Probiotics for UTI Prevention: Can it Help?

Probiotics are popular dietary supplements people take to support general health, support digestion, and potentially reduce gastrointestinal problems like antibiotic-associated diarrhea. But as researchers learn more about the body's microbiome, they're discovering how much influence it has in health and disease. One of the areas of interest is the use of probiotics for urinary tract infections (UTIs). When you have recurrent urinary tract infections, you need to take antibiotics that may affect the balance of beneficial and harmful bacteria in the body, potentially contributing to your frequent UTIs.

Read on to learn about probiotics for UTI prevention and what the science says about how it may help.

What is a urinary tract infection?

UTIs are common and costly health issues caused by pathogenic bacteria that enter the urinary tract and multiply. UTIs affect people of all ages but are more common in females because they have a shorter urethra — the tube that carries urine from the bladder and out of the body — that's very close to the anus. Bacteria from the anus, usually Escherichia coli, enters the urethra and travels to the bladder, causing an infection.

Some of the symptoms you may have with a UTI include:

• Painful urination
• Frequent urination
• Cloudy or strong-smelling urine
• Pelvic pain
• Fever

Urinary tract infections don't clear up on their own and need antibiotics. When left untreated, the infection may spread to the kidneys or other parts of the body.

Many women have recurrent urinary tract infections, experiencing two or more UTIs in six months or three or more UTIs in 12 months. Frequent UTIs mean frequent use of antibiotics, which may lead to antibiotic resistance, making the infection harder to treat. Researchers are looking into how probiotic supplements may help reduce recurring infections.

Probiotics for UTI prevention: does it work?

You may automatically associate the microbiome and probiotics with gut health, but the microbiome refers to all the microorganisms that live in and on the body, including the skin and mucosal areas. The bacteria on the skin and mucous membranes contribute to the protection against infection. An imbalance in the harmful and beneficial bacteria in these areas increases the risk of infection.

Lactobacillus species are beneficial bacteria found as dominating the urogenital area (urinary and reproductive systems), including the vaginal and bladder lining. Women with an imbalance of their urogenital flora or an imbalance of Lactobacillus species are more likely to have UTIs and bacterial vaginosis — a vaginal infection caused by an imbalance of bacteria.

The connection between urogenital flora imbalance and UTIs sparked interest in the potential benefits of probiotics for restoring balance and preventing recurring infections. However, current research data fails to show any significant effects of using probiotics for UTI prevention.

Clinical research on probiotics for UTI prevention

A 2012 clinical trial published in JAMA Internal Medicine compared probiotics to antibiotics in preventing UTIs in postmenopausal women. This was a randomized, double-blind, noninferiority trial, which is a study that tests to see if a new treatment isn't worse than the existing treatment. The women in the study received 12 months of preventive antibiotic treatment with either trimethoprim-sulfamethoxazole or oral capsules containing Lactobacillus rhamnosus GR-1 and Lactobacillus reuteri RC-14. UTI recurrence in both groups was about the same, so the researchers concluded that the probiotic didn't meet the criteria for the prevention of recurrent urinary infections.

A 2024 study published in Clinical Infectious Diseases found that prophylactic supplementation with a vaginal probiotic consisting of Lactobacilli, with or without an oral probiotic consisting of lactic acid bacteria and Bifidobacteria, decreased recurrent urinary tract infections in premenopausal women with a history of frequent UTIs.

While there have been other studies with similar results, most clinical trials investigating the use of probiotics for preventing UTIs were small and highly limited, using different strains of probiotics, doses, and methods of administration. When researchers took a closer look at these studies, they found little evidence to support the statements that probiotics may prevent UTIs.

Research does seem to indicate, however, that Lactobacillus probiotics hold the most promise, with Lactobacillus crispatus CTV-05 or Lactobacillus rhamnosus GR-1 and Lactobacillus fermentum B-54 strains standing out as the best probiotics for UTIs, especially in terms of vaginal probiotics. Taking the same probiotics as an oral supplement may not work in some cases.

Should you use probiotics for UTIs?

Research suggests that probiotics can't treat or prevent UTIs. However, supplementing with a probiotic when taking an antibiotic for your UTI may reduce side effects like antibiotic-associated diarrhea and protect the gut microbiome.

Probiotics are safe and well-tolerated by most people, but they can cause side effects like diarrhea, nausea, vomiting, and constipation. People with compromised immune systems should talk to their doctor before trying a probiotic to reduce the risk of infection.

Talk to your doctor about using probiotics for UTIs before buying a supplement. They can provide guidance on the strains and doses that may provide the best results.

Alternative prevention methods for UTIs

There's no single way to fully prevent UTIs, but taking steps to improve urinary health may reduce the risk.

Drinking plenty of water and urinating when you have the urge (instead of holding it in) may help flush out harmful bacteria in the urinary system. Healthcare providers also recommend wiping from front to back to minimize the risk of transferring E. coli from the anus to the urethra.

Cranberry supplements may also lower the risk of urinary tract infections. Cranberries are a source of proanthocyanidins (PAC), a class of polyphenols that helps stop E. coli from sticking to the bladder lining. How effective cranberry supplements are at lowering the risk of an infection may depend on form and dosage.

D-mannose, a type of simple sugar, also inhibits E. coli's ability to adhere to the bladder lining. Supplementing with D-mannose may support recovery from a UTI and possibly prevent future infections. However, research is in the early stages, and more studies are needed.

Final word

If you have recurrent urinary tract infections, you may try almost anything to prevent another infection. Probiotics may not work for everyone in terms of UTIs, but they may help when you're on antibiotics for your infection by easing side effects like diarrhea.

Always consult with your doctor when considering complementary treatments to manage health concerns for individualized guidance.

Article history

Our experts strive to provide up to date information and update articles when new information becomes available

September 13, 2024

Fact checked by Sandra Vigelienė, BSc

September 13, 2024

Updated by Jill Corleone, RD

September 01, 2023

Expert reviewed by Healthnews Research Team

September 01, 2023

Written by Laura Juozaponytė