Assistant Editor

Alexis Jones is an assistant editor at Women’s Health where she writes across several verticals on WomensHealthmag.com, including life, health, sex and love, relationships and fitness, while also contributing to the print magazine. She has a master’s degree in journalism from Syracuse University, lives in Brooklyn, and proudly detests avocados.

5 Worst UTI Complications – What It’s Like to Have a Severe Urinary Tract Infection

For something that affects such a tiny part of the body, UTIs have a big impact on the half of all women who get them. The regular symptoms are bad enough, but when things get worse — or when the doctors don’t listen, or when the meds don’t work — it’s a nightmare.

Here, five women share their scariest UTI moments, because if at least half of us are going to suffer through them, we might as well do it together.

Rebekah, 23, says she did everything right: She used a condom and peed after sex. But within a week, she was in so much pain she couldn’t leave her apartment.

“I went home with a stranger at the beginning of the semester. He wore a condom and I figured it was fine. The next day, I felt more pain than normal after sex, and it started to burn when I went to the bathroom. The burning escalated exponentially within 24 hours — it just hurt so bad.

My friend told me I probably had a UTI and to get AZO. But it only got worse, so I went to the doctor after about a week, was diagnosed with a UTI, and was given antibiotics. But my UTI didn’t respond to the antibiotics, so it only got worse. I became sicker, peeing became excruciating, and I felt pulsating in my lower back. I had a fever and chills and genuinely wondered if I was going to die.

It was very humbling to sit in my own orange urine, knowing this was the only way I could pee.

I went on more antibiotics: One for my kidneys, which were now also infected, and a different one for my UTI. I peed in a bathtub with Epsom salts — it hurt less to pee this way. It was very humbling to sit in my own urine, turned bright orange from AZO, knowing this was the only way I could pee. I had a cycle of yeast infections from all the antibiotics, which was a nightmare. I missed four weeks of classes.

I was so careful. I used protection and told him not to come inside me, and used the bathroom right after. I’m so sick of people saying, Just pee after sex! Because I did. I haven’t had sex since.”

Jess, 31, had to miss her college orientation due to yet another recurrent UTI — this time so bad it developed into sepsis.

“I frequently got UTIs in my teens and early 20s. They happened for a variety of reasons: I had sex, sat in a car for too long without peeing, or didn’t drink enough water and got dehydrated. There were a couple of doctors who tried to figure out why I was getting them so frequently, but I was never really given a sufficient explanation. It was very frustrating — I felt helpless.

One particularly bad incident was when my parents and I were on a semi-cross-country road trip to start my freshman year of college. I started not feeling great pretty early on in the trip. It was a two-day drive, so we stopped to stay at a hotel in the middle to break it up. By the time we checked into the hotel, I was throwing up, feeling dizzy, and having UTI symptoms — burning when I went to the bathroom and feeling like I had to go all the time.

I felt helpless.

We immediately drove to the hospital in my new college town the next day and I was checked in. The doctors said I had a UTI that had spread to my kidneys and developed into sepsis. I spent four days in the hospital.

My parents took my stuff and moved it into my dorm for me. I didn’t meet my roommate until after I checked out of the hospital, and I missed orientation. It was a huge bummer — I was really worried that it was going to be difficult for me to make friends, or that the situation with my roommate would be weird because I didn’t meet her before. It was an important step in becoming a college student, and I missed out on a lot of that.”

Miranda, 24, felt a UTI coming on and started guzzling sugar-free cranberry juice because she read that would help. Two days later, she had the horrible realization that it didn’t.

“I was having a lot of ‘alone time’ with my boyfriend freshman year of college. Being generally inexperienced and a little naive about post-sex self-care, a UTI was bound to happen.

I remember waking up one morning and feeling like I had to pee really badly, like nothing in my life could have mattered more than getting to a toilet right away. It burned a little, but I chalked it up to just having held it too long. It wasn’t until I had to pee again not even thirty minutes later and found blood in my pee that I decided to consult Dr. Google.

The internet suggested it was a UTI and I read that if you catch it early, you can usually get rid of it by drinking sugar-free cranberry juice. My mom was living across the country and I didn’t want to go to the doctor if I could help it — I was a freshman in college and didn’t even know what an urgent care center was. So I went to the local Walmart and loaded up on two jugs of juice, went back to my dorm, and started chugging.

