Wellness Unfiltered with Dr. Anika Ackerman, MD: A Urologist’s Take on UTIs, Vaginal Health, and Why Symptoms Keep Coming Back

For many women, issues like UTIs, vaginal imbalance, or pelvic discomfort don’t happen just once. They show up again and again (and again). And while treatment can provide temporary relief, it often doesn’t explain why the pattern keeps repeating.

This gap between symptoms and long-term solutions is something we hear about constantly, and it’s part of the reason we created Wellness Unfiltered, a monthly interview series focused on real, experience-driven conversations with experts who are working directly with women navigating these challenges.

In this edition, we spoke with Dr. Anika Ackerman, MD, a urologist specializing in women’s health. Her work centers on the issues that are often normalized or overlooked, like recurrent UTIs, vaginal imbalance, and persistent pelvic symptoms.

After seeing how frequently women were treated in cycles without clear answers, Dr. Ackerman shifted her focus toward identifying patterns, root causes, and the connections between systems, especially the relationship between vaginal and urinary health.

In our conversation, she explains why these issues tend to recur, how the vaginal microbiome helps protect the urinary tract, what role biofilm plays, and what a more proactive, long-term approach to care actually looks like.

With that, here’s Dr. Ackerman.

This post is for informational purposes only and does not constitute medical advice. See full disclaimer below.

10 Questions for Dr. Anika Ackerman, MD

1. Can you introduce yourself and share a bit about your background and what led you to specialize in urology and women’s health?

A: I’m a urology provider focused on women’s health, specifically the issues that tend to get brushed off, like recurrent UTIs, vaginal imbalance, pelvic symptoms that women are told are “normal.” I got into this space pretty intentionally after seeing how often women were dismissed or stuck in cycles of temporary fixes. It never sat right with me that so many patients were being treated over and over again without anyone asking why this keeps happening. That’s really where my focus is now, getting to the root and helping women actually understand what’s going on in their bodies.

2. Walk us through a day in the life of a urologist, and what are some of the daily habits that help you stay balanced?

A: Most of my day is patient care, but it’s a lot more than just diagnosing and prescribing. It’s connecting patterns, educating, and often undoing years of confusion or misinformation. I see a lot of recurrent issues, so there’s a big focus on long-term strategy, not just quick fixes. I treat women of all ages, but a majority of them are middle-aged, perimenopausal, and menopausal women.

For balance, I keep things pretty simple: hydration and nutrition, movement, and trying to remain protective of my time for my family. I also try to be mindful about not carrying work home with me. When you care and care a lot, that’s easier said than done, but it’s necessary.

3. From your professional perspective, how are urinary health and vaginal health more connected than most women realize?

A: They’re not separate systems, even though they’re often treated that way. The vaginal microbiome plays a huge role in protecting the urinary tract. When that balance is off, whether from antibiotics, hormones, or certain products, you’re much more likely to see both BV and UTIs.

This is one of the biggest reasons women get stuck in cycles. If you’re only treating the bladder but ignoring the vaginal environment, you’re missing half the picture.

4. What’s one belief or piece of advice about women’s health that you think needs to be retired?

A: That suffering is just part of being a woman. It’s not. Pain, recurrent infections, urgency, leakage… these might be common, but they’re not something you’re supposed to just accept and live with.

5. You see many patients dealing with recurring issues, whether it’s BV, UTIs, or both. Are there habits or products you see typically driving that cycle of recurrence?

A: A lot of it comes down to well-intentioned things that are actually working against them. Overuse of antibiotics without any plan to rebuild the microbiome is a big one. Harsh soaps, “feminine hygiene” products, and anything that disrupts the natural balance can also contribute.

Then there’s the pattern of treating each infection like it’s random, instead of recognizing it as part of a cycle. If you don’t address what’s driving it, it’s going to keep coming back.

6. We’ve been hearing more about biofilm in relation to both BV and UTIs. Can you break down what biofilm is and why it makes these issues harder to fully resolve?

A: Biofilm is basically how bacteria protect themselves. It’s a structured layer they create that makes them much harder to eliminate. So even if symptoms improve with treatment, the underlying bacteria can still be there, just shielded.

That’s a big reason why some women feel like they’re doing everything right but still dealing with recurrence. We’re not always fully breaking through that layer.

7. What do you think women have been taught to “just live with” when it comes to their bodies, but shouldn’t have to?

A: Honestly, a lot. Recurrent UTIs, constant urgency, leakage after kids, pain with sex, feeling “off” all the time vaginally… these things get normalized way too quickly, and they shouldn’t be.

8. Is there a Happy V product that has become part of your routine? Which key elements about the product make you choose this one over others?

I’m very selective about what I use and recommend. I look for products that support the body rather than override it, especially when it comes to the microbiome.

What stands out to me is when a product is actually designed with both vaginal and urinary health in mind, uses clinically supported ingredients, and focuses on long-term balance instead of quick fixes. That’s what I gravitate toward.

9. In your experience, where is the biggest gap between what women are experiencing and how the healthcare system is responding?

A: Women are experiencing patterns, and the system is treating isolated episodes. That’s the disconnect.

A patient will come in with years of recurring symptoms, and instead of stepping back and looking at the full picture, it’s often just another prescription. There’s also not enough education. Patients aren’t being told why this is happening or how to prevent it.

10. What does a more proactive, rather than reactive, approach to urinary and vaginal health actually look like in practice?

A: It’s about consistency and prevention. Supporting the microbiome, being mindful about what you’re using on and in your body, staying hydrated, and paying attention to early signs instead of waiting until things escalate.

It’s also about understanding your own patterns. Once you know what your triggers are and how your body responds, you can actually get ahead of it instead of constantly playing catch-up.

Keep the Conversation Going

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Disclaimer: This blog is for informational and educational purposes only and is not intended to diagnose, treat, cure, or prevent any disease. Statements about supplements have not been evaluated by the Food and Drug Administration. For more information about vaginal infections, visit the CDC or speak to a licensed healthcare provider.