What doctors don’t know about UTI prevention and why probiotics are very important

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What my doctors and nurses told me to do for UTI prevention? Drink water, pee before and after sex and eventually, when none of this worked, take preventive antibiotics! Hell no.

My first UTI

The nurse sent in my prescription for antibiotics, warned me to take all of them even if the symptoms go away and also gave me the “lifestyle instructions”. Mainly she advised that I pee before and after sex, wipe from front to back and urinate frequently.

Frankly, I do not like taking antibiotics but if I do, I follow the instructions precisely. I knew that antibiotics work like a death squad: they kill bad, but also some beneficial bacteria. However, I thought since I eat yogurt regularly I should be fine. The drugs helped almost instantly and I thought I would never have a UTI again.

Shortly after – my second UTI

A couple of weeks later, during a road trip to Colorado I felt the familiar symptoms. I’ve got to tell you, my first UTI outbreak was horribly painful and developed super fast. Within the first couple of hours I was peeing with blood and dying from pain. So the second time I wasn’t thinking too long and called the doctor again. They made me come in, took a urine sample (yep, it was E. coli) and gave me a prescription for yet another antibiotic. And of course, the nurse repeated the well-known “pee after sex” mantra as the best way to go about UTI prevention.

Third and forth UTIs & antibiotic prevention

My “wake up call” was when my doctor said that the next step is to take a preventive dose of antibiotics every time after sex. Basically, just take a pill every other day in my case. Come on, that’s way too much even from a layman’s perspective!

I started researching the issue. It is not easy to find answers online since there are too many opinions and all kinds of “kitchen pantry” solutions. By then I had already tried cranberry pills, blueberries and echinacea. Baking soda helped to relieve the pain for a while but never “cured” the infection. Fortunately, I found an article on PubMed, that had research about probiotics and their role in UTI prevention.

…Before we proceed any further, make sure you understand the mechanics of why sex causes UTI. This post will explain you why if you are having UTIs after sex, you need to take care of your vaginal flora first. For a graphic version and detailed explanation see this infographic.

My secret: UTI prevention with probiotics

Probiotics work in your body to help grow beneficial bacteria and bacterial flora is increasingly recognized as an important defense to infection. These beneficial bacteria help to “restrain” E. coli, the cause of most UTIs on the planet. Now imagine, every time you take antibiotics, you kill E. coli but you also kill these beneficial bacteria in your body.

Right after your infection has been cured with antibiotics you actually become more vulnerable to re-infection with E. coli again! And given that the main source of E. coli is always there for you (your own asshole, pardon my French) it makes total sense that recurrent UTIs are so wide spread.

Every time you take antibiotics, you kill E. coli but you also kill these beneficial bacteria in your body

What is more important, probiotics are safe to use with no side effects, safe for the elderly, pregnant women and kids, and sold over the counter. This is the best UTI prevention you can implement today. There is really no risk in suggesting probiotics to anybody. It should be a logical continuation for patients treated with antibiotics. This type of advice is so much more valuable, than the classic “pee before and after sex”.

I spent about $30 on a monthly supply of potent probiotics. Needless to say, yogurt and kefir should be also part of the plan, but probiotics in these products are low in concentration (and are also not the type that your vagina needs). The brand I bought in Wallgreens advertised targeted delivery of the probiotics to my “lady parts”, which sounded like exactly the place where I needed them.

Three brands of probiotics you can try, to prevent UTI

Here are couple brands of the probiotics (I used RepHresh Pro-B), which promise targeted delivery of the good bacteria, where you need them most:

1) RepHresh Pro-B Probiotic Feminine Supplement, 30-Count Capsules

2) Douglas Laboratories iFlora Multi-Probiotic – 60 Vegetarian Capsules

3) Jarrow Formulas Fem-Dophilus, 60 Capsules

Three months after my experiment with the probiotics I wrote an email to my doctor telling him about my discovery. He thanked me for sharing and replied: “we are seeing more benefits from probiotics, so I could definitely see how it could work”. Duh?

I also posted comments on a couple of UTI related sites with the same information and finally, decided to start this blog.

