For all the turmoil sleepless nights have caused the 31-year-old in the last year, they were merely a side effect of the “constant agony” of not fully being able to empty her bladder.

“The anxiety was crippling,” says Dickinson, whose battle with a painful chronic urinary tract infection (UTI) took over her “whole life” and left her grappling with suicidal ideation.

“You feel so helpless that I just thought to myself, ‘Is there a way out of this?'” Dickinson says, adding that she was often too anxious to even leave her Brisbane home.

“[There were] moments I would have rathered, honestly, to just end it all than continue suffering like that for God knows how long.”

Albanese’s Coalition-backed $100 million women’s health trials ‘side-step best practice’

Approximately one in two women and one in 20 men will contract a UTI in their lifetime. For most, it’s a minor medical annoyance easily treated with broad-spectrum antibiotics.

Not all of the package’s initiatives – which the Coalition says will be matched dollar for dollar if Opposition Leader Peter Dutton is elected this year – have been warmly received.

The government’s pledge of more than $100 million for two national trials supplying over-the-counter contraceptives and treatment for uncomplicated UTIs directly from pharmacies side-steps best practice, according to the Australian Medical Association (AMA).

“Unfortunately the announcement for funding of autonomous pharmacy prescribing risks fragmenting care,” AMA President Dr Danielle McMullen says.

“The vast majority of people with a concession card can receive care with no out of pocket costs through their usual GP who has access to their health history and can make sure that their treatment is tailored to their unique circumstances.

“Patients deserve the full suite of treatment options to be available for their reproductive healthcare and UTIs – only GPs can offer this.”

In Queensland, South Australia and Western Australia, legislative change has allowed patients to bypass GPs. Trained pharmacists can supply antibiotics to people with female anatomy aged 18 to 65 after reviewing their symptoms and agreeing they present with uncomplicated UTIs.

Patients with signs of serious infection or complicated UTIs – which automatically includes people with male anatomy, who are under 18 or over 65 years old, have had previous recurrent UTIs or are pregnant – would be referred to their doctor.

New South Wales, the ACT, Victoria and Tasmania have similar trials either underway or announced, with results from the University of Newcastle’s 12-month clinical assessment due this year.

When ‘quicker, easier and cheaper’ UTI treatment comes at a cost

Gynaecologist Dr Pav Nanayakkara acknowledges that pharmacist-prescribed antibiotics can provide patients with quicker, easier and cheaper access to treatment for simple UTIs and reduces strain on overloaded GPs and emergency departments – but it can come at a cost.

“A less comprehensive history and assessment may result in risks such as misdiagnosis, fewer opportunities to investigate structural causes and potential antibiotic resistance if antibiotics are inappropriately used,” says Nanayakkara, who works with women’s health non-profit Jean Hailes.

“It would be important to have regulatory bodies overseeing the rollout with strict protocols, establish tools to monitor antibiotic prescribing patterns, and ensure adequate follow up and confirmation of diagnosis.”

Diagnosing a UTI is more than ticking boxes on a list of symptoms, something Dickinson wishes she could tell her past self.

Before April 2024, she’d only ever experienced a UTI once when she was 18. She went to the GP, listed her symptoms, and walked out with antibiotics. The whole thing was over within 24 hours.

More than a decade later, she started feeling those same symptoms – a strong and unrelenting urge to urinate, a burning sensation while urinating, and only passing small amounts at a time – while away for a long weekend in Noosa.

She assumed it would be another easy fix even as her symptoms worsened. She had no reason to believe otherwise.

Dickinson booked a video call with a doctor and was prescribed a broad-spectrum antibiotic used to treat the most common bacteria that causes UTIs. 

The doctor also advised her to undergo a urine test as soon as possible to determine the exact bacteria strain that had caused her UTI, but Dickinson was in so much pain she couldn’t bear to wait the 24 hours it would take to get the test results.

Had she done so, she would have learned that she had ESBL E. coli, which is resistant to common antibiotics. The medication she’d been prescribed was utterly ineffective.

“Towards the end of that course of antibiotics I thought, ‘Oh, God, something might be wrong here… this could be a bit of a medical emergency,'” Dickinson recalls.

After four sleepless nights, she finally went to hospital. It became her “second home” for six months while she tried to fight the UTI.

“It was so debilitating,” she says of the ordeal. “It impacts your social life, your sex life, your ability to work, your general happiness. Everything… it was all consuming.”

Chould a UTI vaccine be on the table?

There has been speculation of an oral spray vaccine that could help reduce UTIs in men and women, though data on its long-term effectiveness and side effects at this stage is limited.

Pineapple-flavoured MV140 (also known as Uromune) is needle-free and targets four of the major species that cause UTIs when sprayed under the tongue daily for three months. It is not approved in Australia, the United States or the United Kingdom.

Nanayakkara says chronic UTIs should be “appropriately referred for specialist investigation to exclude structural causes, multi-resistant strains or other conditions that can present similarly” before pursuing the vaccine route as a treatment option.

But doctors warn there’s a reason it’s only available to patients in consultation with GPs and specialists, and not just because the TGA has not received an application to register MV140 in the Australian Register of Therapeutic Goods.

“Vaccines like Uromune are promising for recurrent UTIs but data is still limited,” Nanayakkara says.

“Rather than pushing for availability [of the vaccine], a push for further research into medications like this can always help with assessing generalisability across populations and those who may benefit most.”