x-ray of urinary system biology
x-ray of urinary system biology
x-ray of urinary system biology

Urinary tract infection 101

Written by

Kayleigh Maxwell


  1. What does a UTI feel like?

  2. The main causes of a UTI

  3. UTI risk factors in pregnancy and pre/post-menopause

  4. Medical conditions which can increase the risk of UTI

  5. How to treat a urinary tract infection - can I get antibiotics for a UTI without seeing a doctor?

  6. Preventing UTI - good and bad foods for cystitis

  7. Preventing UTI - building new habits for UTI prevention

  8. UTI causes and symptoms during pregnancy

  9. Treatment options for UTI in pregnancy

  10. What are the signs of UTI during/after menopause?

  11. The connection between menopause and UTI - what does having lower oestrogen mean?

  12. What is Lactobacillus?

  13. UTI treatment post-menopause

  14. How to prevent UTI post-menopause

Urinary tract infections (UTIs) are very common, affecting 50-60% of women at some point in their lifetime (around 150 million people every year worldwide), and can be very unpleasant. 

According to the NHS, there are up to 10 million GP appointments per year for UTI. 

This suggests that up to 1 in 7 of the UK population require treatment every year. 

Failure to treat UTIs can lead to serious health complications - in 2019, the NHS spent £434m treating 184,000 emergency hospital admissions for UTI.

1. What does a UTI feel like?

urinary system biology x-ray

There are two main areas where you can get a UTI, the lower urinary tract and the upper urinary tract. Lower urinary tract infections tend to form in the urethra and/or bladder. 

Some of the most common symptoms of (lower) UTI are (1):

  • Urinary urgency: Feeling a constantly strong urge to pee

  • Urinary frequency: Needing to pee more often than usual

  • Pain or a burning feeling when urinating

  • Incontinence (leaking urine)

  • Blood in the urine / cloudy urine

  • Lower stomach / lower back pain

Upper urinary tract infections can happen when an infection spreads from the urethra and/or bladder to the kidneys. (See: Stages of a Urinary Tract Infection).

How do you know if a UTI has spread to your kidneys? (2)

Symptoms of an upper UTI (kidneys) include:

  • Upper back pain

  • Nausea / vomiting

  • Fever / chills

Infection of the kidneys can be life threatening. If you are experiencing any of these symptoms and feel that you may have a more serious infection, it is important that you seek help from a medical professional straight away.

But why are urinary tract infections so common?

2. The main causes of a UTI

woman with lower back abdominal pain

Scientific research findings from the last couple of years have suggested that hot weather, bacteria in the gut, and Vitamin D deficiency may be risk factors for UTI:

Hot weather

A study from the US published this year found that when the average temperature of the past week had been 25-30°C, the number of UTIs reported increased by 20-30% compared to when the temperature was 5-7.5°C. (3) The reason behind this connection may be dehydration. In hotter weather, it is possible to become dehydrated, which is a major risk factor for UTI.

Gut bacteria

It is relatively well known that certain hygiene practices can lessen the risk of UTI, such as wiping front to back and peeing after sex. This is because bacteria from your gut can be transferred to your urinary tract, and a recent study confirmed a link between the bacteria present in the gut and the bacteria detected in UTI. (4)

Vitamin D

Another study published in 2020 demonstrated a possible connection between Vitamin D deficiency and UTI, as participants in the study who experienced UTI had considerably lower levels. (5) Vitamin D is important for immune function, so without it the body is less equipped to fight a bacterial infection like UTI. In the UK, it is estimated that around 30-40% of the population are Vitamin D deficient (owing to the lack of sunshine!) (6), meaning it is especially important to find ways to increase your Vitamin D intake. Sources include oily fish, eggs, and cereals. (7)

3. UTI risk factors in pregnancy and pre/post-menopause (8)

Premenopausal UTI

The most frequent causes of UTI in premenopausal women include those related to sexual activity: frequency of sexual activity, use of spermicides (which some condoms contain), and having a new sexual partner. Other common predispositions include a personal or family history of UTIs and certain  blood groups. Genetic influences also mean that some women will have urinary tracts that are more susceptible to colonization by harmful bacteria.

Postmenopausal UTI

As well as the premenopausal risk factors listed above, lower levels of oestrogen post-menopause mean that not as much “good” bacteria is produced in the body which would normally fight off harmful bacteria. Also, continence issues and pelvic organ prolapse are common post-menopause which can lead to problems with storing urine and emptying the bladder. If the bladder cannot fully empty, harmful bacteria is more likely to set up shop.

