Updated February 21, 2017
Urinary tract, and especially bladder infections are super common – over half of us will have at least one at some point in our lives, up to 20% of all women have some urinary discomfort or a bladder infection every year, and as many as 20% of us gals will have a recurrence 6 months after a bladder infection. That’s a lot of bladder infections!
Bladder and kidney infections are both types of urinary tract infections. This article will focus on bladder infections, because kidney infections require antibiotic treatment, whereas, common bladder infections often respond well to natural therapies.
By preventing bladder infections, you can prevent break the UTI cycle, including preventing recurrent bladder infections, as well kidney infections, which usually arise as a result of a bladder infection. By treating them naturally, you can avoid the overuse of antibiotics which can wreak havoc on your gut and microbiome, and as a result over time, especially when you have to take them regularly for recurrent bladder infections, have a bigger impact on your health
Symptoms of a Bladder Infection
The most common symptoms of a bladder infection are frequent (and sometimes terribly painful) urination, urgently needing to pee, aching, cramping, or pressure above the pubic bone (that bony ridge down low in the front of your belly), and feeling tired, unwell, or low energy (malaise). You might notice blood in your urine (or on your toilet tissue), something up to 40% of women with a bladder infection experience.
They can make you feel awful enough to have to miss work, and untreated, can progress into more serious kidney infections which can make you really sick.
In a bladder infection, symptoms usually come on pretty suddenly, and there is no fever with a bladder infection. In contrast, kidney infection symptoms generally come on gradually, and there is usually fever, chills, nausea, and low back pain. Antibiotics are important for kidney infections, but bladder infections in healthy adult women who are not pregnant can often be treated naturally.
In young, sexually active women, sudden onset of painful urination can also be due to chlamydia infection, or more rarely gonorrhea, so getting a urine culture that includes these tests is a good idea.
Vaginal yeast infections can also cause irritation of the urethra, leading to bladder-infection like symptoms, so consider this as a possible cause if you’ve been struggling with symptoms of a vaginal infection (itching, burning, thick or odorous vaginal discharge) and also consider getting a urine and vaginal culture done in this case if you’re not sure what’s going on.
Both in the prevention and treatment of UTI, the main goals are:
• support your body's natural defenses against infection
• restore microflora balance and health
• promote bladder pH that is inhospitable to harmful bacteria
• prevent bacteria from adhering to the wall of the bladder
Part 1: Preventing Bladder Infections Naturally
Before we talk about treatment, let’s talk about prevention.
Bladder infections arise from bacteria in the bladder – usually E. coli, though there are a few other bothersome varieties, too. Kidney infections generally occur when bacteria from the bladder travels up the ureters, the tubes that carry urine from the kidneys to the bladder.
Bacteria can take hold in the bladder when:
- we’ve been eating excess sugar (or drinking alcohol which is high in sugar) which dampens the immune system and also feeds unhealthy gut and vaginal flora
- when we’re under stress
- having a lot of sex (particularly with a new partner, or more than usual as on a honeymoon or vacation)
- or experience disruptions in the balance of the vaginal or gut flora for example, from taking antibiotics, diet, or other triggers.
Both the gut flora and vaginal ecology play a key role in preventing UTIs by keeping bacteria that can migrate from either place to the urethra in check. Lactobacillus species naturally present in the vagina specifically prevent E. coli from proliferating.
Some women may actually be genetically predisposed to getting more urinary infections – this may be the case if your mom had them a lot, too. But this does not make you doomed to have them; it just means you want to be extra thoughtful in preventing them.
When bladder infections keep coming back, they can either be relapsing, meaning the same one isn’t really clearing and it keeps creeping back up, or more commonly, it is a new infection each time. Either way, you want to make sure there’s nothing underlying going on like diabetes, because high blood sugar can feed bacteria and reduce your immune response, and you want to consider other conditions that can contribute to or mimic urinary tract infection including interstitial cystitis, endometriosis, and chronic vulvovaginitis.
In perimenopausal women, declining estrogen can lead to vaginal dryness that increases the risk of bladder infections. The probiotics discussed in this article can help, as can increasing good quality dietary fats (olive oil, avocado, coconut oil). In some women, specific herbs for supporting estrogen production including hops and vitex can be beneficial.
There’s a lot we can all do to reduce our risk of getting a UTI.
Follow all of these suggestions as recommended, for prevention, for 3-6 months; some women will want to remain on the probiotic and cranberry-d-mannose daily. Also, most women forget to stay hydrated, and we tend to put off peeing until the last possible minute – both of which increase our chance of getting a UTI – so listen to your body! Drink a lot of water and pee as soon as you have the urge.
General prevention suggestions
- Urinate after sex
- Stay well hydrated
- Avoid antibiotic overuse
- Wear underwear with a cotton crotch and avoid wearing thongs if you’re prone to UTI’s. (Think of them as a circus high wire for bacteria to walk across!)
- The use of oral contraceptives (OCs) doubles the risk of UTI, and the use of diaphragms and spermicides doubles the rate of UTI compared to OCs – so if you’re using these and getting UTI’s, consider another form of birth control, from the symptothermal method and condoms to an IUD.
- Menstrual pads are more likely to increase UTIs over using tampons, so consider switching if UTIs are a chronic problem for you, or change your pad more often and wear only pads made from natural cloth or organic cotton.
- Wipe from front to back after a bowel movement – a lot of women do it the other way around and this can increase UTIs.
- If you practice anal sex, avoid contact near the bladder during and after as this is a risk factor.
- Avoid bubble baths and vaginal hygiene products (i.e., douches), which increase irritation in the area and also damage the healthy vaginal flora.