Thanks to the Internet nowadays the results of medical trials and research are no longer just for the doctors. I suggest you take matters in your own hands and see if probiotics can help you to break the cycle of recurrent UTIs.

31 COMMENTS

  1. Hey, I got reccurent UTI and the frustration that comes with it, but your blog is way helpful than what the doctors have recommended to me for the past 2years! Yupp,thankyou so much.

  2. Probiotics are the greatest solution I have come across. After having near constant infections for a good while, I now get less than a handful a year. Increasing my water intake also helped enormously.

    So glad this information is so easily searchable online – never once heard it from a doctor!

    • Emily,
      Thank you for sharing! Probiotics are a part of a standard treatment in many countries in Western and Eastern Europe, but still have not been popularized among clinicians in USA.
      I’m so glad it’s working for you! Don’t settle on your result, you can rid yourself of UTI completely. Best wishes for upcoming new year!

  3. thank you!! Sigh! Going through my third one in less than a month right now. I’m desperate. Will take probiotics and see if it at least helps with the symptoms. Already tried two different antibiotics. Makes sense that I would be more prone to it after taking the antibiotics!

    • Hi Aylin,

      Thanks for dropping by!
      Familiar story, but still it is heartbreaking to hear that another doc failed to suggest probiotics to avoid this vicious cycle.
      Yes, please get probiotics (make sure to get the right ones – see my posts about the types). Don’t be desperate. You have all you need to safely help yourself to never experience a UTI again.
      Make sure to finish your antibiotics first and completely and then, 12 hrs later get started on probiotics. Proiotics won’t help with fighting an existing infection, since it is already in the bladder, but will create a healthier vaginal flora going forward. Allow yourself couple weeks before claiming the victory and take D-Mannose for prevention while restoring your good bacteria. There are other preventive techniques that you can utilize in the first couple weeks to ward off e.coli while restoring your vaginal flora.
      You will be back to normal in no time 🙂

      Best wishes!

    • Hi J!
      Thanks for stopping by. Good question. There are multiple factors that affect vaginal flora, therefore there is no “one size fits all” answer!
      Here are the factors:
      1) Microbiological characteristics of every vagina is different to begin with 🙂
      2) By adding certain probiotic strains as a supplement one tries to introduce helpful bacteria into their microbiome. Nobody really knows what is the “perfect balance” of bacteria.
      3) Some probiotic strains are more researched than others in their effect on vaginal flora, but still it is more art then science.
      4) Probiotic’s potency varies! Methods of administering probiotics will also influence how quickly you’ll deliver the beneficial bacteria where they most needed.
      5) Your lifestyle continuously affects your microbiome resulting in varying levels of beneficial and pathogenic bacteria with time.
      With all this being said, here is an article that describes an experiment of promoting growth of certain type of beneficial probiotic strains in a group of women who suffered from bacterial vaginosis. According to the study, they were able to see positive results within a week. I’d say target for a 30 day cycle and repeat in times of stress, after eating/drinking too much sugar and starch (Thanksgiving anybody?) and if taking antibiotics. Not a medical advice!
      Best of luck,

  4. Hi I’m ttc and i have big issues with uti’s sexual related only. Before i was using D.Mannose it work great. But now i want to conceive and heard d mannose bind the sperms. Now I’m planning to use probiotics Fem Dophilus to prevent uti. Does it will be helpfull? Or is there will be any effect during the period of conceving?

    • Hi Ken, thank you for sharing your experience. I’ll update my post about D-Mannose side-effects with this information. I think it is helpful for the women who are trying to conceive to consider the possible effects of D-Mannose binding with sperm.
      In terms of probiotics, there is more and more research out there about the importance of healthy bladder microbiome in UTI prevention and studies suggesting that lactobacilli play a role in preventing infection. I would imagine healthy vaginal flora would benefit your reproductive goals as well!

