UTI Treatment Without Antibiotics
Roughly 50-60% of all women will experience a urinary tract infection (UTI) at some point in their lifetime (1). Not only are UTIs one of the most common types of bacterial infections, they’re also responsible for billions of dollars in health care costs each year (2). Antibiotics are commonly prescribed for UTIs, but antibiotics have tons of downfalls. As a health professional and as someone who’s had to deal with her fair share of UTIs over the years, I’m going to share with you my pearls of wisdom and go into the nitty gritty details of how I get rid of UTIs without the use of antibiotics.
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What are UTIs?
Urinary tract infections are caused by an overgrowth of “bad” bacteria in the urinary tract. The urinary tract used to be thought of as a sterile environment, but recent investigations show that the urinary tract, like the digestive tract and other parts of your body, has its own bacteria-filled microbiome that plays a protective role in urinary health (3). Generally speaking, when the “bad” bacteria outnumber the “good” bacteria, bad stuff happens.
The most common culprit is Escherichia coli (E. coli), which is responsible for roughly 80-90% of non-hospital-acquired UTIs (4). When your body’s natural defenses fail you, E. coli is able to multiply like crazy and stick to the walls of your urinary tract. The stickiness of E. coli is what can really make UTIs tricky to deal with.
UTIs can affect any part of the urinary tract: the urethra, bladder, ureter, and, in severe cases, even the kidneys, though bladder infections are the most common types of UTIs (5).
How to tell if you have a UTI
UTIs are diagnosed by a urine test – this can be done at a doctor’s office. There are also over-the-counter tests that you can do at home. AZO test strips are a popular at-home UTI test that I have personally used (you’ll want to test your urine first thing in the morning and read the results at the correct times). Make sure you get tested at the first sign of symptoms. (I also like to re-test after I treat the UTI to make sure the infection is actually gone.)
Common symptoms of a bladder infection include:
- Burning/pain while peeing
- Cloudy urine
- Weird smelling urine
- Stronger and more frequent urge to pee
- Feeling like you need to pee, but not much comes out
If a bladder infection goes untreated (or if treatment doesn’t work), the infection can spread to the kidneys.
Common symptoms of a kidney infection include:
- Pain where your kidneys are located (they’re located on your back, below your ribs, and on either side of your spine)
Kidney infections can be very serious and require an immediate visit to a doctor for treatment. If a kidney infection isn’t treated, irreversible kidney damage can occur (5).
What causes UTIs?
Women are more prone than men to get UTIs – this is mainly due to the urethra.
The urethra is a tiny tube that is located near the vagina (on the front wall, below the clitoris, but just above the vaginal opening). The urethra is the tube that carries urine from the bladder to the outside of the body. The length of the urethra in women is much shorter than it is in men, so “bad” bacteria (such as E. coli) don’t have to travel as far to reach the bladder and cause infections.
Common causes of UTIs:
Wiping the wrong way
Women have the misfortune of having the urethra located just around the corner from the anus, so it’s easy for bacteria from the colon to make their way over to the urethra and cause infection. This is why it’s so important to always wipe front-to-back.
Insufficient lubrication during vaginal sex can cause too much friction/irritation to the urethra, increasing your chances of infection (so make sure you partake in some foreplay to help rev up your engine before any penetration takes place; you can also use a non-irritating lubricant, if needed).
“Bad” bacteria can also be introduced by your partner or a sex toy. Bacteria that’s in/near your vaginal opening that is “shoved” into the area near the urethra during sex can lead to infection as well.
UTIs that are related to sex can be avoided when both parties practice proper hygiene and toys are properly cleaned. It can also help to pee before and after sex to flush out unfriendly organisms around the urethra before they have a chance to wreak havoc.
Too warm and moist
Having an excessively warm and moist environment in the crotch can create an environment that unfriendly organisms love. This can be caused by: wearing tight-fitting pants, wearing non-breathable underwear made from synthetic fabric (opt for cotton underwear or other natural fabrics), wearing panty liners or pads all the time, and so on. Sitting around in a wet bathing suit or wet clothes (including post-workout sweaty undies… eww) is also a recipe for disaster.
Thongs may be able to help you get rid of visible panty lines, but they can come at a cost. Since the back part of a thong is very likely to come into contact with E. coli from your colon/anus, it can easily transfer E. coli to the urethra if the thong placement shifts during the day (this is even more problematic if you wear a thong during workouts).
