By the age of 24, nearly a third of women will have had a urinary tract infection (UTI) at least once and 50% of women will experience at least one in their lifetime. For pre and post menopausal women occurrence and recurrence is even higher.
Much like the gut microbiome, the vagina is a complex ecosystem of bacteria, and fungi. When in an optimal state, it is populated by different strains of lactobacilli with Lactobacillus crispatus often considered the dominant bacterial resident. Other healthy bacteria present could include L. iners, L. jensenii and L. gasseri. These bacteria maintain a healthy level of acidity which stops pathogens from taking a hold. When disrupted, pathogenic bacteria get a hold and can translocate to the urethra causing recurrent UTIs.
Some reasons for recurrent UTIs
Menopause
As oestrogen levels drop there is less glycogen available in to feed lactobacilli which maintain the right level of acidity in the vagina. Pathogenic bacteria like e- coli can then take a hold and although asymptomatic in the vagina can cause problems in the urethra.
Anything which disrupts the natural pH (acidity) of the vagina…
can lead to pathogenic bacteria getting a hold and subsequent translocation to the urethra. Contraceptive spermicides and vaginal douching are all pH disrupting.
A history of UTIs
A History of UTIs can increase the risk of having another one. After an infection small clusters of E. coli can remain within the urethra, vagina and gut and create a protective shell around themselves (biofilm). Biofilms enable bacteria to survive in less than perfect conditions and make it easier to cause reinfection.
Nuture the vaginal microbiota to help reduce the occurrence and re-occurance of UTIs:
Something as simple as not over washing can help to promote a healthier vaginal community as well as avoiding contraceptive spermicides, where possible. Wear bamboo or organic cotton breathable underwear to allow the natural bacterial community to thrive, and If you experience vaginal dryness then use a good quality water based lubricant rather than an oil based lubricant which will disrupt the pH.
Balancing the vaginal microbiome
- Lactulose (prebiotic) – sold commercially to improve bowel movements, is a wonderful source of food for lactobacilli which then produce lactic acid. Lactic acid maintains the correct pH of the vagina.
- Lactulose comes in liquid form and is really simple to use. 2ml of lactulose syrup mixed in 8ml of warm water can be applied via syringe or spray before bed. Use nightly for one week, then two or three times weekly for another three weeks.
- Green tea is another vaginal prebiotic which has been shown to increase the growth of lactobacilli while at the same time inhibiting pathogenic bacteria. It naturally decreases the pH in the vagina and inhibits the growth of biofilms which protect against pathogenic bacteria. To use brew a strong pot of tea using loose leaf green tea and allow to steep until cool. This can be used either on its own in a spray or Sitz bath or as the 8ml of warm water with the lactulose syrup.
Dealing with a mild UTI once in place:
- Uva Ursi (bearberry) – Traditionally used for its diuretic properties and to treat UTIs, the herb is now approved and recognised in Germany as a treatment for bladder infections. The leaves of the plant contain strong anti microbial properties and are responsible for the therapeutic action.
- Cranberry – Has anti-adhesion properties which can be used as a prophylatic and during infection to prevent pathogenic bacteria from adhering to the cell wall. It is also an antimicrobial in its own right. However cranberry on its own is unlikely to shift an infection once in place.
- Goldenseal – Berberine, the active constituent in Goldenseal, exerts its antimicrobial properties by preventing e.coli from adhering to the bladder wall.
- Horsetail – One of the oldest and most well known herbal remedies has been shown to have antimicrobial properties against a range of pathogens found in the urinary tract including: E.coli, K pneumonia, P mirabilis, S aureus and E. faecalis.
- Nettle – Has traditionally been used as a treatment for arthritis, rheumatism, UTIs, kidney stones and gingivitis. It has been shown to exhibit antimicrobial properties against a range of gram negative and gram positive bacteria implicated in UTIs.
- Vitamin C – Vitamin C is an effective antimicrobial and can be used as a supplement to support antibiotic therapy for UTIs. It is also helps to strengthen the immune system. It has also been shown to work well in combination with cranberry, and the probiotic Lactobacillus Rhamnosus GG.
- Vitamin A – Has been shown to be effective at reducing renal scarring in acute episodes of UTI
- Vitamin D – Studies have shown that vitamin D can help to strengthen the bladder lining. It also supports the immune system.
- Zinc – can help to support our immune system. It is also essential for the activation of vitamin A and can help to strengthen the lining of the bladder.
- D Mannose – Is a simple sugar which has been shown to reduce the level of pathogenic bacteria adhering to the cell wall in the urinary tract and also makes those pathogens more vulnerable.
- Probiotics – can help to maintain a healthy vaginal pH.encouraging the growth of Lactobacilli which will discourage the production of pathogenic bacteria. Probiotics are also known for their ability to regulate the immune system
Remember – Treating a urinary tract infection (UTI) early using natural approaches can help to reduce reliance on antibiotics. However if a UTI travels to the kidneys, antibiotics should be used to limit any further damage.
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