  5. My almost 12 year old daughter has been getting UTI’s since she was five. This school year has been especially rough. She had back to back to back to back UTI’s from January-mid APril and missed a lot of school. She has become very good at knowing her symptoms, and they always culture her urine, including after she has finished antibiotics. Of course, I am very concerned about the amount of antibiotics she has had over the past six years and especially this past year so I started seeking alternatives. I read about d-mannose a couple months ago and she has been taking it twice daily for about a month with the intent of reducing it to once/day. Her doctor was not familiar with d-mannose but was supportive of trying it. She was swimming at a water park for two days this past weekend and I was concerned about the increased potential for a UTI due to being in a wet bathing suit for long periods of time. I upped her d-mannose to three times/day and have been hoping for the best. On Tuesday night she mentioned she had felt some mild UTI symptoms while at school. Wednesday morning she was feeling uncomfortable. I brought a urine sample to the doctor and started her on d-mannose every 2-3 hours. By mid afternoon she said she wasn’t having any UTI symptoms but her stomach was upset. Today she also has no UTI symptoms but an upset stomach. Her doctor just called and said the urinalysis came back clean but her urine was milky (maybe from the d-mannose?) so they were still going to culture it and run another test. So…finally to my questions. Do you think it is possible for d-mannose to work that quickly(less than 12 hours)? Can it cause milky urine? Can it interfere with a urinalysis? I’m thinking she may have misread her symptoms and in fact does not have a UTI. Also, my daughter does take a probiotic but not specific to vaginal health. My daughter does not take pills or capsules well. I was hoping to be able to open the capsule and mix with something but I am guessing they are time release and would not be as effective. Any thoughts on this?

    I have spent countless hours online looking for helpful information and this is the first time I came across you sight. Thank you! I will be obsessed with it for the next few days.

    • Hi Jen,
      I’m so sorry to hear! Poor girl. Hope supplementing with D-Mannose will help to stay healthy!
      Here are my thoughts:
      1) If culture test comes negative (knock on wood) than D-Mannose worked for your case. See if you can lower the dose to get rid of the upset stomach issues. If you use it early enough I don’t see a reason why it wouldn’t work fast!
      2) No, it should not make any effect on her urine. How persistent is this symptom? Many factors can affect why urine appears cloudy. There are three main factors: increased protein, crystals and puss/blood due to infection. I would personally worry if this persist but your urine analysis should show what is the reason. It could be as harmless as diet change. So let’s hope it is.
      3) I don’t think D-Mannose would interfere with the test (but again, I’m not a physician). They will try to grow whatever bacteria are present in urine and the fact that mannose is also there would not affect the bacteria viability IMHO 🙂
      4) Quite frankly, I don’t think you guys should really worry about vaginal probiotic since she is 12. Vaginal health plays important role when UTIs are triggered by sex. I would suggest to focus on bladder health probiotics instead. These are chewable for kids and have some good strains. There are plenty of chewable options on the market.
      5) Definitely see if diet could help to keep pH of urine lower.
      Most importantly, have you checked for any abnormalities in her bladder/urethra or any stones? I’m sure you did but thought I would ask. With kids it could be an issue with urine flow and anatomy issues. If this is the case, then focusing on supporting low pH and eating plenty of fiber to maintain growth of good bacteria could be helpful.
      Also, have you tried homeopathy? I’ll be soon posting an interview with a local homeopathic doctor that I found very intriguing.
      Best of luck and best wishes to your daughter!
      Let me know what your urine culture shows. Fingers crossed!

      • Thank you so much for your quick reply. I had my daughter back off of the d-mannose and she is feeling better. I will look into bladder health probiotics and will think about her diet. She has fortunately been cleared of all abnormalities. Her doctor and I feel that her initial UTI’s were caused by poor bathroom habits and delayed voiding (which is still an issue though getting better). I’ll look for your interview with the homeopathic doctor and let you know about her urine culture.

        • Great! (re: no abnormalities). But really really strange.. I’ll send you a link once post is out and hopefully your cultures are clear!