Not peeing often
Holding it for long periods of time instead of excusing yourself to pee when you first feel the urge can increase your chances of UTIs. So can dehydration. The reason? Infrequent urination can give any “bad” bacteria that are already present in your urinary tract more time to multiply and cause infection (1).
Messing with Mother Nature
Douches, sprays, perfumes, harsh soaps, feminine deodorants and other products that are aimed at covering up the natural scent of your vagina are not really doing you any favors. Not only are these products generally irritating to a very sensitive part of your body, but they often upset the natural balance of bacteria in that region (increasing your chances of “bad” bacteria taking over and causing infection).
Pads and tampons?
It’s been my personal experience that pads and tampons can lead to UTIs. This may be a result of the material that these products are made from or the environment that’s created when these products are used (going back to the point about excessive warmth and moistness). I’ve personally found that my recurrent UTIs finally stopped after I switched to using a menstrual cup in 2015.
UTI treatment options
Antibiotics for UTIs
Most conventional doctors will prescribe antibiotics to treat UTIs. Antibiotics definitely have their drawbacks:
- Antibiotics disrupt the balance of bacteria throughout your body (2, 6) – the “good” bacteria get wiped out along with the “bad” bacteria, allowing room for other pathogens, such as candida albicans, to take over (this is why it’s not uncommon for women to get vaginal yeast infections after taking antibiotics)
- Antibiotics can lead to antibiotic-resistant bacteria (which are much harder to get rid of) (2, 6)
- Antibiotics can cause adverse health effects, such as nerve damage, joint pain, tendonitis, dizziness, light sensitivity, gastrointestinal distress, chest pain, seizures, liver disease/failure, impaired kidney function, and others (7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18)
I, personally, prefer to avoid antibiotics unless they’re absolutely necessary. Because of this, I’ve found other ways that I can nip a UTI in the bud without having to rely on antibiotics, as long as I tackle it early. The methods that I use don’t work for everybody and there are cases where antibiotics are truly needed (such as when the infection spreads to the kidneys).
D-mannose for UTIs
One of the most effective products that I’ve found to stop a UTI in its tracks is D-mannose powder. D-mannose is a type of sugar (related to glucose) and only small amounts of D-mannose can actually be used by the body – the rest gets expelled through urine. Studies suggest that D-mannose works by sticking to E. coli, which prevents the E. coli from sticking to you… so when you pee, the bacteria are more easily flushed away (19, 20).
Is D-mannose effective for UTIs?
Studies have looked at the effectiveness of using D-mannose prophylactically in order to prevent the recurrence of UTIs. In one particular study, 308 women were initially given a course of antibiotics (Cipro) for 1 week, then they were divided into 3 equal groups. The first group received 2g of D-mannose powder daily, the second group received 50mg of nitrofurantoin (antibiotic) daily, and the third group received nothing. After 6 months, 98 of the 308 women experienced a recurrent UTI, with 60% of these women coming from the third group that received no prophylactic treatments. 20% of the women in the antibiotic group experienced a recurrent UTI and only 15% of women in the D-mannose group experienced a recurrent UTI. (19) Other studies that have tested the effectiveness of D-mannose for UTIs have seen similar results (21, 22).
Though I don’t recommend using treatments prophylactically across the board in order to prevent recurrent UTIs, this info may be useful for those with more stubborn cases. In my professional opinion, you’re generally much better off figuring out what’s contributing to your UTIs and making changes as needed in order to prevent UTIs from recurring.
Is D-mannose safe?
When D-mannose is used appropriately, it’s relatively safe for those who are already in good health. The most common side effects of D-mannose are diarrhea and bloating, though some resources warn that it could harm the kidneys if taken in large doses (D-mannose may not be appropriate for those who already have kidney issues). D-mannose is generally not recommended for those with diabetes or for women who are pregnant or breastfeeding (mainly because D-mannose hasn’t been studied yet for pregnant/breastfeeding women, so it’s best to err on the side of caution) – definitely check with your doctor if you fall into one of those categories. (23)
Should I take D-mannose powder or D-mannose capsules?
