Urinary Tract Infection in Women

Urinary tract infections (UTIs) are caused by bacteria and are 10 times more common among women than men. About 30 percent of UTIs go away and do not recur. When UTIs do recur it is often because the treatments used to suppress bacteria seem to work at first but do not produce a lasting cure. UTIs can also recur when a woman is infected again by a different kind of bacterium.

Signs and Symptoms

• Pain or burning when urinating
• The need to urinate more often than usual
• A feeling of urgency when you urinate
• Blood or pus in the urine
• Cramps or pain in the lower abdomen
• Chills or fever (fever may be the only symptom in infants and children)
• Strong-smelling urine
• Pain during sexual intercourse

What Causes It?

Some risk factors include the following.

• A new sex partner or multiple partners
• More frequent or intense intercourse
• Diabetes
• Pregnancy
• Use of irritating products such as harsh skin cleansers
• Use of irritating contraceptives such as diaphragms and spermicides
• Use of birth control pills
• Heavy use of antibiotics
• A blockage in the urinary tract (benign masses or tumors)
• A history of UTIs especially if the infections were less than six months apart

What to Expect at Your Provider's Office

Your health care provider will feel your abdomen and kidneys for changes and use laboratory tests such as a urine culture to find out if you have a UTI. If the usual treatments do not work your provider will explore the possibility that you have some other condition. Other illnesses can cause symptoms that mimic a UTI such as sexually transmitted diseases.

Treatment Options

Treatment Plan

Antibiotics get rid of the bacteria that are causing your infection. They also stop the infection from reaching your kidneys. Pain relievers and alternative treatments can help relieve symptoms.

Drug Therapies

Prescription

• Antibiotics—used for 1 to 3 days or for 7 to 10 days; it is important to take all medication prescribed; various side effects
• Aminoglycoside antibiotics—by injection; for severe UTIs with infection or toxins also found in the blood; various side effects

Over the Counter

N/A

Complementary and Alternative Therapies

Nutrition

• Drink a lot of fluids such as herb teas and water. Avoid sweetened fruit juices and other sweetened drinks.
• Eliminate refined foods fruit juices caffeine alcohol and sugar.
• Cranberries and blueberries contain substances that inhibit the binding of bacteria to bladder tissue. Drinking unsweetened cranberry juice regularly seems to help lower the risk of UTIs and can help cure one if you drink it when you first feel symptoms.
• Vitamin C (1 000 mg three times per day) makes urine acidic which inhibits bacterial growth.
• Beta-carotene (25 000 to 50 000 IU per day) is necessary for immune function and mucous membrane integrity.
• Zinc (30 to 50 mg per day) supports immune function.

Herbs

Herbs may be used as dried extracts (capsules powders teas) glycerites (glycerine extracts) or tinctures (alcohol extracts). Teas should be made with 1 tsp. herb per cup of hot water. Steep covered 5 to 10 minutes for leaf or flowers and 10 to 20 minutes for roots.

Start herbal therapy at the first sign of symptoms and continue for three days after you start feeling better. Teas work best for treating UTIs because the additional fluid intake helps the "flushing action." Combine two herbs from each of the following categories and drink 4 to 6 cups per day.

• Urinary antiseptics are antimicrobial: uva ursi (Arctostaphylos uva ursi) buchu (Agathosma betulina) thyme leaf (Thymus vulgaris) pipsissewa (Chimaphila umbellata)
• Urinary astringents tone and heal the urinary tract: horsetail (Equisetum arvense) plantain (Plantago major)
• Urinary demulcents soothe the inflamed urinary tract: corn silk (Zea mays) couch grass (Agropyron repens)

Marshmallow root (Althea officinalis) is best used alone in a cold infusion. Soak 1 heaping tbsp. of marshmallow root in 1 qt. of cold water overnight. Strain and drink during the day in addition to any other urinary tea.

For advanced or recurrent infections prepare a tincture of equal parts of goldenseal (Hydrastis canadensis) and coneflower (Echinacea purpurea). Take 30 drops four to six times per day.

