How to Prevent UTIs

Medically reviewed on May 19, 2023 by Amy Harris, MS, RN, CNM. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.

Table of contents

• How Common Are UTIs?
• How Do You Get a UTI?
• Besides Sex, What Else Can Cause UTIs?
• UTI Risk Factors That Are the Same Regardless of Your Gender
• How to Prevent UTIs
• What If Your UTI Prevention Plan Doesn’t Work and You Think You Have a UTI?
• Address Your UTI Symptoms with Everlywell
• Related Content

Urinary tract infections, or UTIs, occur when bacteria enter the urethra and infect the urinary tract. This type of infection can affect both men and women; however, women and people assigned female at birth (AFAB) are 30 times more likely to get a UTI compared to men and people assigned male at birth (AMAB). [1]

UTIs can be uncomfortable and painful, but they are also treatable—and even preventable with the right lifestyle choices, such as consuming water regularly and avoiding possible bladder irritants. We’re exploring how to prevent a UTI, as well as common causes and symptoms.

How Common Are UTIs?

Urinary tract infections are fairly common: About 50-60% of women will have a UTI in their lifetime, compared to only 12% of men, according to the American Urological Association. [2] For both genders, the risk of a UTI increases with age, with the possibility of developing a UTI doubling in women 65 and older. [2,3]

How Do You Get a UTI?

There are several different ways people get UTIs, depending upon their gender, lifestyle, age, and other medical conditions. The most common cause of UTIs, especially for females or people assigned female at birth (AFAB) is the accidental transfer of bacteria normally living in the gut, from the anus forward to the urethra (opening to the urinary tract that leads up to the bladder where urine is stored). [4] Large numbers of bacteria normally live in the area around the vagina and rectum and also on your skin. They don’t cause any problems for you or your urinary tract until they are transferred into your urethra and up into your bladder (called cystitis) or kidneys (called pyelonephritis). There are several different ways bacteria can end up in your urethra, different based on your anatomy.

Sexual activity (especially anal intercourse), poor hygiene, or wiping from back to front instead of front to back all help give bacteria a ride up to your urethra. Women and people AFAB are more likely to develop a UTI because their urethra openings are also closer to possible contaminant sources, such as the anus and vagina, [4] compared to the opening of the urethra at the end of the penis. Female’s urinary tracts are also shorter than men’s, so bacteria have a shorter trip to the bladder or kidneys (two common sites of bacterial infections). [4] It is less common for men or those assigned male at birth (AMAB) to develop UTIs in relation to sexual activity, although males having anal sex with other males and uncircumcised males are slightly more likely to have a UTI in their lifetime. [5] That said, the symptoms associated with a UTI will vary depending on the location of the infection, such as the following:

• Urethra – Those with an infected urethra will likely experience a burning sensation when urinating, as well as unusual discharge.
• Bladder – When the bacterial infection reaches the bladder, pelvic pressure, lower belly discomfort, painful urination, and bloody urination may develop.
• Kidneys – A UTI that spreads to the kidneys can cause pain in the back or side, as well as a high fever, shaking, chills, nausea, or vomiting.

See related: Kidney Infection vs. UTI

The type of bacteria that most commonly cause a UTI are from the Enterobacteriaceae family,4 which include: [5]

• Klebsiella
• Enterobacter
• Citrobacter
• Salmonella
• Escherichia coli (E coli)
• Shigella
• Proteus
• Serratia

Some birth control methods or the type of sexual lubricant may also increase the risk of a UTI in women and people AFAB, such as: [6]

• Spermicides – Spermicides, including gels, foams, films, and suppositories, are placed in the vagina before sexual intercourse to prevent sperm from reaching an egg.6 Sometimes, they can irritate the skin inside and around the vagina, which can lead to bacterial infections that may enter the urinary tract.
• Diaphragm – A diaphragm is a small silicone cup that is also placed inside the vagina to prevent the passage of sperm. However, they may also slow urinary flow following intercourse, which can cause bacteria to increase. [1,6]
• Unlubricated condoms – Similar to spermicides, unlubricated condoms can cause skin irritation and possible bacterial infection in both men and women. [6]

Besides Sex, What Else Can Cause UTIs?

In young people, the most common cause of UTIs is sexual activity. While not technically transmitted through sex (UTIs are not considered STIs), they are definitely related. There are several other reasons why people of both genders can develop UTIs. These include: [7]

• Catheterization – sometimes during a medical procedure, when hospitalized, or in older age, people need the help of a tube (catheter) inserted through their urethra to empty the urine in their bladder. As many as 15-20% of all hospitalized patients will use a catheter during their hospital stay. [8]
Blockage of the urinary tract – most commonly caused by kidney stones, an enlarged prostate in males or those AMAB, or urinary tract problems (common in babies)
• A recent urinary tract procedure or surgery