Whether you decide on D-mannose powder or capsules is a personal choice. I personally prefer the powder form of D-mannose. With powder, it’s easier to customize the dose to your specific needs and if you don’t like swallowing pills, powder is definitely the way to go. Going with powder also allows you to avoid the extra ingredients/fillers from the capsules themselves. As far as taste, I would describe D-mannose as having a mild, sweet taste – it’s not unpleasant (in my opinion), but it can take some time for some folks to get used to the flavor.
D-mannose dosing and frequency
There currently aren’t any clear guidelines for appropriate dosing of D-mannose for UTIs. That said, the following is the regimen that I’ve personally used. This is not intended to act as medical advice; this is simply to provide an insight into what I personally do when I have a UTI.
I’ve found that it takes several doses of D-mannose to be effective against UTIs. At the first sign of UTI symptoms, I dissolve 1 teaspoon of the D-mannose powder in some water and drink it up; I repeat this every 2 to 3 hours.
When I do this, I’ve noticed that symptoms start to improve after a couple hours or so, and my symptoms are totally gone within 1-2 days. After symptoms are gone, I then gradually reduce the frequency that I take the D-mannose powder (I usually cut it down to 4-5 times per day, then 3-4 times per day, and so on). I generally end up taking the D-mannose powder for a total of 5 to 7 days.
During the time that I’m taking D-mannose, I also make sure I hydrate like crazy. I aim to drink at least 8 ounces of water every hour while I’m awake. The more you pee, the less chances the bacteria have to attach to the walls of your urinary tract, and the quicker you can flush them out.
[Note: it’s not good to have too much water in a very short time-frame – this can cause water toxicity, which can be deadly. It’s usually best to spread out your water evenly throughout the day instead of drinking a bunch all at once.]
Probiotics for UTIs
In addition to taking D-mannose, I also take a probiotic supplement that is aimed at supporting urinary tract health. The “good” bacteria in the probiotics can help keep the “bad” bacteria under control. Renew Life Ultimate Flora Vaginal Formula is one probiotic that I like for urinary/vaginal support.
One of the reasons why UTIs are so likely to reoccur after taking antibiotics is probably because of the damage that antibiotics inflict on the microbiome. As already stated, antibiotics wipe out “good” bacteria along with the “bad” bacteria. Since “good” bacteria play a role in the strength of your immune system (among other things), you’re making yourself more vulnerable to future infections by taking antibiotics.
Should I take pain relievers for UTIs?
UTIs are painful and it’s super tempting to reach for pain relievers at the first sign of infection – I get it. That said, I personally don’t like to use pain relieving products when I have a UTI.
It’s easy to under-treat the infection when you don’t feel symptoms. It’s also easy to fail to seek other treatment quickly if the method you selected isn’t working. Either of these scenarios can lead to developing a kidney infection, which is much more serious and requires an immediate trip to the doctor.
I would much rather deal with the irritation of the UTI (which usually only lasts for a couple of hours, as long as I use D-mannose right away) than to have a false sense of security about the status of the infection.
On a personal note: I’ve had UTIs spread to my kidneys twice (not a good time, I assure you – a lot of nausea and projectile vomiting was involved). My kidney infections required serious courses of antibiotics to treat. In BOTH CASES, I had finished my course of antibiotics for the bladder infection, yet the infection still managed to spread to my kidneys. This just goes to show you that you can’t assume that antibiotics will always treat a UTI.
To recap the steps to treat UTIs…
- It’s better to prevent UTIs instead of having to continuously treat UTIs. Look at your lifestyle and see if there’s anything that you’re doing (or wearing) that could be contributing to UTIs. This may require some detective work (for me, trading in the pads/tampons for a menstrual cup put an end to my recurring UTIs). When in doubt, work on strengthening your immune system and overall health – you can do this by eating whole foods (avoiding heavily processed foods), taking probiotics, drinking plenty of water, correcting any nutrient deficiencies (vitamin D is a big one for immune system health), limiting exposure to environmental toxins, getting sufficient sleep, lowering stress, being active, reducing food-induced inflammation… among other things.
- If you have symptoms of a UTI, go to your doctor or take an at-home UTI test, then treat the UTI ASAP – the earlier you treat it, the better. If you can, take another UTI test after treatment to help ensure that the infection is actually gone.
- If you want to treat your UTI without antibiotics, D-mannose shows a lot of promise for UTIs in the few studies that have been conducted so far (I’ve also personally experienced UTI relief from using D-mannose).
