From my inbox

Letters From Women With Recurring UTIs, And What I Wrote Back

I did not expect the post. These are six of the letters that have stayed with me, printed with permission and with names changed. If you recognise yourself in one of them, you are in better company than you think.
Margaret Ellis, RN (Ret.)
Margaret Ellis, RN (Ret.) 34 years urology & geriatric ward · September 14, 2026
Diane · 61, Toledo OH

I have had nine infections since Christmas of last year. My doctor has been kind about it but at the last appointment she said there was nothing else to try and I should think about a long-term low dose. I cried in the car. I am not the crying sort.

Margaret

Diane, nine in that time is not you being unlucky and it is not you being difficult. A standing low dose is what gets offered when the cupboard is bare, and it manages the infections without ever addressing why they keep arriving. You are allowed to want a different question asked. Crying in the car after being told there is nothing else seems to me an entirely proportionate response.

Ruth · 54, Bend OR

Please be honest with me. I have bought cranberry, D-mannose and two different probiotics in the last two years. Why would this be any different? I am tired of spending money on jars.

Margaret

That is a fair question and I would rather answer it than dodge it. Those three all work in the urine — they aim to stop bacteria sticking as they pass through. None of them does anything about what has already settled on the wall. If your pattern is a clean sample and a return six weeks later, you have been treating the water and leaving the surface. That is the difference, and if that does not describe your pattern, do not spend the money.

Angela · 47, Macon GA

I am on a course right now. Is it safe to take something alongside it, or do I wait until I have finished?

Margaret

Finish your course. Always finish the course — nothing I say here changes that. There is no reason to stop taking it while you are on antibiotics, but tell whoever prescribed it, because that is what I would want if I were still the one prescribing. The point of this is the weeks after the course, not the course itself.

Patricia · 66, Scranton PA

Mine always come after being with my husband. I have never told a doctor that. I did not know how to say it and I did not want it written down.

Margaret

Patricia, you have just written it down to a stranger, which tells me how long you have been carrying it. It is one of the most common patterns there is and it is one of the least often said out loud. It is not about being clean, it is not about anything either of you is doing wrong, and you have nothing to be embarrassed about. I wish somebody had made room for you to say it twenty years ago.

Jean · 72, Sioux Falls SD

I have had these on and off since my forties. Is it too late for me to bother?

Margaret

Sediment is cumulative, so you have more of it than a woman of forty. What you do not have is any reason to think it is fixed in place. I would give it a proper run rather than a month, because thirty years of build-up is not a thirty-day job — but no, I do not think seventy-two is too late to stop organising your life around the bathroom.

Carol · 58, Erie PA

I do not have a question. I wanted to say thank you for the sentence about not apologising. I have apologised to every receptionist I have ever handed a sample to. I did not realise until I read it.

Margaret

You are very welcome, Carol. I took a lot of those samples and I never once thought less of the woman handing one over. I am sorry that was not obvious from the other side of the desk.

If you have read this far, you have probably recognised yourself somewhere in it. I have written out what I take and why, on the next page, with the prices as they are.