UTI during pregnancy 

Pregnancy is also linked to issues with storing urine and emptying the bladder, and asymptomatic bacteriuria (the presence of bacteria without UTI symptoms) is very common. 

However, it is important to note that (contrary to prior beliefs) urine is not sterile, meaning that healthy bladders are not completely void of bacteria but rather they contain fluctuating levels of different bacterial species. (9) Some UTI testing methods (e.g. standard culture) will return a positive result, when in fact the bacteria found by the test is part of the normal microbiome (community of bacterial species) within the bladder. This is important to note because unnecessarily taking antibiotics increases the risk of antibiotic resistance, and in pregnancy increases risk to the foetus.

4. Medical conditions which can increase the risk of UTI (10)

Pelvic organ prolapse

Pelvic organ prolapse happens when the bowel, bladder, womb or top of the vagina slip down from their normal position, and is caused by weakening of the pelvic floor muscles due to things like pregnancy, menopause and hysterectomy. 10 When these organs descend, it leads to more difficulty emptying the bladder for around 40% of people, increasing the risk of UTI.

Neurogenic bladder

Neurogenic bladder is defined as bladder issues (e.g. issues with storing urine, emptying the bladder, bladder overactivity) caused by damage to the brain or spinal cord, or nerve damage, as this type of damage can disrupt signals from the brain to the bladder. Medical conditions which can be associated with neurogenic bladder include spina bifida, multiple sclerosis (MS), Parkinson’s disease, stroke, spinal cord injury and diabetes. With conditions like these, bladder issues are more prevalent, and so UTI is also more prevalent.


Neurogenic bladder, and other bladder conditions, can also require the use of a catheter. Catheterisation increases the risk of UTI as the catheter can carry bacteria, and so it is crucial to maintain good hygiene practices, including both hand and catheter hygiene.

5. How to treat a urinary tract infection - can I get antibiotics for a UTI without seeing a doctor?

If you do suspect that you have a UTI, it is important that you do a urine test, which you can do at home with the TestCard UTI test kit (available at Superdrug.com www.dearspharmacy.co.uk www.midwaypharmacy.co.uk www.weldricks.co.uk). We understand how debilitating a urine infection can be, but with TestCard you can take a urine test and get the results from the comfort of your home, and if your results are positive for UTI you can also use our treatment partner to get antibiotic treatment delivered straight to your door. 

However, if your symptoms become more severe or you begin to experience signs of a kidney infection (e.g. vomiting, fever, chills), it is important that you seek help from a medical professional straight away.

But how can I prevent a UTI?

Want to know how to keep UTI (AKA cystitis) at bay? There are a number of things you can try to help prevent a UTI. These include changes to what you eat and drink, getting rid of bad habits, and introducing some new good ones.

6. Preventing UTI - good and bad foods for cystitis

glasses of cranberry juice

Do cranberries help prevent a urinary tract infection?

A common belief is that drinking cranberry juice will fix all your UTI-related problems! Although it has been found that cranberries contain compounds which may help to protect cells in the bladder against harmful bacteria, the evidence is very mixed on whether ingesting cranberry is effective at preventing cystitis, and more research is needed before firm conclusions are made. (11) However, there are a number of other changes you can make to your diet to help prevent a urinary tract infection, which are better supported by evidence.

The do’s and don’ts:


✅ Drink lots of water: Sometimes dehydration can actually cause a Urinary Tract Infection or cystitis. When you have a urinary tract infection, you may not want to drink as much to avoid having to go to the toilet to avoid that burning sensation when you pee or because peeing may be very painful. But actually, keeping hydrated can help to flush harmful bacteria out of your system. A review of studies found that for those who are prone to UTIs, increasing daily water intake proved very effective at preventing UTI. (12) The Eatwell Guide recommends drinking 6 to 8 glasses of water a day. (13)

✅ Eat a healthy, balanced diet, including high-fibre foods: This can help to avoid constipation. Constipation increases bacteria growth, therefore increasing the chances of harmful bacteria causing an infection.

✅ Try to include antioxidants (e.g. blueberries, cranberries) (14), anti-inflammatories (e.g. nuts, leafy greens) (15), probiotics (e.g. yoghurt) and prebiotics (e.g. garlic, onion) (16) in your diet. These are full of vitamins and minerals, they help to protect against harmful bacteria, and they encourage the growth of “good” bacteria.