I woke up at 3 a.m. feeling like someone had kidney-punched my guts.

The cranberry juice was horrible. I had to pinch my nose. I didn’t realize something could be so bitter. But it brought temporary relief, in that it hurt less to pee. So assuming it was working, I continued drinking the juice for two more days until I considered myself cured.

The short story is that I was, in fact, the opposite of cured. I woke up at 3 a.m. feeling like someone had kidney-punched my guts. I rolled out of bed, vomited, and buckled over from blinding pain in my lower back. I called a friend to take me to the emergency room. The doctors did a urine test and diagnosed me with a kidney infection from leaving my UTI untreated for too long.”

Doctors told Zairia, 18, that her high fever was probably the flu, even though she pointed to her kidneys and said “this is where it hurts.”

“The symptoms started out really small. Slight pain when I urinated, typical UTI stuff. I didn’t go to a doctor until I had a fever a few weeks later — my fever got really high and I couldn’t stomach any food at all. It was absolutely horrible.

They took my urine, they even checked for pneumonia. They were like, ‘We think you have the flu, you have to let it run its course and it’ll be gone.’ I told them, ‘My back hurts really bad, is that normal?’ And I started pointing to one specific spot that was hurting a lot more. I said, ‘I really think it’s my kidney, right here in my lower back.’

We later found out my kidneys had become so infected that they were swelling and pushing against my back muscles, making the pain worse. Thankfully the doctor at my original appointment took a urine test and called a couple days later to say they cleared a prescription for antibiotics for me. They said, ‘It wasn’t the flu, you actually have a really bad UTI that spread to your kidneys, and if you don’t take the antibiotic within the next 24 hours, it can spread to your bloodstream.’

They were like, ‘We think you have the flu, you have to let it run its course and it’ll be gone.

To take what I had told them and all of my symptoms and say, ‘It’s just the flu, you’ll be fine’ wasted my time and made me feel like I wasn’t being listened to. Now that I understand how dangerous UTIs are, it makes me feel like I was cheated. I wouldn’t wish what I experienced on my worst enemy. Once I got the antibiotics, I started feeling better within a couple of hours. I was super upset I had been sick longer than I needed to be.”

Carolyn, 24, thought all women got UTIs all the time like she did. Sometimes the antibiotics worked, sometimes they didn’t. But none of her regular doctors could give her any real answers.

“I used to get UTIs frequently, like every few months, and would either go to an immediate care clinic or my gyno, depending on availability. The docs always just rattled off the typical UTI instructions, like ‘pee after sex,’ and ‘wipe front to back,’ and prescribed me an antibiotic.

When the antibiotics worked, I waited for the next UTI, thinking it was normal to have them a few times a year since no doctor said otherwise. When the antibiotics didn’t work, docs just prescribed another one. I felt defeated, and like this was just something I had to deal with as a woman.

I finally went to a urologist after a really bad UTI sent me to the ER. I had spent the night out drinking with friends, and I woke up with a burning sensation and shooting pain in my urethra when I went to the bathroom. I looked into the toilet and saw a ton of blood.

I looked into the toilet and saw a ton of blood.

My friend took me to the hospital, where the ER nurse asked for a urine sample. I remember when I handed it over, she was like, ‘Oh my God, this is horrible.’ The doctor told me he was shocked the sample still had blood in it. They prescribed me two different antibiotics.

The ER doctor didn’t make any effort to give specialist recommendations or transfer me to the hospital — I had to take the reins and do the research to find a urologist. The urologist ran tests, but only after I pressed and asked why I was experiencing so many UTIs did he tell me it’s because my urethra is really narrow. He didn’t offer any help.

I still don’t really have an answer for how to get the help I need. My gyno is aware about my UTIs and I keep him in the loop when I have one but access to him is challenging. I feel like people don’t acknowledge how truly awful and distracting the pain is. It’s something I just have to grin and bear.”


Hannah Smothers

Hannah writes about health, sex, and relationships for Cosmopolitan, and you can follow her on Twitter and Instagram. Her work can also be found in the Cut, Jezebel, and Texas Monthly.