Dietary Suggestions for Prevention
- Keep your gut and vaginal flora healthy with a diet low in sugar and high in fiber, especially from leafy green vegetables every day
- Eat lacto-fermented veggies at least 3 times each week
- Eating fermented dairy products three times per week (yogurt, for example) was shown in one study to dramatically reduce the likelihood of getting a UTI; if you are vegan or paleo, consider a non-dairy yogurt with live active cultures.
- For some women, avoiding or reducing bladder irritating foods including sugar, vinegar, tomatoes, citrus, black tea, coffee, and yup, sorry…chocolate, too, can help.
Nutritional and Herbal Supplements for Prevention
- Take a probiotic 1-2 capsules daily that contains Lactobacillus species, and if you have recurrent vaginal infections as well, make sure it also contains Lactobacillus reuteri and rhamnosus
- Take Cranberry-d-mannose capsules, twice daily. Cranberry can dramatically reduce the colonization and growth of bacteria in the urine, preventing UTI as well as being an important part of treatment of infection. Cranberry extract and juice can be used as well, but I find the cranberry-d-mannose form far superior for prevention.
- Vitamin C: Studies have shown vitamin C enhances the release of nitric oxide in the urine, and that this effect has antimicrobial activity against three of the most common urinary bacteria that cause UTIs. A generally recommended dose for prevention is 500 mg twice daily.
Part 2: Natural Treatment of Bladder Infections
Herbal and nutritional remedies can be excellent alternatives to antibiotics for treating bladder infections and preventing them from recurring. They can help to kill off the harmful bacteria, reduce irritation and inflammation in the urinary tract, boost immunity, and restore healthy flora in the vagina and gut.
Below is the plan I have my patients follow at the onset of bladder infection symptoms. Each part of the plan is important – so don’t skip anything unless there’s something in the plan you know you don’t tolerate.
You can expect symptoms to start to improve after 12-24 hours, though they might initially get worse over the first few hours while treatment is kicking in. Symptoms should be significantly better in 24-72 hours, with complete resolution in 5 days. Because of the high recurrence rate of UTIs, I recommend following this plan for 1 week, after which I suggest you go to the prevention plan above for another week.
This treatment is NOT intended for pregnant women; please see my book The Natural Pregnancy Book for UTI in pregnancy. The plan below is safe while breastfeeding, but if you have a UTI in the few weeks after birth, please also see your midwife or doctor for appropriate recommendations.
General and Dietary Treatment
- Cut out all sugar in your diet for 5 days
- Drink 6 to 8 – 8 oz. glasses of water each day
- Urinate at first urge – don’t hold your urine!
- Avoid sex during treatment and for a few days after
Nutritional Supplements for Treatment
- Take 4 probiotic capsules daily for 2 days, then 2 capsules daily for 5 days. The probiotic should contain Lactobacillus species, and if you have a vaginal infection as well, make sure it also contains Lactobacillus reuteri and rhamnosus
- Take 1000 mg. vitamin C every 4 hours for 2 days, then 500 mg. every 4 hours for 5 additional days
Herbal Remedies for Treatment
- Drink 8 oz. of cranberry juice every 4 hours for 3-5 days, then 16 oz/day for a week, or take Cranberry-d-mannose, 2 capsules twice daily, or if powder, 1 tsp. twice daily for 1 week, or take cranberry extract capsules 400 mg. every 2 hours for 48 hours, and then every 4 hours for 5 days
- The most effective herbal preparations for bladder infection are herbal infusions because they flush through the urinary tract. Here’s a simple and effective preparation: Mix 1/3 ounce each of uva ursi leaf, marshmallow root, and yarrow blossoms and place in a quart sized mason jar or a 4-cup French press. Steep for 1 hour then strain out the liquid or plunge the French press. Dose: 1/2 -1 cup every 4 hours, taken hot or cold. This preparation will keep refrigerated for 48 hours. You can get these herbs from Mountain Rose Herbs; I suggest ordering them overnight mail if you need them right away. Keep them on hand if you tend to get UTIs or
- If you don’t want to make this tea, you can use any of the following products instead: Cranberry Bladder Defense by Planetary Herbals, Cranberry ReLeaf by Herbs, Etc., Herb Pharm Urinary Support + Calm Waters, or Uva Ursi capsules + Marshmallow Root capsules by Nature’s Way. Take these products as directed on the package but take every 2 hours for the first 24 hours, then every 4 hours for the next 5 days.
- If you are experiencing spastic, cramping bladder pain, also take 30 drops of cramp bark tincture plus 30 drops of wild yam tincture and 5-10 drops of kava kava tincture (avoid the kava kava if you have any liver problems or are taking other medications) every 2-4 hours for the first 24 hours, and reduce to every 4-6 hours for the next 24 hours.
When to See Your Doctor and When an Antibiotic is Recommended
While natural self-care is incredibly empowering, my goal in providing this information is not to encourage you to avoid necessary antibiotics. But I do want you to have the information that can help you avoid rounds of unnecessary antibiotic treatment when a natural, effective approach is available. If you have fever, chills, and lower back pain, this is more likely to be a kidney infection, so see your doctor right away, and yes, antibiotics are appropriate. Similarly if you are pregnant and have a kidney infection antibiotics – and sometimes even hospitalization for IV antibiotic treatment — may be appropriate. If you are pregnant and have a bladder infection, unless you are working with a medical doctor or midwife truly skilled in the use of herbal and natural remedies, and sometimes even then so, a short course of antibiotics may be appropriate to avoid the risk of preterm labor or development of kidney infection, both of which can occur in pregnancy due to UTI.
For young girls (under 10 years old) with urinary tract infections, and when there is a kidney infection in any woman at any age, antibiotics are considered appropriate.
If you do require an antibiotic, take it along with a daily probiotic as discussed above to UTI treatment, and then continue the probiotic for 3 months after, along with starting the protocol above for UTI recurrence prevention.