❌ Drinking caffeinated drinks and alcoholic drinks: Both of these are diuretics. If you become dehydrated, bacteria are more likely to grow. (17)

❌ Drinking sugary drinks: Sugary drinks irritate the bladder, and when bladder tissue cells are damaged, the bladder wall is more susceptible to infection. (17)

urine colouring infographic

For more information on how to prevent cystitis with dietary changes, check out our Nutrition and Hydration blog.

7. Preventing UTI - building new habits for UTI prevention

older woman looking out window in contemplation

How long should you hold a pee?

It is important not to delay having a wee. Holding a wee means holding in bacteria that could become harmful if it travels up the urinary tract. 

Does sex cause UTI? 

Urinary tract infections are not sexually transmitted, however, sexual activity can introduce new bacteria into the urinary tract, and it is important to flush it out before it can do any damage and affect your sex life! For this reason, it is especially important to pee after having sex to prevent a UTI. 

Keeping clean and dry

If you wear clothing that is tight and traps moisture, this creates a perfect environment for bacteria to grow. Bacteria thrive most in warm and humid environments. If possible, choose breathable fabrics, for example cotton underwear, to help prevent cystitis. (17)

Similarly, changing incontinence / menstrual products / underwear  frequently avoids the creation of a bacteria-friendly environment.

Lastly, (something we have heard a lot of recently!) hand washing is essential! Especially if you are changing incontinence / menstrual products, as any bacteria that you pick up on your hands could be introduced to the urinary tract and could then become harmful. (18)

Looking after the good bacteria

Products such as soaps, vaginal lotions and bubble bath products can disrupt the bacterial make-up in the vagina. This can mean a reduction in the amount of “good” bacteria, which is needed to counterbalance the bad. (19)

Spermicide can also be harmful to “good” bacteria. Opting for products (e.g. condoms, lubricants) which do not contain spermicide is a good precaution to take to prevent a urinary tract infection. (17)

Fighting off the bad bacteria

Taking showers instead of baths is also a good precaution to take to prevent a UTI. Bathing allows bacteria the opportunity to travel through water into the urinary tract. But showering, as well as avoiding getting bath & body products near the area, lessens the chance of bacteria entering the urinary tract and upsetting the bacterial balance. (17)

Wiping front to back is another important habit to develop. Cystitis is often caused by bacteria from the gut entering the urinary tract, and wiping front to back is a simple method to reduce the risk of this transfer. 

The scientific evidence for the efficacy of these dietary and habitual changes is often mixed, but there is still good reason to believe that these measures can help to prevent an infection, so it is worth experimenting with different prevention strategies.

How to prevent a UTI after menopause

Each year, around 9% of women over the age of 50 will get a case of cystitis. (20) Similar preventative measures for UTI are recommended post menopause, as well as the use of vaginal oestrogen. Oestrogen levels naturally drop after menopause, and this can impact the bacterial make-up in the vagina. The amount of good bacteria is less, and the chance of infection by harmful bacteria is higher. (21) Therefore, the use of vaginal oestrogen is recommended to prevent a urinary tract infection. (22)

How to prevent a UTI with a catheter (CAUTI)

One study found that in a large sample of NHS patients, 12.9% said that they were using a catheter. Using a catheter puts you at risk of developing a urinary tract infection because of the bacteria that can get into the urinary tract. 

If you live with an indwelling catheter or intermittent catheterisation, it is especially important to keep good hand hygiene, handle the catheter as little as possible, and to clean the tube and the area where the tube is inserted, to prevent a UTI. (23) Bladder & Bowel have more information on catheter use:

8. UTI causes and symptoms during pregnancy

close up of hands cupping pregnant belly

While over half of women will experience a UTI at some point in their lifetime, UTI (also known as cystitis) affects approximately 8% of women who are pregnant. (24)

Asymptomatic bacteriuria (ASB) is also very common in pregnancy. This is when there are bacteria in your urinary tract but you are not actually experiencing any symptoms or signs of a UTI.

But why is the risk of UTI higher during pregnancy? How do you tell the difference between cystitis symptoms and pregnancy symptoms? And is it safe to be using antibiotics?

