Urinary Tract Infections: Prevention, Treatment and Medication

By: Holly L. Thacker, MD • Posted on September 24, 2024

What is a UTI?

A urinary tract infection (UTI) is common and becomes increasingly more so with increased sexual activity and age. Approximately one-half of all women experience at least one UTI in their lifetime.

Most infections begin in the urethra, the tube that drains the bladder. The theory is that because the opening of the urethra in women is in close proximity to the anus and vagina, bacteria from the skin enter the urethra and infect the urinary tract. That may account for the higher infection rate in women.

Post-menopausal women also may experience bladder or uterine prolapse, or a shifting of these structures from their normal position. This shift can lead to incomplete emptying of the bladder and create conditions conducive to bacterial growth. Changes in hormone production in postmenopausal women, particularly estrogen, also can alter vaginal flora, the good organisms that populate the vagina and fight bacteria.

Bladder infection vs UTI

You have probably heard UTI and bladder infection used interchangeably, but there is a difference. UTIs can affect any part of the urinary tract, including urethra, ureters, bladder or kidneys. A bladder infection is a UTI that only affects the bladder. Symptoms of a UTI and a bladder infection can be very similar, so it’s important that you see your physician if you have signs of an infection.

Symptoms and signs of a UTI

Pain or burning while urinating
Frequent urination
Feeling the need to urinate even though you have an empty bladder
Pain in the abdomen, pelvic area or lower back
Blood in your urine
Fever or chills
Fatigue
Confusion
Nausea and vomiting

If you are menopausal then you should be aware of an ongoing lack of estrogen in your body. This leads to thinning of the vagina and the skin around the urethra. As the skin gets sensitive and atrophic, menopausal females run a risk of an increase in UTI and burning and discomfort with urination.

Preventing UTIs

You can reduce your risk of developing UTIs by:

Drinking plenty of water daily: This can help flush out bacteria from the urinary tract
Urinating whenever the need arises
Wiping from front to back to reduce spreading bacteria
Cleansing the vaginal region before intercourse
Urinating before and after intercourse
Avoiding vaginal hygiene sprays and douching, which may be irritating
During your menstrual cycle, be sure to regularly change your pads and tampons
Wear loose fitting clothing and cotton underwear: Tight fitting clothing creates a moist environment, which promotes bacterial growth

Supplements that may help UTI symptoms

Oral concentrated cranberry

Cranberry juice has a reputation of preventing urinary tract infections, however, it’s cranberry extract supplements that can help decrease your chances of getting a UTI - not cranberry juice from the grocery store

Oral D-mannose

D-mannose is a simple sugar found in fruits and can be used to prevent or treat UTIs. The following supplement dosage is based on whether you have a UTI or are trying to prevent a UTI:

500mg three times a day to prevent UTIs
1 gram three times daily if you are experiencing UTI symptoms

What foods to avoid

Certain foods can contribute to urinary frequency, urgency and discomfort. If bladder symptoms are related to dietary factors strict adherence to a diet that eliminates the food should bring marked relief in 10 days.

Once you are feeling better, you can begin to add foods back into your diet, one at a time. If symptoms return, you will be able to identify the irritant. As you add foods back to your diet it is very important that you drink significant amounts of water.

Below are acidic foods that are considered irritants to the bladder and should be avoided if you are prone to urinary tract infections.

Alcoholic beverages
Apples and apple juice
Cantaloupe
Carbonated beverages
Chili and spicy foods
Chocolate
Citrus fruit
Coffee (including decaffeinated)
Cranberries and cranberry juice
Grapes
Guava
Peaches
Pineapple
Plums
Strawberries
Sugar*
Tea
Tomatoes
Vitamin B complex
Vinegar

*Some women report that sugar flares their symptoms.

UTI Treatment

If you think you have a urinary tract infection, it’s best to see your physician or healthcare clinician. Some minor UTIs can sometimes go away on their own, but most will need treated with an antibiotic. As with all prescribed antibiotics, it’s important that you take the full course of antibiotics and follow the directions.

Be Strong, Be Healthy, Be in Charge!
-Holly L. Thacker, MD

Holly L. Thacker, MD, FACP is nationally known for her leadership in women’s health. She is the founder of the Cleveland Clinic Women’s Health Fellowship and is currently the Professor and Director of the Center for Specialized Women’s Health at Cleveland Clinic and Lerner College of Medicine at Case Western Reserve University. Her special interests are menopause and related medical problems including osteoporosis, hormone therapy, breast cancer risk assessment, menstrual disorders, female sexual dysfunction and interdisciplinary women’s health. Dr. Thacker is the Executive Director of Speaking of Women’s Health and the author of The Cleveland Clinic Guide to Menopause.

women's health, urinary tract infections, UTIs, bladder irritants, cranberry, women's health tips, kidney infections, bladder infection, dr. holly thacker, Dr. Thacker

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