What You Need To Know
Most women will experience a few UTIs over their lifetime. The "honeymoon cystitis" our mothers were told about speaks to one of the primary causes of UTIs—the milking action of sexual activity, which can cause bacteria from the vaginal or anal area to get into the bladder and urethra. Neglecting treatment of a UTI can be dangerous because the infection can ascend into the kidneys. If you think you may have a UTI, have a urine culture taken. If it is positive for bacteria, your doctor will prescribe an antibiotic that will usually cure the problem without further treatment.
Recurrent bladder infections, however, require a different approach. Chronic use of antibiotics to treat recurrent UTIs doesn’t address the underlying imbalance in the body that is leading to the infections. Antibiotics can also kill off helpful vaginal ﬂora, resulting in yeast infections, diarrhea, and—unfortunately—recurrent urinary tract infection.
Listen To Your Body
The symptoms of urinary tract infections include burning on urination, blood in the urine, and fever.
What Causes This
Women with episodic urinary symptoms often find that the episodes are accompanied by anger or feeling "pissed off." Developing a urinary tract infection may be the body’s way of releasing anger. Pay attention to what happened in your life and relationships 24 to 48 hours before the onset of the symptoms. When the anger becomes more chronic and less available on a conscious level, the symptoms may take the form of continual urinary urgency and frequency.
Studies have shown that women with chronic bladder infections have more free-ﬂoating anxiety and more obsessive personality traits and tend to experience emotions only through their bodily symptoms (somatoform disorder) compared to women without this problem. Several researchers have found that women who feel the need to urinate frequently but who don’t have infections are more anxious and neurotic than those without the problem. Similarly, women who are anxious also experience urinary urgency (feeling as if you can’t make it to the bathroom in time), needing to get up at night to urinate, and frequent urination.
Get a medical evaluation to be sure that you don’t have some anatomical problem that is contributing to your infections. Make sure that the outer third of your urethra is well estrogenized. Your doctor should be able to evaluate this during a pelvic exam, because the urethra runs right under the top part of the vagina and is easily felt and observed. If there is any evidence of thinning of the outer urethra, which is common in menopausal and perimenopausal women, get a prescription for estrogen cream and use it in the upper part of the vagina, right along the urethral ridge. I recommend estriol 0.5 mg vaginal cream. The usual dose is 1 gram (one-quarter teaspoon) once daily for one week, then twice or three times per week or as needed thereafter. Other forms of vaginal estrogen also work well, including Estrace and Vagifem. The small amount needed to re-estrogenize the urethra does not raise levels in the blood signiﬁcantly and is considered safe.1
Spiritual and Holistic Options
- Stop all caffeine, even decaf, for two weeks because caffeine is a bladder irritant. Reintroduce to see if symptoms recur.
- Drink lots of water or unsweetened (or artificially sweetened) cranberry juice the minute you feel any bladder symptoms. The extra liquid helps flush out bacteria, and cranberry juice also acidiﬁes the urine, making it harder for bacteria to grow. Drink 16 oz. per day to treat an infection, or 8 oz. per day to prevent infections.
- Try cranberry capsules available at natural food stores. Cranberries contain a substance that prevents bacteria from sticking to the bladder wall, thus decreasing the risk for recurrent infection.
- Take a probiotic regularly to help recolonize your gut with "friendly" bacteria. Because the anus and urethra are so close anatomically, encouraging the growth of favorable bacteria in one area of the body also helps the other. My favorite probiotic is PB 8, which unlike most other probiotics doesn’t have to be refrigerated.
- Another way to help restore your vaginal ﬂora if you’ve had repeated UTIs and multiple courses of antibiotics is to dip a stiff tampon (such as OB) in plain organic yogurt and put it in your vagina. Change "yogurt tampons" every three or four hours. You can also douche with yogurt or put a probiotic capsule directly in your vagina each night for a few nights.
- Acupuncture and Chinese herbs work very well for recurrent UTIs.
- The herb uva ursi contains a natural antibiotic that relieves bladder infection. The powdered solid extract (20 percent arbutin) comes in capsules; take two three times per day. You can also take the tincture—one dropperful in a cup of water three times per day.
- Vitamin C helps prevent reinfection. Take 1,000 to 2,000 mg every day, and if your infections are associated with sexual activity, take 1,000 mg before and 1,000 mg after sex. Drink plenty of ﬂuids, and be sure to urinate within one hour of having sex.
- UTIs are often associated with frequent or traumatic sex (sex that involves injury to the vaginal and vulvar tissues). Treatment involves making the necessary adjustments in your sex life to decrease trauma. This may mean using a lubricant if you suffer from vaginal dryness. It may also mean rethinking any aspects of the relationship that are less than satisfactory.
- Repeated bouts of infection and/or burning on urination can also be related to a woman’s contraceptive method. If your diaphragm is too large, it can irritate your urethra during intercourse, causing bacteria to enter the urethral opening and migrate up to the bladder area. Also, the use of condoms or contraceptive creams that contain the spermicide nonoxynol-9 can cause urethral irritation and burning on urination. It will go away when you stop using the offending agent.
- Don’t introduce bacteria into your urethral area. After using the toilet, make sure you wipe yourself from front to back, not the other way around.
- Castor oil packs applied to your lower abdomen two or three times a week can work wonders in preventing UTIs because they appear to improve immune system functioning.
Learn More | Recommended Reading or Resources
- Iosif, C.S. (1992). Effects of protracted administration of estriol on the lower genito urinary tract in postmenopausal women. Arch. Gynecol. Obstet., 251(3), 115–120; Kirkengen, A. L., et al.(1992). Oestriol in the prophylactic treatment of recurrent urinary tract infections in postmenopausal women.Scand. J. Prim. Health Care, 10 (2), 139–142; Raz, R., & Stamm, W. E. (1993). A controlled trial of intravaginal estriol in postmenopausal women with recurrent urinary tract infections. N. Engl. J. Med., 329(11), 753–756.
Last updated: August 21, 2009