Probiotic pessaries and other remedies for urinary tract infections

Urinary tract infections are quite-common in women, though they can affect men too. Normally, the cause of these infections appears to be organisms (such as E. coli) making their way up the urethra (the pipe taking urine from the bladder to the outside) into the bladder where they can ‘set up camp’ on the bladder wall. Women are perhaps more prone to urinary tract infections because the urethra tends to be much shorter than in men (so more chance of the organisms making their way into the bladder before being flushed out during urination). Also, the opening of the urethra to the outside in women is quite close to the anus, a source of potential organisms however scrupulous one’s personal hygiene is. Sexual intercourse can increase the risk of infection (so-called ‘honeymoon cystitis’).

Keeping the bladder well-flushed with urine may help reduce infections for those prone to them. The idea would be to drink enough water each day to keep the urine pale yellow in colour. To combat honeymoon cystitis it is sometimes recommended that women urinate as soon as possible after sex. There is sense in this, but I don’t know how practical or comfortable for women to have sex with a full-ish bladder. To reduce the risk of contamination, wiping front to back after going to the toilet is probably a good idea.

One natural remedy that has been shown to have some value in treating cystitis is cranberry, and in practice I quite-often suggest cranberry supplementation for individuals who are prone to urinary tract infections. You can read more about cranberry and the evidence for it here, here and here. The first of these links includes some information about the sugar D-mannose which also appears to offer considerable protection from urinary tract infections.

Another approach I like to use in practice is ‘probiotic pessaries’. The idea here is to add more healthy bacteria to the vagina and surrounding area, in an effort to keep less healthy organisms at bay in this area. I was interested today to read about a recently-published study in which probiotic pessaries were used in women prone to urinary tract infections [1]. About women used 1 probiotic pessary for each of 5 days, followed by weekly pessaries for 10 weeks. The control group (also about 50 women) received ‘placebo’ pessaries in the same dosing regime.

15 per cent of the women with the active pessary had a recurrence of urinary tract infection over the course of the study compared with 27 per cent of the control group. The difference was not statistically significant, possibly due to the relatively small numbers of people used in this study.

I find a combination approach, perhaps not surprsingly, tends to work best when managing urinary tract infections in the long term. I have also found, in practice, that these approaches almost always lead to a very significant reduction in infection episodes and symptoms associated with this issue.


1. Stapleton AE, et al. Randomized, Placebo-controlled Phase 2 Trial of a Lactobacillus crispatus Probiotic Given Intravaginally for Prevention of Recurrent Urinary Tract Infection. Clinical Infectious Diseases 2011 doi: 10.1093/cid/cir183

5 Responses to Probiotic pessaries and other remedies for urinary tract infections

  1. maria xerri 22 April 2011 at 12:04 pm #


    thanks for all the amazing info god bless always.

  2. Margaret Cahill 3 May 2011 at 11:47 am #

    I have to say that the cranberry suggestion is quite old but very effective as long as you take the pure stuff, and not the ‘cranberry juice drink’ widely sold in supermarkets. I suffered really badly for a couple of years which seemed to coincide with a new relationship – and I was at the doctors every couple of months in absolute agony. After many different antibiotics, acupuncture, detox, you name it… and lots of cranberry tablets (I found those more effective than the juice) a Bowen practitioner suggested something called Serrapeptase. It was discovered that the saliva in silkworms contains an enzyme which literally eats up old inflamed tissue,which includes an awful lot of problems including UTIs. I presume the content of the tablets is a replicant rather than the actual enzymes! I started taking it last June, and I haven’t had a single occurrence of cystitis since then. I took it for 3 months and now only start again if I feel any familar aches which suggest it is starting up again. Can’t recommend it highly enough. Maybe Dr Briffa can look at this too.

  3. Kirsten 11 May 2011 at 2:44 pm #

    I’ve found that I generally feel the urge to urinate after sex, even if my bladder is pretty much empty. It makes me think that the recommendation has some biological/evolutionary support, since my body seems to naturally want to do it. Then again, I haven’t exactly polled other women about this, so maybe it’s just me. 🙂

  4. natalie 15 October 2011 at 8:50 pm #

    D-mannose really works – it has completely changed my life and I can’t recommend it highly enough. Cranberry and all the other remedies that are normally suggested made no difference at all. I wish more doctors would suggest it to people!

  5. Nadia 11 October 2012 at 2:30 pm #

    I have had UTI symptoms for over 2 months now. I tried *everything*. Uva Ursi, D-Mannose, Cranberry, nettle tea, Alka Selzer, bicarbonate of soda, lemon barley juice, lime juice, no carbs and absolutely no sweet stuff, no caffeine, no alcohol. (I can’t take antibiotics). And I *still* had “UTI” symptoms! I didn’t have abdominal pains, back aches, fevers or any other feeling of unwellness other than this infernal burning after I went to the loo and then the need to go almost straight away again! I then stumbled across a thread saying that Candida, can give the symptoms I’ve been having!!! The thread went on to advise that Acidophilus could be useful. I started taking one twice a day two days ago. The burning was gone the following morning and so far it has not come back… I could have cried with relief!!! Why do GPs not know about this??? Thank goodness I can’t take antibiotics because that would have made it so much worse! Anyway, its still early days but bearing in mind that its been two days so far going to the loo normally, this is bliss! So far so good! 🙂

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