Some of the risk factors for UTI in pregnancy are the same as those for non-pregnant women:

  • History of urinary tract infection

  • Anatomical differences

  • Harmful bacteria getting into the urinary tract during sexual activity

  • Bacterial imbalance caused by diet or digestive issues

  • Dehydration

And other UTI risk factors are pregnancy-specific (24, 25):

  • As the uterus expands, it puts pressure on the urinary tract

  • Hormonal changes can disrupt fluid passing from the kidneys to the bladder, meaning that urine is stored for longer, leading to a buildup of bacteria

  • Medical procedures during pregnancy which involve the insertion of a catheter or other device can also introduce bacteria to the urinary tract

The anatomical and hormonal changes that occur during pregnancy are more likely to be risk factors for cystitis between weeks 6 to 24 of pregnancy.

Another possible risk factor is the balance of different bacterial species within the microbiomes (communities of bacteria) in your body. That being said, research is lacking on possible changes that may occur, so it isn’t possible to make any certain conclusions about this one yet. (26)

Signs of UTI in pregnancy

If you have a urinary tract infection, the symptoms will also be similar to those of UTI in non-pregnant women. Here are the most common symptoms (27):

  • Feeling a strong need to pee very frequently

  • Stinging or burning when you pee

  • Pain in your lower tummy

  • Cloudy urine

  • Blood in your urine

  • Smelly urine

Similarly, symptoms of a kidney infection (an upper UTI) are the same in pregnant and non-pregnant women, the most common being back pain, fever and chills. (25)

As mentioned before, pregnant women are more at risk of having bacteria in their urine even in the absence of symptoms (AKA asymptomatic bacteriuria), and if infection goes undetected it could lead to complications for both the mother and the foetus.

Infection puts the mother at greater risk of anaemia, pre-eclampsia and inflammation or irritation of the uterus lining (endometritis) post-partum. Risks to the foetus include restricted growth and preterm delivery. (24)

You might be concerned that you have experienced, or are experiencing, one or more of the symptoms listed above, as there is some overlap between cystitis symptoms and pregnancy symptoms. For example, it is very common to experience a frequent urge to pee, or discomfort in the tummy or back when pregnant. And in pregnancy the sensations that you experience may change extremely frequently. 

But if you are experiencing multiple signs of a UTI and are worried that you may have an infection, it is important that you do a urine test, which you can do at home with the TestCard UTI test kit (available at Superdrug.com , Weldricks, Midway Pharmacy, Dears Pharmacy).

9. Treatment options for UTI during pregnancy

medicine, apple and glass on table top

So a dipstick urine test shows that there is a high likelihood that you have a urinary tract infection - what do you do next? 

You should speak to your doctor straight away.

NICE (the National Institute for Health and Care Excellence) advises doctors to conduct a urine culture and a susceptibility test when testing for UTI in pregnant women. (28) If there is an infection, this helps them decide which antibiotic will be the most effective and safest at getting rid of the infection. 

However, they will most likely start you on a course of antibiotics straight away while waiting for the test results, and change the antibiotic later on if necessary.

How long do antibiotics take to work?

The following antibiotic treatment is recommended by NICE (although results of a previous urine culture or susceptibility test may influence the choice) (28, 29):

  • First choice - Nitrofurantoin for a course of 7 days

  • Backup options (if there is no improvement with Nitrofurantoin) - Cefalexin or Amoxicillin for a course of 7 days 

Studies show that UTI symptoms can become much less severe after three to four days on antibiotics. (30, 31) That being said, it is extremely important to complete the whole course of the antibiotics you are prescribed, even if symptoms clear up, so that none of the bacteria causing the infection are left behind and able to cause another infection.

Are antibiotics safe for UTI in pregnancy?

Although there are risks associated with antibiotic use, (32) the most important thing is that complications resulting from more severe infection are avoided, and the most effective treatment for cystitis in pregnancy are antibiotics. 

The antibiotics prescribed by a medical professional for cystitis will be those that are safest during pregnancy, and will be informed by an antibiotic susceptibility test, which helps the doctor to make a decision about the most appropriate antibiotic to prescribe.

For more information about how antibiotic treatment decisions are made within the NHS for UTI during pregnancy, there are some useful flow diagrams in these NHS guidelines.

