Women are eight times more likely than men to get urinary tract infections, mainly because female anatomy makes it easier for fecal bacteria to reach the urinary tract. Lower UTIs, the most common type, develop in the bladder and cause abdominal pain, pelvic pressure, or burning urination. Upper UTIs, in which the infection has spread to the kidneys, are more serious and harder to treat; symptoms include back pain, fever and nausea. Menopausal and postmenopausal women are at higher risk because they have lower levels of oestrogen--the hormone triggers production of protective antimicrobial proteins in the bladder.
Staying hydrated keeps fluid moving through your system, which flushes bacteria out of the urinary tract and body. Any liquid is better than none, but it's best to avoid sugary or caffeinated drinks, which may promote UTIs. Start with an extra glass of water with each meal and drink more if urine looks darker than pale yellow.
Wipe from front to back (or wipe front and back separately) after using the bathroom. This prevents UTI-causing microbes from being moved into the urethra. Also, urinate soon after intercourse to help wash away any bacteria that may have been transported into the urinary tract during sex.
3. Cranberry juice or supplements
Research on cranberry's effectiveness is mixed, but it's worth a try if you're prone to UTIs. Cranberry contains proanthocyanidins, compounds thought to prevent bacteria from adhering to urinary tract walls. Drink 250mL of pure, unsweetened juice a day; if it's too sour for you, try a supplement.
For women who have had UTIs in the past, one study found that taking probiotics can help prevent repeat infections. Look for a product that contains lactobacillus bacteria, a strain that's been shown to support a healthy genitourinary tract. Or try naturally probiotic foods like yogurt and kefir (look for "live and active cultures" on the label).
Another preventive measure for recurrent infections is supplements of D-mannose, a simple sugar found naturally in the body. Studies have shown that the supplements can keep UTIs from coming back, likely by preventing bacteria from sticking to urinary tract walls. Consider taking D-mannose daily for 6 months for prolonged protection.
3. Pain relievers
Over the counter phenazopyridine can relieve pain, burning and the frequent urge to urinate. Don't be alarmed if your urine turns red-orange or brown; it's a harmless side effect. Over the counter pain relievers can help with flank or back pain, but that kind of pain may be a sign the UTI has spread to the kidneys and you should see a doctor.
Most UTIs can be treated with a 3-day course of antibiotics. Be sure to take the full course of medicine, even if symptoms go away: Quitting too soon raises the risk that a UTI will rebound. Call your doctor as soon as you start feeling symptoms—going untreated too long can allow the infection to spread to the kidneys.
2. Vaginal oestrogen
For postmenopausal women, applying oestrogen to the vagina via a topical cream or suppository has been shown to reduce recurrent UTIs by strengthening vaginal tissues, fostering growth of healthy lactobacillus bacteria, and reducing pH so the genitourinary environment is less friendly to invading bacteria.
3. Suppressive therapy
If you suffer from recurrent UTIs, your doctor may prescribe a 6-month regimen of low-dose antibiotics; this may be extended for up to 5 years for severe UTIs. If your infections seem tied to sexual activity, your doctor may recommend taking an antibiotic only after sex, which is often as effective as daily drug therapy.
First published: 2 Jan 2020