This article was originally published on November 17, 2014, but was updated and re-published on March 10, 2019.
Amanda Austin is a Registered Dietitian Nutritionist and Certified LEAP Therapist who approaches health and wellness from an integrative and functional perspective. She loves a good DIY, making a mess in the kitchen, and working up a sweat. She’s also obsessed with her incredibly spoiled fur-babies, which includes a rambunctious Boston Terrier, 2 cranky house cats, and 3 boisterous chickens.
I have had a confirmed UTI for the past 5 days. I have had 4 doses of Bactrim with not much relief at all. Come to find out today that the bacteria is resistant to this med. I was just prescribed Macrodantin. I would like to know the difference between the AZO cranberry tabs vs. D-mannose. I just purchased both but want to take whichever works best. Why do you prefer D-mannose? Thanks so much for taking the time to read.
Amanda Austin, RDN, CLT
I don’t personally have any experience with the AZO cranberry tabs, but I chose to use d-mannose for my own UTIs because there are studies confirming its effectiveness. I’ve personally found d-mannose, probiotics, and plenty of water to be all that I needed to eliminate my own UTIs (though, thankfully, I haven’t experienced a UTI since I wrote this article in 2014). Hope it works as well for you as it did for me! 🙂
What happens if you have sex while having a uti?
Amanda Austin, RDN, CLT
The UTI will likely not make sex very pleasant (assuming you’re still having UTI symptoms), but sex also carries the potential of introducing more bacteria to the urinary tract, which could make the UTI worse. It’s best to hold off on sex until you know for sure that the UTI is gone.
I have been struggling with UTIs since I was 18 years old and the Lady Soma Cranberry Pills work faster than other products to relieve the pain with my UTIs. I use this while I am waiting to get in to see the doctor to relieve my pain and/or while I am waiting the the antibiotics to start working which usually takes anywhere from 12-24 hours.
This stuff helps to alleviate the pain (burning, urgency, etc) associated with UTIs within 20-40 minutes of taking the pills.
I had surgery a little over a week ago and was catheterized. Today I noticed my urine has a horrible smell. I called my surgeon who told me he’s not a fan of antibiotics and to just hydrate myself and drink cranberry, (which has never helped me before)… I reported the nausea to his office last week but had no outward signs of infection at the incisions so they told me to just keep an eye on them for infection and keep my upcoming appointment. I honestly think I need antibiotics at this stage and that the cath introduced nasty bacteria into my bladder. He said the catheter was only in me for 30 minutes. Um, would the time even matter? The pressure and urgency have begun as well. I keep reading nausea is a symptom of kidney infection… could I home treat at this stage, with this scenario??
Amanda Austin, RDN, CLT
If you’re experiencing signs of kidney infection, that’s definitely not something to take lightly. If it were *me* and it was the very beginning stages, I would try the d-mannose ASAP and, if not noticing improvements in a couple hours or so, I wouldn’t hesitate to take antibiotics. There’s nothing wrong with taking antibiotics if they’re truly needed, just make sure you take extra good care of your microbiota. Generally, S. boulardii is good to take while on antibiotics… I’d take that as well as probiotics geared towards urinary tract health (such as this one by Renew Life) – take probiotics a few hours away from your dose of antibiotics. Sorry this happened to you! It’s bad enough having to endure a surgery without the bonus of an infection. 🙁
I’ve had a UTI for 4 days now. I’ve been drinking about 80 oz of water a day since it started (now I know what a fish feels like…lol). I’ve found a lot of relief from the burning (except when I first wake up in the morning…if I sleep) and the urges to go have decreased a bit today. Do you think that means the infection may be leaving my bladder due to all the water? I really can’t afford a Dr. visit as I have no insurance right now. I can’t even afford the pills you suggested. Basically, I’m on SSDI and live at poverty level…although the state won’t help with my medical because it says I’m just above their idea of poverty level…go figure. Anyways, for that reason, I’m trying to rid my UTI on my own. So I just wanted your opinion on whether or not you think my UTI is clearing up. Thank you! And thank you for your wonderful article too! 🙂
Amanda Austin, RDN, CLT
Oh no! So sorry to hear that! It’s certainly possible that the water has been helping with the infection, but I can’t say for sure. Definitely monitor your symptoms and be particularly watchful of any signs of kidney infection (since that’s much more serious).