Health Essentials from Cleveland Clinic

The myths about preventing and treating a urinary tract infection (UTI) are many, but let’s get to the truth.

About 60 percent of women will experience this common malady (and the painful, frequent and sometimes urgent urination that goes with it) over their lifetimes.

At the top of the UTI “myth list” is the widely held belief that drinking cranberry juice or taking cranberry supplements can prevent and treat UTIs.

“There is an active ingredient in cranberries that can prevent adherence of bacteria to the bladder wall, particularly E. coli,” says urologist Courtenay Moore, MD. “But most of the studies have shown that juice and supplements don’t have enough of this active ingredient, A-type proanthocyanidins (PACs), to prevent bacteria from sticking to the urinary tract.”

Overall, clinical studies on the efficacy of cranberry juices and extracts for the prevention of UTIs are conflicting.

In a 2013 meta-analysis, cranberry juice and tablets reduced the occurrence of UTIs compared to placebo in women with recurrent UTIs.

A 2012 Cochrane review concluded that cranberries did not significantly reduce the occurrence of symptomatic UTI, but cranberry juice may decrease the number of symptomatic UTIs over a 12-month period in women with recurrent UTIs.

Also, because supplements are not regulated by the Food and Drug Administration (FDA), it is not known how much of the active ingredient each product contains. Therefore, many of the products may not have enough of the active ingredient to be effective in preventing bacteria from sticking to the bladder wall.

“The bottom line? Cranberry can’t hurt, and it may help,” Dr. Moore says. She says it may be worth trying if you struggle with UTIs as the risk in doing so is very low.

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How you can help prevent UTIs

Dr. Moore says she’s heard all of the myths about how to prevent or treat UTIs — drinking lots of water, urinating after sex, avoiding tight-fitting pants and staying away from hot tubs, bubble baths and tampons. None of these beliefs is supported by any scientific data, she says.

On the other hand, here are three things that Dr. Moore says women should do to help prevent UTIs:

1. Take precautions to prevent UTIs after sexual activity. “Frequency of sexual activity is strongly correlated with UTIs,” she says, and multiple partners and a history of sexually transmitted diseases put you at the greatest risk. If you’re prone to recurrent UTIs, Dr. Moore advises against using spermicides or barrier contraceptives (like a diaphragm) and will often recommend a single dose of an oral antibiotic be taken before or after sex.
2. Develop good bowel habits. Urinary tract infections are caused when bacteria from the rectum strays into the vagina, she says. That most commonly happens when you have constipation or diarrhea, so do what you can to stay regular.
3. Balance “good” bacteria with bad. For post-menopausal women with recurrent UTIs, Dr. Moore often uses a combination of topical (vaginal) estrogen and probiotics. Menopause alters vaginal pH, causing a change in bacterial colonization. Topical estrogen normalizes vaginal pH so that the vagina is hospitable to good bacteria again. The “good bacteria” or lactobacillus from taking probiotics can then colonize the vagina. “You want more healthy bacteria so less bad bacteria can adhere to the vagina,” she says. Rushing to the grocery store for yogurt isn’t enough, though. “Not all yogurt brands have probiotics in them, and you’d have to eat about seven a day to get what you need,” she says.

Even though UTIs happen frequently, you can take steps to lower your risk.

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