How to prevent a UTI when pregnant

One way to avoid the use of antibiotics is by preventing the development of an infection in the first place. There are a number a key steps you can take to prevent a urinary tract infection while you are pregnant (27):

  • Wiping from front to back avoids the travel of bacteria from the gut to the vagina, and then the urinary tract

  • Try as best you can to fully empty your bladder when you pee, to ensure that bacteria doesn’t hang around in the urinary tract

  • Keep hydrated so that any harmful bacteria are flushed out of your system

  • Oldie but goodie - pee after sex! This also flushes away potentially harmful bacteria, which can enter the vagina and then urinary tract during sexual activity

  • Don’t wear clothing that is too tight - wear looser, more breathable clothing including cotton underwear

  • Keep the area clean and dry, and avoid the use of soaps, vaginal lotions or bubble bath products. These can affect the functioning of ‘good’ bacteria which is needed to counteract the bad

  • Eat a healthy, balanced diet. Ingesting plenty of vitamins and minerals will help to balance your microbiome, and also prevent constipation, another risk factor for UTI.

For more tips on preventing cystitis with dietary changes, check out our Nutrition and Hydration blog.

Asymptomatic bacteriuria (ASB)

Regardless of the symptoms you experience, you will likely be tested occasionally for urinary tract infection while pregnant. This is due to the prevalence of ASB sitting at around 10%, meaning that around 10% of pregnant women will test positive for a significantly high level of bacteria in their urine even though they experience no signs of a UTI, like burning or stinging when peeing or having cloudy urine . (26) The risk factors mentioned above all contribute to this prevalence rate during pregnancy.

If you test positive for asymptomatic bacteriuria, a similar treatment pathway as above will be followed, and more details can be found in these NHS guidelines.

You may be wondering why asymptomatic bacteriuria needs to be treated at all, if you have no symptoms and feel otherwise fine. But if untreated, around 25% of pregnant women with ASB will develop a symptomatic UTI, and for around 50% the infection will spread to the kidneys. (25)

That being said, prescribing antibiotics for asymptomatic bacteriuria during pregnancy should be a decision made with care. Your personal medical history and personal preference for medication use should be taken into consideration, and you and your doctor should be able to make an informed decision together. 

There is also currently a push for research looking into whether shorter courses of antibiotics could be just as effective at treating cystitis. (32) But in the meantime… you can read up on the NICE recommendations, and if you have concerns about symptoms, want to know more about preventing UTI, or are worried about the implications of antibiotic use, don’t be afraid to speak to your doctor or pharmacist!

10. What are the signs of UTI during/after menopause?

older woman holding testcard pouch

Getting a UTI can be a pain for women of any age, but women Peri-Menopause post-menopause are especially at risk of developing a urinary tract infection.

The prevalence of lower UTI (also known as cystitis) in women increases with age, and up to 15% of women over the age of 60 will develop recurring UTIs. (33)

Many older women believe that urinary symptoms such as needing to go to the toilet a lot, or continence issues, are just a normal sign of aging. (33) Also, scientific research into women’s health issues is lacking, and there is still a lot we don’t know about the causes and mechanisms of certain illnesses. Healthcare providers often don’t have answers when it comes to chronic conditions, leave their female patients in the dark, and show a lack of empathy and understanding. For these reasons, it is understandable why you might put off a visit to the doctor about urinary symptoms. (34)

But these symptoms could be a sign of UTI, and UTI shouldn’t be ignored, so it is important that you get appropriate care and the treatment that you need.

What to look out for

Common signs of a UTI include cloudy urine, a burning or stinging feeling when you pee, abdominal pain, and needing to go to the toilet more urgently and more often than usual. (35)

Incontinence can also be a sign of cystitis, although it is also a very common issue in women, becoming more prevalent with age, and is not necessarily indicative of an infection.

Up to 60% of women report at least some incontinence, and studies have found that around 70% of women first start to experience urinary incontinence following their final menstrual period. (33)

That being said, if you experience symptoms, like cloudy wee or pain when peeing, that are not normal for you and you think that they might be cause for concern, it is a good idea to check for UTI by taking an at-home urine test.

11. The connection between menopause and UTI - what does having lower oestrogen mean?

For Perimenopausal or post-menopausal women, the most reported factors that can increase the chance of developing cystitis include living with another chronic condition such as diabetes, having a history of urine infections before menopause, having a family history of UTI, and having structural abnormalities in the pelvic area. (36, 37)

However, the risk factor that is discussed most often is the decline of oestrogen which occurs with menopause. The decline of the hormone oestrogen has a significant impact on the functioning of the urinary tract. So let’s look at how this is connected to urinary tract infections… (37)

First of all, lower quantities of oestrogen are associated with a number of anatomical changes (33):

  • The urethra (the tube that carries urine from the bladder out of the body) becomes shorter

  • The lining of the urethra becomes thinner

  • The muscle that controls urine leaving the bladder becomes less efficient

  • The bladder becomes less capable of holding large amounts of urine

  • The muscles of the vagina and the muscles of the pelvic floor lose volume

These changes interfere in different ways with the passing of urine through the urinary tract and out of your body, therefore increasing the chance of infection occurring. 