A mercenary from Poland admitted that he was fighting the Russians and not helping the Ukrainians


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Photo: Global Look Press

A Polish mercenary nicknamed Korets told Gazeta Polska Codziena why he fought as part of the Azov neo-Nazi regiment banned in the Russian Federation for terrorism in Ukraine.

The man said that he was in the military in the past, but left the army for family reasons. He considers himself a football ultra and served in Ukraine along with several hundred representatives of fan teams from all over Eastern Europe. They were commanded by a fan of the Minsk “Dynamo” nicknamed Puma.

The Polish mercenary noted that he was often asked why he was going to help the Ukrainians.

“But I went there to fight the Russians, and not to help the Ukrainians, whom, I confess, I am critical of,” he said.

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Nitrogen: what is it and where is it used?

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Nitrogen generation

Basic Theory

Did you know that most of the air we breathe is nitrogen? Oxygen is essential for survival, but air is 78% nitrogen and only 21% oxygen and a small amount of other gases. Despite the fact that the human body does not use this nitrogen, it is very useful in various industries. Simply put, there is an unlimited source of nitrogen available for use that allows you to produce your own nitrogen instead of purchasing it from various suppliers. All you need is a compressor and a nitrogen generator that separates the nitrogen molecules from the oxygen molecules in the compressed air. The result is an unlimited, economical and safe gas supply available at any time of the day.

What is nitrogen?

First, it is an inert gas. It is odorless, colorless and does not support life, however it is essential for plant growth and is a key additive in fertilizers. Its application extends far beyond horticulture. Nitrogen is usually in liquid or gaseous form (however, solid nitrogen can also be obtained). Liquid nitrogen is used as a refrigerant that can quickly freeze food and medical research objects, and it can also be used for reproductive technologies. For clarification, we will focus on gaseous nitrogen.

Nitrogen is widely used, mainly because it does not react with other gases, unlike oxygen, which is highly reactive. Due to their chemical composition, nitrogen atoms require more energy to break down and interact with other substances. On the other hand, oxygen molecules break apart more easily, so the gas becomes much more reactive. Gaseous nitrogen has the opposite properties, providing an inert atmosphere when needed.

Nitrogen generators provide benefits for virtually all industries

The lack of reactivity of nitrogen is its most important quality. As a result, the gas is used to prevent slow and fast oxidation. The electronics industry is an excellent example of this use, as the production of printed circuit boards and other small components can lead to slow oxidation in the form of corrosion. In addition, slow oxidation is common in the food and beverage industry, in which case nitrogen is used to displace or replace air in order to better preserve the final product. Explosions and fires are a good example of rapid oxidation because they require oxygen to propagate. Removing oxygen from the tank with nitrogen reduces the likelihood of these accidents occurring.

Own nitrogen production

If nitrogen is to be used in the system, it is recommended to consider three main ways of obtaining gas. The first is to rent a nitrogen tank on site and supply gas, the second is to use nitrogen gas supplied in high pressure cylinders. The third way is to produce your own nitrogen using compressed air. Buying or renting nitrogen can be very inconvenient, inefficient and costly because you have to deal with a third party supplier. For these reasons, many companies have moved away from leasing and have opted to produce their own nitrogen with the ability to control quantity, purity and pressure for the required application. Additional benefits include cost stability, no shipping costs or delays, elimination of the hazards associated with cryogenic storage, and elimination of waste from evaporation losses or the return of high pressure cylinders that are never completely emptied. There are two types of nitrogen generators: membrane nitrogen generators, as well as nitrogen generators using PSA (Push Swing Adsorption) technology, which provide a very high degree of purity – 99.999% or 10 PPM (parts per million) or even higher. Learn more about the latter option here.

What are the practical applications of nitrogen gas?

Because nitrogen is an inert gas, it is suitable for a wide range of applications in many industries. It should be noted that different levels of purity may be required for different applications. While some applications may require exceptionally pure nitrogen, such as in the food industry or the pharmaceutical sector, this gas may be less pure in other applications, such as fire prevention.

Take a look at some typical industrial uses for nitrogen gas below.

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