Urinary tract infections are common in the U.S. with about 3 million cases per year. Today I’ll discuss specific recommendations for UTI prevention based on current scientific evidence and clinical experience.
Below I will lay out my recommendations in order of MOST recommended products and lifestyle modifications for UTI prevention. This is based on personal experience and scientific research.
Products:
- Medication: In doing my research, I recommend Phenazoypyridine tablets. These tablets provide fast relief for burning, stinging, and muscle spasms that may be accompanied with UTIs and usually work within an hour. While I only take these pills as a last resort, they are a great back-up to have with me at all times in case the following natural recommendations do not work. Warning: You can buy these pills over-the-counter at any convenience store, but I recommend eating before taking the pill as it can cause stomach upset.
- D-mannose powder: D-mannose powder is an indigestible sugar (safe for diabetics!) found in cranberries. E. coli is the primary bacteria that causes UTIs. The bacteria has little “hairs” called fimbriae that stick to the bladder lining, causing inflammation and the classical UTI symptoms of stinging and burning with urination. D-mannose powder inhibits these fimbriae from adhering to the bladder lining, flushing out the UTI-causing bacteria whenever you urinate. A randomized controlled trial of 308 women with history of recurrent UTIs split the women into three groups: those supplementing with d-mannose powder in water daily, women taking Nitrofurantoin, an antibiotic for the urinary tract once daily, and women who received no treatment for 6 months. After 6 months, women who either used D-mannose powder or Nitrofurantoin had a statistically significant lower rate of UTIs. In addition, D-mannose powder worked just as well as the antibiotic and women using the powder experienced significantly less side effects! In another study, researchers administered D-mannose twice daily for 3 days and then 1/day for ten days to observe any possible initial success. After promising results, participants were then randomized in either receiving D-mannose powder or not receiving prophylaxis for 6 months. Patients who used D-mannose powder reported significantly less symptoms of UTI compared to the non-supplemented group and compared to the participant’s original baseline symptom scores. The science is promising, but I didn’t need studies to convince me. I tried it for myself and experienced the wonders and relief of using D-mannose powder. On days where my pain is not extreme I drink one spoonful of D-mannose powder mixed in with 8-12 ounces of warm water (make sure it is warm water so the powder dissolves). On days with more pain I will drink 2 or even 3 glasses of the powder solution. I recommend the powder over the capsules as you get more bang for your buck and it is more easily digested into the urinary tract than the capsules. My favorite brand for D-mannose powder is NOW Foods. I order the 6 ounce container which lasts me about 6 weeks.
- Probiotics: The evidence on probiotics is extremely limited (due to the fact that OTC herbs/supplements are not regulated by the FDA the same way prescription medications are, and thus strain type and dosing can vary widely, even amongst the same brand). However, I do recommend taking 1 capsule of Ultimate Flora’s Women’s Complete 90 billion capsule once a day. This is the best probiotic strain I have found on the market that has been effective for me in preventing UTIs and yeast infections. Different strains may work better for you. Always consult a physician before starting an herb or supplement to make sure it does not interact with any medication.
- Healing foods:
- Kimchi → fermented food full of probiotics
- Plain kombucha → not sweetened with any sugar or juices as this feeds bacterial and fungal growth– I recommend GT’s plain kombucha. Warning: Kombucha is acidic and can be irritating to the bladder lining in some individuals.
- Apple cider vinegar → Apple cider vinegar is an amazing food that should be stocked in everyone’s kitchen. I will write a separate post about the properties of ACV, but it is a powerful anti-bacterial and anti-fungal treatment. For prevention of UTI’s I recommend drinking 1 tbsp mixed in with 8 ounces of warm water once a day. If UTI recurrence is common, try twice a day. Also make sure you buy ACV with “the mother”. The mother contains the probiotic strain that is so beneficial to gut flora and the urinary tract. Bragg’s ACV is my go-to brand. Warning: ACV is acidic and can be irritating to the bladder lining in some individuals.
- Pasture-raised Greek yogurt→ also FULL of probiotics – I recommend Wallaby’s brand
- Unsweetened cranberry juice → be careful about this one. If you suffer from chronic UTI’s cranberry juice may be too potent for your bladder, which is why I recommend D-mannose powder as a first course of action. D-mannose powder is also the sugar extracted from cranberries that prevents UTIs. The only benefit you really gain from drinking cranberry juice is the antioxidant potential.
- Yogi’s Kava Stress Relief Tea: Kava promotes relaxation and stress-relief and has some anecdotal evidence of providing UTI relief.
Lifestyle recommendations:- Consider stopping your oral birth control. Hormonal fluctuations can irritate the bladder and cause more painful bladder symptoms at certain times of the month. Further, certain types of contraception may be more irritating (for example, the copper IUD works by causing local inflammation and may worsen symptoms due to the proximity of the bladder to the uterus).
- Make sure you and your partner are clean before sex. Urinate within 30 minutes after having sex, but not BEFORE or if your bladder is not full. Urinating just a few droplets is worse than not urinating at all because it opens up your urethra to outside bacteria instead of flushing it out. If you don’t have to urinate after sex, pour a scoop of d-mannose powder into 8 oz. of warm water and drink, especially before going to sleep for the night. Also do NOT hold your urine in. If you have to urinate, then go to the bathroom. Holding urine in can cause bacteria to multiple and perpetuate infection and inflammation.
- Use a water-based lubricant during sex. Oil-based lubricants can cause bacteria to stick to the vaginal wall and surrounding area, increasing risk of UTIs. Using lubrication also prevents bladder irritation due to friction. I recommend Sliquid Organics, as it is paraben and glycerin-free.
- Get 7-9 hours of sleep a night.
- Practice stress-reduction techniques such as yoga, meditation, and regular exercise such as weight-lifting or swimming. Remove the clutter from your life. A clean space and work area is a clear mind. Don’t over-commit yourself to activities/extracurriculars that will add unnecessary stress to your life.
- Surround yourself with friends and family who can provide mental and physical support.
- Consider a heating pad, epsom salt bath or additional muscle relaxants such as magnesium malate/bisglycinate/citrate.
There are a plethora of other treatments that may soothe UTI symptoms and recurrences.
I cannot tell you how much these few modifications have improved the quality of my life and helped me become virtually pain-free on a daily basis. I remain pain-free by drinking my D-mannose powder at least once a day, taking probiotic capsules, and drinking or eating fermented food once a day. This may seem like a lot, so if it overwhelms you start with one lifestyle modification such as using D-mannose powder or capsules. Once this becomes part of your daily routine, you may consider adding in another modification.
I hope this post will provide some relief and relevant information to anyone struggling with chronic UTIs or looking to prevent UTIs in the future. Thank you for reading and please comment if you have any further questions.