They also increase the risk of continence problems, as well as pelvic organ prolapse (when one of the organs in the pelvic area moves down and presses against the vagina), which in turn also increase the risk of UTI. (38)

12. What is Lactobacillus?

Also, as well as anatomical changes, lower oestrogen levels have an important effect on the bacteria living in the urinary tract. Oestrogen helps with the production of glycogen. This is very important because glycogen is food for Lactobacillus (good bacteria). Therefore, less oestrogen means less glycogen, which means less food for good bacteria to grow and thrive. And that good bacteria is needed to create a protective environment. (39)

Without as much Lactobacillus, harmful bacteria are more likely to invade the urinary tract and cause an infection.

To put this in perspective, one study found that when looking at urine samples from premenopausal women, Lactobacillus accounted for 78% of bacteria in the sample, whereas for post-menopausal women it was found that Lactobacillus accounted for only 42% of the bacteria in the urine sample. (40)

This is why having lower oestrogen levels is one of the most significant risk factors for cystitis in post-menopausal women.

13. UTI treatment post-menopause

So we have an idea of what UTI looks like, and why it is more prevalent in older women. But what do you do if you get a urine infection? And how can you prevent a UTI from happening in the first place? Let’s look at some treatment and prevention methods.

Antibiotics are the most used treatment for urinary tract infections, but how long do antibiotics take to work?

Nice (the National Institute for Health and Care Excellence) recommends a 3 day course of antibiotics for a one-off UTI, (41) and for recurrent UTI they recommend regular use of antibiotics to prevent further infections (antibiotic prophylaxis). (42)

However, for post-menopausal women, before prescribing antibiotic prophylaxis, it is recommended that doctors first prescribe oestrogen. 

As we have already discovered, having low oestrogen levels greatly increases the likelihood of developing cystitis because of its effect on Lactobacillus. But introducing oestrogen to the body (normally as a pill, a cream, or a ring inserted directly into the vagina) (39) is shown to increase the amount of Lactobacillus in the vagina and urinary tract. Therefore, using oestrogen as a prevention technique has the potential to significantly reduce the risk of UTI. (43)

Treating a UTI without antibiotics

If you keep getting urine infections and using oestrogen has not worked, do you have to take antibiotics? You may be concerned about antibiotic use, and for good reason. If you take antibiotics too often your body builds up resistance to them, and then it can become harder to fight future infections. Some people also experience unpleasant side effects with antibiotics.

Some studies show that it is possible for urine infections to resolve on their own, without antibiotic treatment. (44) However, it is also possible for an infection to worsen and spread to the kidneys if left untreated.

So if you have symptoms which are really bothering you, it is important to do a urine test, which you can do with the TestCard UTI test kit, to get a better idea of whether you may have an infection. Then you can decide on the best treatment for you.

14. How to prevent UTI post-menopause

There are a number of non-antibiotic home remedies you can try to prevent urine infections from happening in the first place. Let’s look at a few.


How does cranberry juice help UTI? Cranberries contain something called a proanthocyanidin, which stops bacteria attaching to the walls of the urinary tract. Cranberries are also an anti-inflammatory, meaning they can prevent the development of symptoms. However, their effectiveness for women post-menopause is still under debate. A recent review found no significant effect for the use of cranberry to prevent UTI, which means they cannot be recommended. (38) But if you get UTIs frequently, it is always worth exploring prevention options to find what works for you.


D-mannose is another commonly used supplement to prevent UTI. It has been found that for postmenopausal women, urinary symptoms can be significantly improved with D-mannose. (38) It is even suggested that taking D-mannose is almost as effective as using antibiotics preventatively. (45) Similar to cranberries, it works by stopping bacteria from sticking to the walls of the urinary tract. (46)


Using probiotics for UTI is also an option. They have a different effect, as rather than deterring harmful bacteria, they help the growth of good bacteria (Lactobacillus). (38) However, it has been suggested that definite conclusions cannot be made about their efficacy. 

