Pelvic Floor Dysfunction And UTI Symptoms: How Can You Tell The Difference?

Pelvic floor dysfunction and UTI symptoms go hand in hand for many people. I didn’t know it at the time, but pelvic floor therapy was the key to regaining my health. Here is my story…

We all know the feeling. The first signs that another UTI is coming.  

Burning when you pee. 

The constant urgency to find a bathroom RIGHT NOW just to be disappointed with a small trickle.  

The constant pain at the tip of your urethra.  

Pressure in your lower abdomen.

Cramping.

Sometimes even a fever and chills. 

Jump To Section:

• The UTI To End All UTIs.  >>>>  
• First UTI Appointment Of Many.  >>>>
• Emotional Roller Coaster.  >>>>
• Pelvic Floor Dysfunction And UTI: Finally A Diagnosis!  >>>>
• Physical Therapy For Pelvic Floor Dysfunction And UTI Symptoms.  >>>>
• Other Fun Side Effects Of Pelvic Floor Dysfunction And UTI.  >>>>

How It All Began

My journey started in July of 2019. I had a few UTIs in college, or at least what I thought were UTIs, and usually they went away with copious amounts of water and over-the-counter AZO for pain relief.  

I say “what I thought were UTIs” because I refused to go to the doctor at that age. Not the wisest decision, I know. But I was a full-time student and working two jobs, and I had no idea how much an appointment would even cost.  

The supposed UTIs always went away though. It got to a point where I could predict their onset (usually after not voiding after sex or having sex with a new partner).  

The symptoms would appear about a day later, and then go away on their own within 3 days. I never thought much about them except that they were incredibly annoying and yet another thing that people with vaginas just had to deal with.

Let’s fast-forward a couple of years to last summer. I had just had sex with my boyfriend, but his bathroom was taken by his roommate.  I had to just awkwardly wait an hour, yes a full hour, for his roommate to get out of the bathroom.

The entire time I just KNEW what I had ahead of me: another UTI. Sure enough, 24 hours later to the minute I started feeling that familiar urgency and pain. 

I didn’t think much of it. I had thought this would probably happen and hoped I could just flush it out of my system like I used to.  

But this was different.  

I had a gut feeling that this was the start of a longer battle.  

The pain was worse than I’d ever felt, I had the chills, and I couldn’t leave the bathroom. I took extra-strength AZO and chugged cranberry juice hoping for the best.  While the AZO did help dull the pain, I knew this was the UTI that would finally send me to the doctor.  

I went to my primary care physician’s office, gave them my pee sample, and waited for the nurse practitioner. My first test did come back positive, (luckily, although as you’ll see I wasn’t so lucky later).  

She prescribed me Macrobid, which she described as a “low-key antibiotic” that I’d barely notice and that would do the trick. It sounded good to me! 

I took the antibiotic for 5 days, and while the pain did lessen for a couple of days, it did not give me full relief. Less than 2 weeks later, I was back to the high pain level I experienced at the beginning, except now I was confused and terrified as to what it could mean that the medication didn’t work. 

I went back into the doctor’s office, this time seeing my primary care physician. 

Have you ever gone to the doctor’s and ended up feeling belittled, embarrassed, and like you were being dramatic?  

That is how my doctor made me feel.  I could see it on her face, she didn’t believe I was in as much pain as I was describing.  

She took another urine culture, and it came back negative, so that must mean I was exaggerating, right?  

No offense to any doctors reading, but my experience is that sometimes they tend to be quick to look at the results in front of them without realizing there is a fairly large margin of error, especially with UTI tests.  

I knew something wasn’t right, and that should have been all that mattered.

My doctor explained why she is conservative with prescribing antibiotics with negative test results, and then tested me for vaginitis and multiple STIs, all of which came back negative.  

She then basically insinuated she could not help me, and asked if I wanted to see a specialist. At the time I said no because the idea of seeing a specialist scared me and I did not have the financial means to see more doctors. 