Homeopathy

Some of the most common remedies used for UTI are listed below. Usually the dose is 12X to 30C every one to four hours until your symptoms get better.

• Staphysagria for UTI's associated with sexual intercourse. The number one homeopathic UTI remedy.
• Apis mellifica for stinging pains that are exacerbated by warmth
• Cantharis for intolerable urging with scalding urine
• Sarsaparilla for burning after urination

Following Up

Preventive measures you can follow:

• Urinate both before and after intercourse.
• Have your health care provider recheck the fit of your diaphragm if you use one.
• Avoid sex while you are being treated for a UTI.

Special Considerations

If you are pregnant you are more at risk for developing a UTI.

Supporting Research

Avorn J Monane M Gurwitz JH Glynn RJ Choodnovskiy I Lipsitz LA. Reduction of bacteriuria and pyuria after ingestion of cranberry juice. JAMA. 1994; 271:751–754.

Berkow R ed. The Merck Manual. 16th ed. Rahway NJ: Merck and Company Inc; 1992.

Blumenthal M ed. The Complete Commission E Monographs American Botanical Council. Boston Mass: Integrative Medicine Communications; 1998:432.

Engel JD Schaeffer AJ. Evaluation of and antimicrobial therapy for recurrent urinary tract infections in women. Urol Clin N Am. 1998;25: 685–701.

Goodman-Gilman A Rall T Nies A Palmer T. The Pharmacological Basis of Therapeutics. 8th ed. New York NY: Pergamon Press; 1990.

Howell A Vorsa N Der Marderosian A Foo Lai Yeap. Inhibition of the adherence of P-fimbriated Escherichia cola to uroepithelia-cell surfaces by proanthocyanidin extracts in cranberries. N Engl J Med. 1998;339:1085–1086. Letter.

Kruzel T. The Homeopathic Emergency Guide. Berkeley Calif: North Atlantic Books; 1992:98–102.

Murray M Pizzorno J. Encyclopedia of Natural Medicine. Rocklin Calif: Prima Publishing; 1990.

Ofek I Goldhar J Zafriri D Lis H Adar R Sharon N. Anti-Escherichia coli adhesion activity of cranberry and blueberry juices. N Engl J Med. 1991;324:1599. Letter.

Schmidt DR Sobota AE. An examination of the anti-adherence activity of cranberry juice on urinary and nonurinary bacterial isolates. Microbios. 1988;55:173–181.

Schultz V Hansel R Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. New York NY: Springer; 1997.

Sobel JD. Pathogenesis of urinary tract infection: role of host defenses. Infect Dis Clin of North Am. 1997;11:531–549.

Sobota AE. Inhibition of bacterial adherence by cranberry juice: potential use for the treatment of urinary tract infections. J Urol. 1984;131:1013–1016.

Ullman D. The Consumer's Guide to Homeopathy. Tarcher/Putnam; 1996.

Werbach M Murray M. Botanical Influences on Illness: A Sourcebook of Clinical Research. Tarzania Calif: Third Line Press; 1994.

Zafriri D Ofek I Adar R Pocino M Sharon N. Inhibitory activity of cranberry juice on adherence of type 1 and type P fimbriated Escherichia coli to eucaryotic cells. Antimicrob Agents Chemother. 1989;33:92–98.

Copyright © 2000 Integrative Medicine Communications

The publisher does not accept any responsibility for the accuracy of the information or the consequences arising from the application use or misuse of any of the information contained herein including any injury and/or damage to any person or property as a matter of product liability negligence or otherwise. No warranty expressed or implied is made in regard to the contents of this material. No claims or endorsements are made for any drugs or compounds currently marketed or in investigative use. This material is not intended as a guide to self-medication. The reader is advised to discuss the information provided here with a doctor pharmacist nurse or other authorized healthcare practitioner and to check product information (including package inserts) regarding dosage precautions warnings interactions and contraindications before administering any drug herb or supplement discussed herein.