Sex & Wellness with Dr. Mary

Episode 9 - Why do I keep getting UTIs

For this episode, we have Marianna Pucillo, a nurse practitioner who specializes in urology in Northern California. Today, we will be talking about UTI.  

UTIs are a huge issue in urology and pelvic floor therapy. We received a letter from Maya of Houston, Texas. She is 45 years old and she keeps getting diagnosed with UTI. Whenever she gets such diagnosis, she is constantly put on antibiotics but the symptoms later return. She is now asking for help regarding her dilemma. 

So, in this episode, we will be sharing with you what the Urinary Tract System is, what Urinary Tract Infection is, Urinary Tract Infection in older people, and what you can do to prevent this issue! 

Let’s talk about:  

00:35 - Introduction to today’s guest 

00:54 – Introduction to the topic

2: 00 – The difficulty of knowing the reason for re-occurring UTI in perimenopausal women

2:30 – The Urinary Tract System

3:05 – Why more women experience UTI compared to men

3:25 – What distinguishes a Urinary Tract Infection 

4:25 – The over-the-counter strips versus urine culture testing to distinguish UTI

6:25 – Importance of getting clear with your symptoms to avoid getting misdiagnosed 

8:07 – The difference between upper and lower urinary tract infection

10:14 – The symptoms of UTI in the older population 

11:41 – Our thoughts on treating patients with antibiotics

13:00 – Differentiating back pains referred to the kidneys and regular back pains

14:08 – When to advocate for yourself to look for other treatments and specialist

14:40 – The typical treatment plan for patients with recurring UTI

16:01 – The anatomy of the urethra and vaginal opening for the older population and understanding the connection between UTI and perimenopausal

18:34 – The correct usage and dosage for vaginal estrogen to work 

22:00 – The most typical times people experience decrease in estrogen 

23:59 – Symptoms of menopause 

25:37 – Understanding the pH level of your vagina

27:06 – Preventative measures to avoid getting recurring UTI

33:06 – Ruling out other conditions like interstitial cystitis 

36:38 – Conclusion


If you have any other questions or topics you want to talk about, send me a message on Instagram. And if you loved this episode, please leave me a rating and a comment with your feedback. Please share this with your friends and loved ones, too!


I also have a free resource for you if you're struggling with bladder urgency: https://resilient-rx.com/bladderdiary/

I’ll see you in two weeks!