I left the office discouraged, embarrassed, and still in a great deal of pain. 

I continued living my life the best I could through the constant pain, with very little relief, and crying every night because of how much the situation was hurting me physically and emotionally.  

I was exhausted and I just wanted answers. I called my doctor’s office again as a last ditch effort and asked to talk to a nurse or doctor again, insisting that something was wrong.  

I talked to probably the rudest nurse I’ve ever talked to, who angrily asked, “have you tried eating yogurt?” 

She was insistent I was just experiencing flora imbalance from the antibiotics I took. I gave up trying to talk to my doctor and went to urgent care for a second opinion.  

Urgent Care For UTIs

At this point it had been about two months of constant pain.  I walked into urgent care determined to get answers. My urine culture came back negative, yet again, but the doctor at urgent care was very sympathetic and gave me a different antibiotic, Bactrim, to try.  

This antibiotic is much more intense than Macrobid, and the doctor said that it should wipe out any bacteria causing me pain.  

Unlike the short relief I felt from the Macrobid, the Bactrim gave me no relief. If anything, I felt as though my symptoms were getting worse. The cultures kept coming back negative, and I was so disheartened that nobody could explain what was going on with my body.  

I called the urgent care center and they said to come back in, so I returned a week later, after my last dose of Bactrim, and took another culture.  

The nurse practitioner that saw me this time prescribed me with Cipro, a third kind of antibiotic commonly used to treat bladder infections.  

She explained that they usually treat UTIs with Macrobid first, then Bactrim, and Cipro if absolutely necessary. With all of the antibiotics I was taking, I was nervous that antibiotic resistance would develop, but I was desperate to try anything.  

I also left with a referral for a urologist, because at that point I accepted that it was the only way I could possibly get relief. The next day I tried to get an appointment for the urologist, but there wasn’t anything available for two months.  

I took the first available appointment and tried to accept the fact that I was going to be in pain for even longer. 

The Urologist

The day of my urologist appointment finally came, and I was terrified. I was the youngest person in the waiting room by about 30 years, and I was the only one alone (my boyfriend could not get work off to come, as hard as he tried).  

Once I went in, they took a urine sample and did an ultrasound right after to make sure that my bladder emptied completely (it did).  

The doctor then saw me, and listened to my full story. I didn’t hold back on my frustrations, and I expressed my feelings that I hadn’t been taken seriously. It was the first time I actually felt heard throughout this whole experience.  

I presented her with the avid research I had conducted, telling her that I suspected I was experiencing recurrent UTIs. I’m sure you are all familiar with recurrent UTIs if you are here reading this. 

She apologized that I had been through something so frustrating, painful, and confusing, and then told me it was time for her to examine me.  

She did a full pelvic exam, pressing on certain parts and asking if it hurt. I’m not going to sugar-coat it, there were moments of pretty intense pain during the exam.  

It didn’t seem much more invasive than a standard pap-smear, so I was confused about the pain.

After she finished my pelvic exam, I got dressed and awaited her verdict. She said that I was experiencing something known as Hypertonic Pelvic Floor Muscle Dysfunction.  

Basically, the muscle tone in my vagina is too high, and I had been experiencing spasms that mimic the symptoms of a UTI.

 This was not something I had come across in my research and I honestly did not fully believe her at first.  

I had so many questions, but my biggest one was: Has this always been an issue and did the initial UTI trigger it? 

Do pelvic floor dysfunction and UTI frequently occur at the same time?

Pelvic Floor Dysfunction And UTI: Causes And Treatment

There are many things that can cause an overactive pelvic floor, and in my case my doctor believes it was a combination of stress, anxiety, and the initial UTI.  

I held my urine for an hour after sexual intercourse, and then continued clenching those muscles throughout my experience with the symptoms, and my muscles were just perpetually clenched at that point.  

