Preventing and Treating Recurrent UTIs

Burning, itching, and the urge to urinate are all symptoms of urinary tract infections (UTIs). They affect both sexes, but women are more often plagued by these infections than men. The reason? A woman’s anatomy and hormones.

“UTIs are common in women at two points in their lives: when they are younger and sexually active, and the second spike is during menopause,” explains urologist Ja-Hong Kim, MD, associate professor in Urology at the UCLA School of Medicine who specializes in female pelvic medicine and reconstructive surgery. “The lack of estrogen, which maintains tissue integrity and proper urine pH, makes women more prone to these infections. Also, the shorter urethra in women allows easier access for bacteria to enter the bladder.”

Chronic illnesses, such as diabetes and cancer, and treatments that alter the immune system add to the reasons why these infections become more prevalent and recurrent in older women. UTIs are treatable, and it is possible to reduce recurrence with the right approach.


UTIs are among the most common infections. You can reduce their recurrence by:

  • Practicing good vaginal hygiene
  • Getting a proper diagnosis through a urine culture
  • Maintaining good gut flora with daily probiotic supplements and/or foods
  • Drinking lots of water to flush out bacteria
  • Adding cranberry and D-mannose supplements

Antibiotic Treatment—Not So Fast

UTI symptoms may or may not be due to an infection. According to Dr. Kim, other causes can be a non-infectious bladder issue, such as an overactive bladder or interstitial cystitis (a chronic painful bladder condition of unknown origin). Also, not all UTIs are due to bacterial infections. Some can be caused by fungal, viral, and atypical bacterial infections. Antibiotics only treat bacterial infections. Taking antibiotics when you don’t have a bacterial infection isn’t helpful. In fact, it can weaken the immune system. The immune system requires the right balance of bacteria to counteract overgrowth of certain bacterial strains that can harm the body.

Home Test Kits Can Be Useful

At-home urine dipstick tests can be purchased without a prescription, but they need to be used in consultation with your physician. Dr. Kim is an advocate of these tests because they can help rule out whether an infection is causing the burning, itching and/or painful symptoms. “These dipsticks can quickly give information about the presence of bacteria, blood, and inflammatory cells in the urine,” she explains. “They’re not 100 percent, nor are they specific as to what is causing the infection, but if it’s negative the chances are very low that you have a bacterial infection.”

If the test kit does detect an infection, the next step is a physician-ordered urine culture. This step is extremely important. Some physicians may bypass it and prescribe a broad-spectrum antibiotic, which, as the name implies, kills a wide array of bacteria. The problem with that approach is twofold: One, it wipes out a lot bacteria that may not be the root cause; and two, it may not get rid of the actual bacteria that are causing the infection. A urine culture that identifies the offending organism enables a physician to select a targeted medication.

UTI Prevention Strategies

Cranberry juice has been an age-old remedy for UTIs. Cranberry makes urine more acidic, making it more difficult for bacteria to grow. Dr. Kim advises cranberry supplements instead of juice, as they are more concentrated.

Similarly, D-Mannose is a supplement that can help clear out the infection by preventing certain types of bacteria from sticking to the bladder wall. By doing so, it helps stop the bacteria from colonizing. Some supplements contain a combination of both cranberry and D-Mannose.

Probiotics help restore the good bacteria, which may have been eliminated through multiple courses of antibiotics. In addition to supplements, you can fortify your gut bacteria with dietary choices such as yogurt, kefir, and kombucha (a fermented tea).

Vaginal estrogen can also be helpful. As a targeted topical cream, it reaches the intended area quickly. “It won’t reverse the aging process,” explains Dr. Kim. “But it can help maintain vaginal tissue health.”

Good hygiene helps prevent bacteria from entering the urinary tract. Wiping from front to back is essential. For extra cleanliness, baby wipes can be especially useful when there is loose stool. Finally, drinking a lot of water will help flush out harmful bacteria before they have a chance to multiply.

While not every UTI is preventable, proper diagnosis, treatment and preventive steps can go a long way to reduce their recurrence.

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