How to prevent UTIs (urinary tract infections)

Urinary tract infections (UTIs) are the most common urological disease in the United States (Liska, 2016). While there are no natural remedies that can cure a UTI, there are some things you can do to prevent infection.

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Escherichia coli (E. coli) causes a majority of UTIs. E. coli can live in the bowel and vaginal cavities, moving into the bladder during sexual activity. Thus, it’s believed that cutting down on E. coli colonies can decrease the risk of a UTI. Lactobacillus also live in the same areas as E.coli. Lactobacillus can prevent E. coli bacterial growth by producing hydrogen peroxide or inciting an immune system response from the host. While further studies are needed, there are increasingly more reports of Lactobacillus probiotics being effective in preventing UTIs (Foxman, 2013). 

Vitamin D is associated with immunity. Recent studies have shown a correlation between lower levels of vitamin D in people with recurrent UTIs compared to those of healthy control subjects who have never had a UTI. Oral vitamin D supplements increase the production of a protein associated with immune system response (Nseir, 2013; Shalaby, 2016).

Peeing plays a huge role in bladder health. Urinating flushes bacteria out of your urinary tract. The American Urological Association suggests nearly half a gallon of fluid (preferably water) a day to stay well hydrated. After drinking plenty of water, don’t put off urinating when you need to, and make sure you’re not rushing yourself to finish. Holding in urine and not fully draining your bladder can increase your risk of UTIs. Lastly, peeing after sex can help get rid of bacteria that may have entered during penetrative sex. (Urology Care Foundation, 2019)

People with vaginas must take special care to avoid germs that can cause UTIs. They should always wipe from front to back, away from the vaginal opening, after bowel movements. While it’s important to keep the vaginal area clean, bubble baths and strongly scented soaps should be kept away from direct contact with the area (Moreno, 2016). 

The term “urinary tract infection” refers to a group of infections that cause inflammation and happen anywhere along the urinary tract, including the kidneys, ureters, bladder, and urethra. UTIs are most commonly caused by bacteria and fungi. In a UTI, pathogens like Escherichia coli (you may know it as E. coli) multiply in the urethra. Some of these germs normally live in areas like the vaginal folds and are pushed into the urinary tract during sexual intercourse (Flores-Mireles, 2015). 

There are two types of UTIs. 

Complicated UTIs refer to UTIs that are associated with an underlying condition that can make the UTI worse. These conditions tend to be nephropathic or uropathic, meaning they come from problems in the kidneys or the urinary tract, respectively. If left untreated, these can lead to severe kidney damage (Nephrol, 2009). Other factors that have been identified for markers of a potentially complicated UTI are (Wagenlehner, 2011): 

• Infection occurs in someone with a penis

• Elderly

• Hospital-acquired infection

• Pregnancy

• Diabetes mellitus

• Immunosuppression

Uncomplicated or simple UTIs refer to an infection that affects an otherwise healthy individual who lacks abnormalities along the urinary tract and can often reoccur. Uncomplicated UTIs are categorized based on their tract location condition—lower infections (e.g., cystitis) and upper infections (e.g., pyelonephritis) (Tan, 2016).

People with vaginas are 30 times more likely to develop a UTI than people with penises. Vaginas anatomically have shorter urethras and, thus, are easier for bacteria to colonize (Sabih, 2020). However, it’s important to remember that people with penises can still develop UTIs (Tan, 2016). Additionally, transgender men on hormone replacement therapy with testosterone may experience an increased risk of UTIs (Land, 2019).

Some risk factors that could make people under 45 years old prone to UTIs are sexual intercourse, use of spermicide, new sexual partners, family history, and childhood history. People over 45 have risk factors like urinary incontinence, fallen bladder (cystocele), and dry vagina. Other risk factors include diabetes, obesity, certain birth controls, and menopause. Contrary to popular belief, one study found that some factors that do not increase the risk of UTI are diet, tampons, clothing fabric, and personal hygiene, such as bathing practices (Najar et al., 2009; NIDDK, 2017).

In a UTI, the pathogens make their way up to the bladder, where bladder health can dictate what kind of infection you develop. Catheterization is the most common cause of a compromised bladder that leads to a UTI. In catheterization, a silicone tube enters the bladder through the urethra. Unfortunately, a protein called fibrinogen can grow on the tube, making it a perfect breeding ground for dangerous bacteria (Flores-Mireles, 2015).

Symptoms can vary, depending on where the infection is located, but they’re important as criteria for diagnosing what type of UTI. The symptoms of a bladder infection (cystitis) tend to revolve around urination: They can include a painful burning sensation while peeing, frequent urination, feeling the need to urinate despite having an empty bladder, bloody urine, or pressure in the groin or lower abdomen. Meanwhile, in kidney infections (pyelonephritis), symptoms present themselves as fever, chills, lower back pain, nausea, or vomiting (CDC, 2019). 

In some cases, UTIs can get worse if left untreated. 

Infections in the lower urinary tract can get worse if they’re not treated immediately. With antibiotic treatment, cystitis can go away within three days (Li, 2020). An untreated bladder infection can turn into a kidney infection. 

Kidney infections tend to be less common but more severe. They can cause high blood pressure, kidney failure, or permanent kidney scars. Renal scarring can make it harder for kidneys to filter as efficiently. If left untreated, pyelonephritis can have severe complications such as (NIDDK, 2017): 

• Abscess (collection of pus) formation in the kidney

• Urosepsis

• Renal papillary necrosis (death of renal cells)

• Acute renal failure

UTI type dictates the prescribed treatment. 

Usually, uncomplicated UTIs respond very well to oral antibiotics. It’s important for healthcare professionals to be mindful of which antimicrobial agent they choose and for patients to complete their prescribed course, as bacteria in the urinary tract can develop resistance to medications. A healthcare provider might choose medications like fosfomycin (brand name Monurol) or nitrofurantoin (brand names Macrobid, Macrodantin, Furadantin) (Tan, 2016; Jancel, 2002).

Treating complicated UTIs depends on the severity of the infection. Treatment management has three goals: management of the abnormality in the urinary tract, antimicrobial therapy, and supportive care when needed. Complicated UTIs are more severe, usually requiring hospitalization. A healthcare provider might choose medications like fluoroquinolones (Tan, 2016).

Some people might be inclined to try to avoid medication side effects by using alternative and at-home solutions.

Cranberry juice is a very popular at-home remedy for UTIs. People believe that cranberries can treat UTIs because the fruit contains a substance that prevents bacteria from sticking on the walls of the bladder and proliferating or colonizing. In a study that focused on a variety of cranberry products, including juice, capsules, and tablets, researchers found that any benefit was insignificant and negligible. Until the active ingredient can be standardized, cranberry products cannot be recommended for actively treating UTIs (Jepson, 2012).

Ultimately, there is currently no research that concludes natural remedies can cure a UTI, and if you have a UTI, you should see a healthcare provider. 

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Current version

May 06, 2021

Written by

Gerrie Lim, MPH

Fact checked by

Mike Bohl, MD, MPH, ALM

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About the medical reviewer

Mike Bohl, MD, MPH, ALM

Dr. Mike is a licensed physician and a former Director, Medical Content & Education at Ro.