        • Hi – unfortunately, I grew up with persistent UTIs and then was plagued with chronic inistitial (sp?) cystitis – which is inflammation of the bladder wall) – it causes blood in the urine, which result in exact UTI symptoms ( sometimes far worse). D-mannose can cause bladder irritation, so it follows that she’d feel the same symptoms. When you reduced the dosage the irritation may have been lessened or eliminated. I would sometimes have so much blood in my urine and no infection, that the college infirmary thought I must have my period. 25 years ago when I was dealing with it, it took me several years and several urologists to figure out what it was – I was so lucky to stumble onto the doctor who was actually doing studies of it at the research hospital in MA. I’m actually relieved when it’s a UTI and not CIC. I “grew out of it” at about 30 – I’ve only had 1 or 2 instances CIC or UTIs in the last 20 years – and now they actually have a medication for it. FYI – the treatment options use to be steroids in the bladder or stretching of the bladder – both of which were temporarysolutions and neither sounded like something I wanted to do. With that knowledge, at the first tingle I would start drinking huge amounts of water and holding it as long as I could repeatedly – it would work!! Obviously make sure you don’t have an infection first!!! If the d-mannose does irritate her bladder or she develops any issues with the antibiotics or u want to avoid them, you may want to try oregano oil or colloidal silver they will knock out most anything bacterial, viral, or fungal without killing the good bacteria. Good luck!!!

  6. What If you are currently having a UTI? I have mild symptoms now so I know one is coming on. I would hate to go get antibiotics again but I have the probiotics you listed

    • Hello!
      Unfortunately, probiotics wouldn’t help with an infection, they work to help you to improve your natural defense in the future.
      Try D-Mannose if you have any available and if symptoms do not disappear right away (within a day or two, but watch out for any flank pain or worsening of the symptoms), ask for Macrobid and do a cycle of probiotics while taking the antibiotic, and one more after would not hurt.
      Best,

  7. Do you have any suggestion on current UTI symptoms? I am tired of taking antiobiotics and would love to cure this without them. I am chugging water like crazy and taking Fem Dophilus which I already take almost daily. I picked up Kombucha too because it was all I could think of! If I have to take another round of antibiotics I will but want to ward this off without. Symptoms are mild and only feeling pain after urinating.

    • Hello K,
      I understand, but sometimes antibiotics are a necessary evil.
      If you have been experiencing UTI symptoms for couple days, I’d suggest to go to a doctor. There are couple remedies that are good option to supplement a UTI treatment: D-Mannose is one of them but by the time you read this I’m afraid it’s too late to experiment with natural remedies. You can still order and try D-Mannose to take it with your antibiotic treatment. If you end up treating UTI with antibiotics, check out this post about alternative approach to UTI treatment that explains importance of NAC for curing recurrent UTIs.
      As to FemDophilus, the probiotics are critical for prevention of recurrent UTI but I’m afaraid won’t do much for treatment. Same with Kombucha.

  8. Hi Anastasia,
    I’m 48 and last August was diagnosed with an under active bladder. There’s no reason at all, I just retain about 500mls of urine after voiding a small amount naturally. I never got UTIs but now that I self catheterise, I get one every 26 to 40 days. It’s always treated with antibiotics. I tend to get an infection during my period. My doc wants me to try cerazette (pill) to stop my periods, which I’m 3 weeks into. I’ve 2 days of antibiotics left. Today I started dmannose tablets (I’ve ordered powder) and I’ll start on one of the probiotics you recommend (ordered that too). I’ve had 8 infections this year and it scares me to think that I’ll either become immune to antibiotics or the infection symptoms will become worse. I wanted to thank you for you info and your blog. I feel much happier that I’ve got HOPE now. Lou

    • Hi Lou,
      Thank you for your kind words 🙂 Sorry to hear about your struggle.
      Check out this information about urine pH as well. Catheter is a major culprit for UTI, let’s see if D-Mannose helps. You can also try adding a broad spectrum probiotic to reduce number of pathogenic e.coli overall.
      There are multiple herbs that could provide antibacterial properties such as Uva ursi, garlic, berberine, tumeric. Research for contraindications and consult with your urologist. Check out this protocol and see what your doctor thinks.
      Best of luck and do not give up.

  9. Hi,
    Thank you for your reply. I will take the advice on board and I will let you know how it goes. Thank God eggs are still on the alkaline list of food! Otherwise I’d be living on fresh air and Mung beans!
    Do you think I should be taking a general probiotic as well as the more targeted probiotic?
    Thank you, Lou

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