We all have different places that we carry our stress.  Some people grind their teeth, some people get migraines, and apparently I carry it in my pelvic floor.  

My doctor referred me to a pelvic floor physical therapist (yes, those exist!) and said that if that didn’t work we would go back to the drawing board. She was pretty convinced though, and that was good enough for me.  

The next day I received a call for my referral to physical therapy (PT).  There was nothing available for, surprise, at least two months.  

There is an ongoing theme in this story, and it is my dissatisfaction with the U.S. healthcare system. I won’t go into numbers, but this whole ordeal has cost me a lot of money due to a less-than-stellar health insurance plan by my employer.  

Waiting for specialists is a nightmare, and my average wait time of about 2 months per specialist was actually pretty miraculous. 

I am pointing this out to say that while issues with UTI symptoms can potentially be costly and not exactly timely, it was absolutely worth it to pursue this and find out the root of my issues. 

What Is Physical Therapy For Pelvic Floor Dysfunction Like?

The day of my first PT appointment I was even more terrified than when I saw my urologist.  

Was it going to hurt?  

Would I be able to trust them?  

Would it be physically challenging?  

When the PT got into the office and greeted me, I immediately felt at ease.  She answered all of my questions, and she sang high praises of my urologist, with whom she had a professional relationship.  

She discussed consent with me, and potential triggers that could occur in our time together if I have had a history with sexual assault, which unfortunately I had.  

I hadn’t even thought of that coming up, but I am so glad that she addressed it before we proceeded. 

She then conducted a thorough examination, similar to the one at urology, and confirmed my urologist’s diagnosis.  

She gave me some education about the urinary tract, and discussed the fact that we would be doing one major exercise together: kegels.  

Except with the kegel exercises I was doing, I was focusing on the letting go part of it, rather than the tightening of the muscles.  

She told me to work on those, and to start trying to recognize moments of stress where I was holding it. Sure enough, in huge traffic jams or before final exams, I noticed I was clenching all of the muscles in my core and was able to start correcting it.  

I went to 10 sessions with her, the first 6 on a weekly basis and the rest biweekly, and I have already noticed a huge difference.  

My pain is completely gone and I’ve made much more of an effort to manage my stress. 

Learn more about pelvic floor therapy from an interview with one of our pelvic floor experts, Dr. Bri Grogan.

While this is not part of the UTI symptoms I experienced, I did want to include this because it is relevant to my story.  The emotional, physical, and mental exhaustion that I suffered from this experience did unfortunately lead to me carrying stress in other parts of my body.  

I am currently on the tail end of something known as “telogen effluvium” which is acute, temporary hair loss after a shock occurs to the body.  

Over the last 6 months I have lost about half of the hair on my head, and while it will grow back, it was devastating. I mention this because…

“…if you are struggling through your UTI symptoms and feel like your feelings are not valid, whether that be a doctor being dismissive or friends/family not believing the gravity of the pain you are experiencing, I promise that everything you are feeling IS valid.”  

Telogen effluvium is usually triggered by traumatic incidents like a car accident, divorce, death of a loved one, or even childbirth. So that puts into perspective how much my UTI symptoms impacted me emotionally and physically.

Final Thoughts On Pelvic Dysfunction And UTI

It feels like another lifetime ago when all of this started happening to me. I have seen many stories online of people who suffered for much longer than I did, and I consider myself fortunate that I was able to find a urologist who could help me figure it out so quickly.  

Every person reading this deserves answers and deserves a life free of the horrible pain these symptoms can cause you.  

If you are hesitant to go to a doctor or a specialist because you don’t believe it will help, I highly encourage you to try anyway.  

My quality of life has drastically improved since I found the right treatment for me. I acknowledge that it is not always that simple for everyone, and I encourage every one of you to advocate for yourself and fight until you find the answers you are looking for.

Share your own story by getting in touch, or comment below. To get answers to commonly asked questions about chronic and recurrent UTI, visit our FAQ page.