Levels of Lactobacillus can also be improved by 45:

  • Stopping smoking

  • Avoiding vaginal moisturisers

  • Not douching

  • And avoiding products containing spermicide

Also, a few studies have assessed the effects of Lactobacillus-containing suppositories, and patients reported different levels of success. (46)

Vitamin D

Lastly, Vitamin D works against UTI by strengthening the immune response of the bladder, (38) and research has shown that for post-menopausal women taking Vitamin D, urinary symptoms were significantly less severe. (46)

As well as using these home remedies for UTI, there are a number of other tricks which are good to get into the habit of using if you are looking to prevent UTI post-menopause. For example, peeing after sex and avoiding very tight clothing (see above). (37)


1 https://liveutifree.com/what-causes-a-urinary-tract-infection/#UTIsymptoms

2 https://www.nhs.uk/conditions/urinary-tract-infections-utis/

3 Simmering, J. E., Polgreen, L. A., Cavanaugh, J. E., Erickson, B. A., Suneja, M., & Polgreen, P. M. (2021). Warmer weather and the risk of urinary tract infections in women. The Journal of Urology, 205(2), 500-506.

4 Magruder, M., Sholi, A. N., Gong, C., Zhang, L., Edusei, E., Huang, J., ... & Lee, J. R. (2019). Gut uropathogen abundance is a risk factor for development of bacteriuria and urinary tract infection. Nature communications, 10(1), 1-9.

5 Ali, S. B., Perdawood, D., Abdulrahman, R., Al Farraj, D. A., & Alkubaisi, N. A. (2020). Vitamin D deficiency as a risk factor for urinary tract infection in women at reproductive age. Saudi Journal of Biological Sciences, 27(11), 2942-2947.

6 Calame, W., Street, L., & Hulshof, T. (2020). Vitamin D Serum Levels in the UK Population, including a Mathematical Approach to Evaluate the Impact of Vitamin D Fortified Ready-to-Eat Breakfast Cereals: Application of the NDNS Database. Nutrients, 12(6), 1868.

7 https://www.nhs.uk/conditions/vitamins-and-minerals/vitamin-d/

8 Storme, O., Tiran Saucedo, J., Garcia-Mora, A., Dehesa-Dávila, M., & Naber, K. G. (2019). Risk factors and predisposing conditions for urinary tract infection. Therapeutic advances in urology, 11, 1756287218814382.

9 Hilt, E. E., McKinley, K., Pearce, M. M., Rosenfeld, A. B., Zilliox, M. J., Mueller, E. R., ... & Schreckenberger, P. C. (2014). Urine is not sterile: use of enhanced urine culture techniques to detect resident bacterial flora in the adult female bladder. Journal of clinical microbiology, 52(3), 871-876.

10 https://www.nhs.uk/conditions/pelvic-organ-prolapse/

11 Fu, Z., Liska, D., Talan, D., & Chung, M. (2017). Cranberry reduces the risk of urinary tract infection recurrence in otherwise healthy women: a systematic review and meta-analysis. The Journal of nutrition, 147(12), 2282-2288.

12 Scott, A. M., Clark, J., Del Mar, C., & Glasziou, P. (2020). Increased fluid intake to prevent urinary tract infections: systematic review and meta-analysis. British Journal of General Practice, 70(692), e200-e207.

13 https://www.nhs.uk/live-well/eat-well/the-eatwell-guide/

14 https://innovativemedicine.com/antioxidant-rich-foods/

15 https://www.health.harvard.edu/staying-healthy/foods-that-fight-inflammation

16 https://sungenomics.com/blogs/learn/prebiotics-vs-probiotics

17 https://liveutifree.com/uti-prevention/

18 https://www.kentcht.nhs.uk/about-us/ensuring-quality/infection-prevention-and-control/dont-dry-out/

19 Al-Badr, A., & Al-Shaikh, G. (2013). Recurrent urinary tract infections management in women: a review. Sultan Qaboos University Medical Journal, 13(3), 359.

20 Hu, K. K., Boyko, E. J., Scholes, D., Normand, E., Chen, C. L., Grafton, J., & Fihn, S. D. (2004). Risk factors for urinary tract infections in postmenopausal women. Archives of internal medicine, 164(9), 989-993.

21 Caretto, M., Giannini, A., Russo, E., & Simoncini, T. (2017). Preventing urinary tract infections after menopause without antibiotics. Maturitas, 99, 43-46.

22 https://www.nice.org.uk/guidance/ng112/chapter/Recommendations

23 Flores-Mireles, A., Hreha, T. N., & Hunstad, D. A. (2019). Pathophysiology, treatment, and prevention of catheter-associated urinary tract infection. Topics in spinal cord injury rehabilitation, 25(3), 228-240.