UTI Risk Factors

Now that you know what causes UTIs, it’s time to talk about what can make it more likely that you get a UTI. Prevention is all about figuring out what you might be doing that increases your chances for getting a UTI or having frequent urinary tract infections. In order to prevent UTIs, you need to know what your UTI risk factors are. This is especially true for women, and older women, who more often experience repeated UTIs: Half of all women who have a UTI will have a recurrence within the next 6-12 months. [1] For women or people AFAB, UTI risk factors include:

• Menopause – During menopause, estrogen levels decrease, which can impact the microbiomes of both the bladder and the vagina. A shift in the makeup of the normal, healthy bacteria puts perimenopausal and postmenopausal women at risk for recurrent UTIs. [9]
• Pregnancy – Pregnancy hormones change the mix of healthy bacteria in the urinary tract, increasing your UTI risk. Also, the uterus (womb) and growing fetus sit on top of a woman’s bladder, making complete emptying of her bladder challenging. Leftover urine with bacteria in it can lead to a UTI. [1]

UTI Risk Factors for Men

Several factors, such as age make men or people AMAB more susceptible to a UTI. Enlargement of the prostate (which health care providers call benign prostatic hypertrophy or BPH for short) is extremely common - nearly every male will experience some increase in their prostate’s size after the age of 40. As the prostate enlarges, it can make complete emptying of the bladder more difficult, cause a “kink” in the urethra, and put older men at much higher risk for infections of several different organs that make up the urinary tract. Men with a UTI diagnosis may have other coexisting infections such as: [10]

• Prostatitis (infection of the prostate, a ping-pong ball-sized gland below the bladder and in front of the rectum)
• Epididymitis (infection of the epididymis, a small coiled tube below the testes)
• Orchitis (infection of the testes)
• Pyelonephritis (kidney infection)
• Cystitis (bladder infection)
• Urethritis (infection of the urethra)
• Infected urinary catheters if the person has something called an indwelling catheter

UTI Risk Factors That Are the Same Regardless of Your Gender

Men and women do have some UTI risk factors in common. These include: [4]

• Increasing age
• Having prior UTIs
• Having to get up during the night to pee
• Diabetes
• Human immunodeficiency virus (HIV) status, receiving immunosuppressive treatments for other conditions, or having a depressed immune system
• A history of prior urinary tract surgeries
• Spinal cord injuries that make it difficult to urinate
• Tumors or kidney stones that block urine flow

More generally, the way we go about our daily life and certain habits can make it easier for either gender to get UTIs. It is these behaviors which may be key when looking for UTI prevention strategies. They include: [4]

• Not drinking enough fluids, or drinking fluids that dehydrate you such as coffee or alcohol
• Holding in urine for long periods of time
• Wiping back to front, using improper hygiene, and not washing your hands after using the bathroom
• Eating and drinking foods and beverages that are bladder irritants [11]
• Wearing tight-fitting clothing
• Using spermicide, non-water-based lubricants, or unlubricated condoms
• Not washing your hands or sex toys before and after masturbation or sexual activity
• Not urinating after having sex

How to Prevent UTIs

Fortunately, there are several effective UTI prevention strategies that can help make it less likely that you will get a UTI in the first place, or that your UTI comes back to haunt you, even after you have seen a healthcare provider for treatment. Try some of these anti-UTI tips to see if you can start living a UTI-free life: [4]

• Stay hydrated – Drinking plenty of water and fluids is essential for helping to prevent UTIs. When you stay hydrated, you are flushing out bacteria and other harmful substances from your body, which can help prevent infections from developing. Aim to drink at least eight cups of water per day, and more if you are exercising or spending time in hot weather.[12]
• Reduce bladder irritants – Try to limit or avoid alcohol and caffeinated drinks, which may irritate the bladder and dehydrate you. [11] Practice good hygiene – For women and people AFAB, wipe front to back after using the toilet to keep gut bacteria away from your urethra. For both men and women, it’s critical to keep the genital area clean and dry. Douches and scented products may also disrupt the microbiome of the vagina, which can lead to a bacterial infection.4 Additionally, take showers frequently and avoid using bubble baths or scented soaps if you take baths.
• Urinate regularly and after sex – Women and people AFAB should always urinate before and after sexual activity to reduce the risk of a bacterial infection. Additionally, holding in your urine for a long period of time can allow bacteria to grow and spread within the urinary tract. It’s recommended to urinate every three to four hours. [2]
• Wear breathable clothing – Wear underwear made of breathable materials, like cotton, and avoid tight-fitting pants that can trap unwanted moisture. Also, change out of any wet clothes, such as bathing suits or workout attire, as soon as possible, since moist environments are optimal for bacterial growth.[2]
• Take probiotics – Probiotics and cranberry juice may be helpful in maintaining a healthy balance of bacteria in your body and in preventing recurrent urinary tract infections, although further research is needed to confirm this.[13,14] Probiotics can be found as supplements and in foods like kimchi, yogurt, sauerkraut, pickles, and sourdough bread.14 Cranberry extract, taken in capsule form, has been shown to reduce the risk of recurrent UTIs in women. [15]
• Avoid skin irritants – Perfumed soaps, sprays, powders, and lotions can irritate the skin around the urethra and may increase the risk of a UTI. They may also throw off the balance of genital bacteria. Instead, opt for unscented products and avoid using products that irritate the genital area. [4]
• Use water-based lubricants during sexual activity – To avoid skin irritation or rashes that make you more susceptible to a bacterial infection, use a water-based lubricant to reduce friction.

