The #1 thing I wish more women knew about preventing UTIs…

[Doctor Rich watching UTI home remedy videos]:

Video 1 [woman putting lemongrass into boiling water]:

“Now you’re not supposed to do this, but this is how I do it. Now you’re also not supposed to do this — but this is how I do it. Nobody showed me this — but I’m telling you, okay? So don’t tell nobody — this is how I do it.”

Doctor Rich [laughing]:

Your c**ch will thank you?!

Video 2 [woman making a DIY-UTI treatment beverage]

“An inch of 100% lime juice or one whole lime, a whole glass of water, and a bit of sugar for flavor. After drinking this three times a day — it was gone!”

Doctor Rich:

Did she just describe homemade lemonade? Sugar, water, and lime?

Hi, my name is Doctor Rich, and I’m passionate about providing every woman with practical knowledge about the world of women’s health. Urinary tract infections (or UTIs) are a very common reason for a visit to the doctor’s office. They’re usually easily treated with an antibiotic, but some patients suffer from recurrent — and even severe — illness from urinary tract infections. Make sure to stick around to the end to find out my number one home remedy! 

Don’t have time to read this post? Watch the video here instead!

Doctor Rich:

So what is a recurrent urinary tract infection? Well, this is defined as three infections in one year or two infections in six months. Urinary tract infections are common in women of all ages. We’ll break down the risk factors in different categories: behavioral, urologic-based risk factors, and genetics.


  1. Having a new sexual partner within the last year, 
  2. Using a spermicide (with or without a diaphragm),
  3. Your mother having UTIs,
  4. Or your first UTI occurring before the age of 15 are risk factors for getting them recurrent. 

Also, cystocele (or bladder prolapse — or your bladder falling down, or a bulging sensation in the vagina) is actually a common risk factor for recurrent urinary tract infections. In fact, as a urogynecologist, I’ll often get referrals (every week!) from patients that have been hospitalized multiple times a year for years or even decades — and the patient didn’t mention that she has the bulge! The family doesn’t know, the primary care doctor doesn’t know — and it would be a relatively simple fix to correct the prolapse (or the bulge) and reduce the recurrent infections. 

Urinary retention can also cause infections. So this is the sensation that you’re not emptying your bladder. Now that may be due to a fallen bladder or bladder prolapse. It can also be due to a prior surgery where someone’s had a sling that’s too tight and you can’t empty your bladder — but these are things that commonly come up with patients who have recurrent infections. 

So why do urinary tract infections happen in the first place? Well, essentially there are normal bacteria that live in the colon (such as E. coli). There are normal bacteria that are in the vagina called lactobacillus, and there’s a normal flora for bacteria in the bladder. 

But what happens is when these get moved around and you get E. coli type bacteria into the bladder — that’s when urinary infections occur. So basically you’ve got the right bacteria in the wrong place. So the diagnosis comes from doing a urinalysis and a urine culture. Now this isn’t necessary every time you have symptoms — but it’s certainly necessary to establish the diagnosis for the two infections in six months or three in a year. Once there’s a diagnosis of recurrent infections, then we can kind of treat as needed. So additional workup — including a CT scan or cystoscopy — are reserved for refractory cases or cases where we suspect another cause (like an anatomic abnormality, or a kidney stone, or urinary retention from some type of surgery). 

How do we not get UTIs

Well, liberal use of water — two to three liters of water a day — can significantly reduce the number of recurrent infections. You can change contraception types to something that does not contain spermicide. Also, peeing after sex (or post-coital void) — urinating immediately afterwards can also reduce the risk. And as your grandmother told you: not wiping from front to back (as simple as that sounds) is a cause of more than one UTI. 

So how about medications for prevention? Well, we only want to use long-term antibiotics as a last resort because it builds up bacterial resistance — and eventually there won’t be ANY antibiotics that can treat the infection and that can lead to kidney infections, sepsis, and in rare cases can even be lethal. 

One of the simple and best preventative medications is vaginal estrogen — particularly in postmenopausal women. The cream helps to support a normal vaginal flora and normal urine flora — and prevent the ascension of bacteria from the colon into the bladder. So what other preventative medications are there? 

There are several medications in clinical human trials that have shown a reduction in the risk of recurrent urinary tract infections. 

  1. Cranberry: Whether that’s in a pill or actually just drinking it — that prevents the binding of the bacteria to the wall of the bladder or the urothelium. 
  2. Probiotics: So it’s important to maintain a normal, healthy vaginal flora with the bacteria that’s supposed to be there (lactobacillus) that prevents other bacteria from being able to exist in that area and ascend to the bladder. 
  3. Methenamine (which is NOT an antibiotic): It acidifies the urine and has general antibiotic properties — and prevents infections from taking hold in the bladder. 
  4. D-Mannose: And this is my number one recommendation. It’s similar to cranberries — it prevents the binding of the bacteria to the bladder wall and reduces the risk of infection. 

The great thing about these four treatment options is that none of them promote bacterial resistance. The problem with getting antibiotics every single time you get an infection is that the antibiotics learn — and then they become resistant to those antibiotics. 

So when is it appropriate to use antibiotics? 

Well, for patients that get recurrent infections — and they have predictable symptoms — it can be appropriate to give a prescription with multiple refills so they know that they can take the antibiotic when they need to take it. Another appropriate time is what’s called post-coital antibiotics. So this is to take an antibiotic right after sex, which is the most common time for bacteria to be able to get into the bladder and cause an infection. 

So what are the downsides of too much antibiotics? We talked about bacterial resistance, which can lead to severe infections. Also there’s direct toxicity: Some people are allergic to antibiotics and can have severe reactions. Furthermore, taking antibiotics all the time kills your normal gut flora — the good bacteria that’s supposed to be there — and as a result, you can get something called C. diff or clostridia, which is a severe diarrhea infection that in some cases can’t be improved without a fecal transplant. (And you don’t want that!)

So citric acid (whether that’s lime, lemon, or supplement) actually does reduce the risk of calcium oxalate stones (or kidney stones) — but not specifically reducing the risk of UTIs unless they’re associated with kidney stones. On the other hand, cranberry juice IS protective at preventing the risk of recurrent urinary tract infections!

There have been studies that have looked at a number of essential oils (or essential oil-derived products) like thyme, lemongrass, and tea tree oil, and the active ingredients thereof in a lab, in a dish — where they have been shown to decrease the growth of bacteria. Now, there are no studies that show that there’s ANY benefit to any of these things in human trials — so you would maybe consider that after you’ve tried all of the other treatments that we talked about today. We and your c**ch will thank you for that!

Thanks for sticking around to the end. I know that was a lot of information. Please like, share, subscribe, and tell your friends!