24 https://www.northdevonhealth.nhs.uk/wp-content/uploads/2019/06/Antibiotic-Guidelines-for-Urinary-Tract-Infection-in-Pregnancy-V3.0.pdf

25 Habak, P. J., & Griggs Jr, R. P. (2019). Urinary tract infection in pregnancy.

26 https://liveutifree.com/uti-during-pregnancy/

27 https://www.mcht.nhs.uk/EasysiteWeb/getresource.axd?AssetID=27214&type=full&servicetype=Attachment

28 https://www.nice.org.uk/guidance/ng109/documents/draft-guideline-2

29 https://www.northdevonhealth.nhs.uk/wp-content/uploads/2019/06/Antibiotic-Guidelines-for-Urinary-Tract-Infection-in-Pregnancy-V3.0.pdf

30 Richards, D., Toop, L., Chambers, S., & Fletcher, L. (2005). Response to antibiotics of women with symptoms of urinary tract infection but negative dipstick urine test results: double blind randomised controlled trial. Bmj, 331(7509), 143.

31 Bleidorn, J., Gágyor, I., Kochen, M. M., Wegscheider, K., & Hummers-Pradier, E. (2010). Symptomatic treatment (ibuprofen) or antibiotics (ciprofloxacin) for uncomplicated urinary tract infection?-results of a randomized controlled pilot trial. BMC medicine, 8(1), 1-8.

32 Storme, O., Tiran Saucedo, J., Garcia-Mora, A., Dehesa-Dávila, M., & Naber, K. G. (2019). Risk factors and predisposing conditions for urinary tract infection. Therapeutic advances in urology, 11, 1756287218814382.

33 Alperin, M., Burnett, L., Lukacz, E., & Brubaker, L. (2019). The mysteries of menopause and urogynecologic health: clinical and scientific gaps. Menopause (New York, NY), 26(1), 103.

34 Bradway, C., Coyne, K. S., Irwin, D., & Kopp, Z. (2008). Lower urinary tract symptoms in women—a common but neglected problem. Journal of the American Academy of Nurse Practitioners, 20(6), 311-318.

35 https://www.nhs.uk/conditions/urinary-tract-infections-utis/

36 Raz, R., Gennesin, Y., Wasser, J., Stoler, Z., Rosenfeld, S., Rottensterich, E., & Stamm, W. E. (2000). Recurrent urinary tract infections in postmenopausal women. Clinical Infectious Diseases, 30(1), 152-156.

37 Baker, J. (2018). Challenges of Treating Urinary Tract Infections in Post-Menopausal Women. Urologic Nursing, 38(1).

38 Caretto, M., Giannini, A., Russo, E., & Simoncini, T. (2017). Preventing urinary tract infections after menopause without antibiotics. Maturitas, 99, 43-46.

39 https://liveutifree.com/uti-and-menopause/

40 Ammitzbøll, N., Bau, B. P. J., Bundgaard-Nielsen, C., Villadsen, A. B., Jensen, A. M., Leutscher, P. D. C., ... & Sørensen, S. (2021). Pre-and postmenopausal women have different core urinary microbiota. Scientific reports, 11(1), 1-10.

41 https://www.nice.org.uk/guidance/ng109/resources/visual-summary-pdf-6544021069

42 https://www.nice.org.uk/guidance/ng112/resources/visual-summary-pdf-6544163629

43 Chen, Y. Y., Su, T. H., & Lau, H. H. (2021). Estrogen for the prevention of recurrent urinary tract infections in postmenopausal women: a meta-analysis of randomized controlled trials. International Urogynecology Journal, 32(1), 17-25.

44 Christiaens, T. C. M., De Meyere, M., Verschraegen, G., Peersman, W., Heytens, S., & De Maeseneer, J. M. (2002). Randomised controlled trial of nitrofurantoin versus placebo in the treatment of uncomplicated urinary tract infection in adult women. British Journal of General Practice, 52(482), 729-734.

45 Jung, C., & Brubaker, L. (2019). The etiology and management of recurrent urinary tract infections in postmenopausal women. Climacteric, 22(3), 242-249.

46 Oberg, J., Verelst, M., Jorde, R., Cashman, K., & Grimnes, G. (2017). High dose vitamin D may improve lower urinary tract symptoms in postmenopausal women. The Journal of steroid biochemistry and molecular biology, 173, 28-32.