What If Your UTI Prevention Plan Doesn’t Work and You Think You Have a UTI?

If you are having symptoms of a UTI such as painful or frequent urination, or cloudy or foul-smelling pee, a healthcare provider for an official diagnosis. They will ask you to leave a urine sample that they can then test for the types of bacteria most commonly associated with UTIs. [7]

Those who have a clinical history of multiple UTIs may also undergo a cystogram, an x-ray of the urinary tract, or a cystoscopic exam, in which a tube is put into the urethra, to rule out additional medical conditions. [13]

If they do diagnose a UTI, your healthcare provider will prescribe antibiotics. How long you have to take antibiotics will depend on how sick you are. The more severe your infection (if you have a kidney infection for example), if you recently had another UTI, or if you have other medical conditions, you may be taking pills for longer, or potentially require treatment more urgently at a hospital. Common medications include: [17]

• Trimethoprim and sulfamethoxazole
• Fosfomycin
• Nitrofurantoin
• Cephalexin
• Ceftriaxone

That said, the most severe UTIs may require the intervention of IV antibiotics.

By taking proactive steps to maintain good health and hygiene, you can reduce your risk of developing UTIs and enjoy better overall well-being.

Will a UTI Go Away On Its Own?

Can a UTI go away on its own? Yes, in some cases, your UTI symptoms will go away without you having to take antibiotics. However, that’s not always the case, and waiting for a UTI to go away on its own is not recommended. If left untreated, a UTI can spread to the kidneys, leading to potentially permanent kidney damage or life-threatening sepsis. [4] Some of the warning signs that your UTI may have worsened and you might have a kidney infection are:

• Fever and/or chills
• Burning sensation when urinating
• Frequent urination or a frequent urge to urinate
• Pain in the back, belly, side, or groin
• Nausea and/or vomiting
• Blood and/or pus in the urine
• Foul-smelling urine

Address Your UTI Symptoms with Everlywell

UTIs are often uncomfortable and, if left untreated, may lead to more serious complications, such as a kidney infection.

While there are certain strategies you can use to potentially prevent a UTI, such as staying hydrated and practicing good hygiene, chances are that most of us will have at least one UTI in our lifetime.

If you are experiencing UTI symptoms, Everlywell provides telehealth visits to help you make sense of your symptoms and potentially receive online UTI treatment.

Book your appointment today.

Related Content

Why Do I Keep Getting UTIs?

Can a UTI Be Transmitted Through Sex?

Can Men Get a UTI?

References

1. Urinary tract infections. Office of Women’s Health. URL. Published February 22, 2021. Accessed May 10, 2023.
2. What is a urinary tract infection in adults? Urology Care Foundation. URL. Published. Accessed May 26, 2023.
3. Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Ther Adv Urol. 2019;11:1756287219832172. URL. Published May 2, 2019.
4. Urinary tract infection (UTI). Mayo Clinic. URL. Published September 14, 2022. Accessed May 10, 2023.
5. Shmerling R. Urinary tract infection in men. Harvard Health Publishing. URL. Published December 5, 2022. Accessed May 10, 2023.
6. Spermicide & contraceptive gel. Planned Parenthood. URL. Accessed May 10, 2023.
7. Urinary tract infection (UTI). Cleveland Clinic. URL. Published April 6, 2023. Accessed May 11, 2023.
8. Catheter-Associated Urinary Tract Infections (CAUTI). CDC. URL. Published October 15, 2015. Accessed May 24, 2023.
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10. Brusch J. Urinary tract infection (UTI) in males. Medscape. URL. Published March 27, 2023. Accessed May 10, 2023.
11. Bladder irritating foods. Cleveland Clinic. URL. Published October 30, 2020. Accessed May 24, 2023.
12. McCollum B, Garigan T, Earwood J. PURLs: Can drinking more water prevent urinary tract infections? Journal of Family Practice. URL. Published April 2020. Accessed May 10, 2023.
13. Williams G, Hahn D, Stephens JH, Craig JC, Hodson EM. Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews 2023, Issue 4. Art. No.: CD001321. DOI: 10.1002/14651858.CD001321.pub6. URL.
14. How to get more probiotics. Harvard Health Publishing. URL. Published August 24, 2020. Accessed May 10, 2023.
15. Liska D. Urinary tract infection should cranberry and probiotics be considered? Nutrition Today. URL. Accessed May 10, 2023.
16. Kidney infection. Mayo Clinic. URL. Accessed May 10, 2023.
17. Habak P, Griggs R. Urinary tract infection in pregnancy. StatPearls. URL. Published July 5, 2022. Accessed May 10, 2023.