How to Prevent Urinary Tract Infections, or UTIs

Taking precautions to avoid experiencing a urinary tract infection is always advisable, even if you are not prone to recurring UTIs. (1)

Proven At-Home Preventive Measures

Some strategies that have been proven effective include the following:

• Wipe from front to back. When either urinating or moving one’s bowels, it’s important to wipe from the front to the back. This helps to prevent spreading bacteria from the anal area to the vagina and urethra.
• Urinate frequently. Fully empty your bladder roughly every two to three hours in order to flush bacteria from your urinary tract before an infection has a chance to begin. Do not attempt to hold your urine to the point when your bladder feels full. The longer urine remains in the bladder, the more likely bacteria will multiply. (2)
• Promptly urinate after intercourse. Vaginal intercourse can introduce bacteria from the genital area and anus into the bladder. Urinating afterward can flush your system and reduce the risk that those bacteria multiply and cause a UTI. (3)
• Drink plenty of liquids. Consuming fluids, especially water, helps to dilute urine and spur more frequent urination, which flushes bacteria from your urinary tract. Moreover, increasing water intake can halve one’s chance of experiencing a recurrent UTI. A study looked at women who drank less than 1½ liters of water daily (about 6 cups) who also had recurrent urinary tract infections (more than three annually). Fifty percent of the women added 1½ more liters of water to their daily routine, while the others did not alter their fluid consumption. A year later, women who upped their water intake reduced their UTI rates by nearly half, experiencing an average of 1.6 infections that year versus 3.1 urinary infections amongst the control group. (4)
• Drink water after intercourse. In addition to drinking throughout the day, it’s important to drink a full glass of water after intercourse to help flush bacteria from your system.
• Clean the genital area. This can diminish the presence of bacteria, thus reducing one’s chances of pulling bacteria into the urethra and into the bladder during intercourse. In addition to keeping the area clean regularly, be sure to also cleanse the area pre- and post-intercourse.
• Avoid diaphragms or spermicides. If you are prone to recurrent UTIs, consider changing your birth control. Diaphragms, spermicides, and spermicide-containing types of contraception can contribute to bacterial growth and kill the good bacteria present in the genital area that work to protects from UTIs.
• Use a personal lubricant. Friction during intercourse can sometimes irritate the urethra and introduce bacteria that cause urinary tract infections. Using a small amount of water-based lubrication during sex can help reduce friction and the risk of infection. (5)

Preventing UTIs With Drugs

At times, antibiotics are used as a preventive measure for those with frequent UTI recurrences. In addition, postmenopausal women can benefit from a different type of a medicinal prevention strategy.

• Antimicrobial Prophylaxis In some cases of urinary tract infection recurrences, a physician may recommend antimicrobial prophylaxis, which is the use of antibiotics to prevent another infection. This has been shown to effectively reduce one’s risk of recurrent UTIs in women with two infections over the previous year. (The typical duration of an initial use of antimicrobial prophylaxis is six months.) (7)
• Postcoital Prophylaxis For those whose UTI recurrences are related to sexual intercourse, taking antibiotics after intercourse (also called postcoital prophylaxis) may be preferable. Depending on the frequency of intercourse, postcoital prophylaxis likely results in less antibiotic use than antimicrobial prophylaxis. (8)
• Estrogen for Postmenopausal Women The use of a vaginal estrogen cream or an estradiol-releasing vaginal ring have both been shown to be an effective strategy for reducing recurrent urinary tract infections in postmenopausal women. In fact, vaginal estrogen has been shown to reduce recurrent UTIs by 36 to 75 percent. (6)

Possible Preventive Strategies for UTIs

While the research is still out on the preventive strategies below, prospects are promising.

• Probiotics The probiotic strain Lactobacillus, found in fermented milk products, has been shown to prevent urinary tract infections in laboratory testing. There’s also promising research that shows the strains L. rhamnosus gr-1 and L. fermentum rc-14 could prevent UTIs as well. (6)
• Cranberry Juice Cranberries contain polyphenols called proanthocyanidins, which may help prevent E. coli from causing urinary tract infections in women, but data is conflicting about the effectiveness. While a meta-analysis published in the journal JAMA Internal Medicine showed a decrease in UTI rates in those who consumed daily cranberry tablets, a subsequent review published in the Cochrane Database found insufficient evidence to recommend routine use of cranberry. (8,9,10)  The American Urological Association does recommend cranberry extract as a preventive measure for UTIs (11); Ellura is a brand of cranberry extract capsules.
• Diet Adjustment Research has shown that urine with higher pH (more alkaline) levels and higher levels of certain metabolites formed by gut microbes are better able to resist recurrent UTIs. It’s thought that one can improve these levels through diet. For instance, calcium supplements raise urinary pH levels. In addition, consuming foods rich in antioxidants, like tea and colorful berries, may encourage growth of metabolites. (12)

Who Should Pay Special Attention to UTI Preventive Measures

Some individuals are at a higher risk for urinary tract infections than others. Those individuals include:

• Women who are sexually active
• Women who are pregnant
• Menopausal women
• Those with diabetes
• Those with kidney stones
• Those who’ve recently had a catheter