How Can I Prevent UTI's?: A Holistic Guide for Those Aged 50 Plus

In our series focusing on holistic health and wellness for those aged over fifty, we are going to take a closer look at some common health issues that affect this age group, and how we can use the prevention over cure approach to mange them.

This article focuses on urinary problems. We delve into common symptoms to look out for, treatment options, and the best ways to manage UTI's naturally! Read on to find out more.

Recurring UTI's

As we get older, our bodies undergo hormonal changes. Following Menopause, decreased oestrogen in women leads to thinning of the uterine wall. This means that bacteria can pass more easily from the bowel through to the urethra (the tube that allows urine to leave your bladder). Whilst reduced Testosterone in men can lead to prostate problems, leading to insufficient emptying of the bladder, which allows bacteria from the bowel to build up in the urine. Both issues can result in reoccurring UTI (Urinary Tract Infections).

Whilst UTIs are not limited to the older generation they are much more common in women, especially peri and post menopausal females. Other groups commonly affected by UTI include, those with pelvic prolapse, diabetics, catheterised patients and those with epilepsy. The figures for a recurrence of a UTI of 2 within 6 months or 3 within a year of the first one, are estimated to be 25-50%.

UTI is rarer in males, however levels do increase in the 50 plus group.

Medical illustration showcasing the Male and Female excretory systems where Upper and Lower UTIs can develop. Highlights the kidneys, ureters, and bladder.

UTI Symptoms

UTI's can be divided into 2 categories, upper and lower. Lower infections target the bladder or urethra (also known as cystitis), and upper infection involves the kidneys or the tubes leading from the bladder (ureter).

Lower UTIs involve problems urinating, lower tummy pain and a mild temperature.

Upper UTIs are more serious, symptoms include feeling or being sick, a high temperature, and pain in the lower back or the sides of your abdomen. Upper UTIs can lead to severe confusion (which can often be mistaken for dementia), and ultimately kidney damage. Therefore it is important to always see a health professional should you start to experience symptoms of a UTI (upper or lower), or for severe symptoms call 111.

The UK Health Security Agency published data in 2023 that stated there had been over 800,000 hospital admissions due to UTI in the previous 5 years so severe symptoms should never be taken lightly. Your GP will usually prescribe antibiotics, even for a Lower UTI once it is confirmed via urine cultures testing.

Unfortunately, the overuse of antibiotics can cause gastrointestinal issues such as IBS (due to decreased intestinal flora), and problems such as Candida (thrush), due to decreased intimate flora. There is also the associated problems that come with antibiotic overuse to consider, namely antibiotic resistance. This leads many people, especially women who may experience regular recurrent UTIs to seek out more natural alternatives.

Top Tips For Preventing UTI

UTI's are primarily caused by bacteria entering the urinary system from the bladder. 80-90% of UTI's are caused by E-Coli (a bacteria which normally lives in your intestines).

E-coli is excreted via faeces, so it is really important is to practice good intimate hygiene, i.e. washing regularly and keeping the area dry, always wiping from front to back.

Next up, we need to stay hydrated and make sure we use the loo as often as we need to, as this helps to flush bacteria out of the urinary tract. Alcohol, caffeine and fizzy drinks can also irritate the urethra so should be avoided if possible. Urinate before and after intercourse, ensuring you fully drain your bladder. This ensures elimination of any bacteria that may have entered the urethra. Avoid anything that can irritate the urethra such as scented products as this can promote infection.

Can Oestrogen pessaries help?

A lack of Oestrogen at any age can have a direct impact upon Genitourinary health and subsequent UTI. Following menopause it is known as GSM - Genitourinary Syndrome of Menopause. This syndrome is often treated with pessaries containing the hormone Oestrogen and can help reduce dryness and itching, improve skin elasticity, lower PH levels to pre menopausal levels, and restore the vaginal microbiome (as vaginal Oestrogen increases the beneficial bacteria Lactobacillus in this area), thus reducing UTI risk.

The NHS describes the potential benefits and side effects of Vaginal Hormone Therapy (VHT), and state that it can be used safely alongside regular HRT because the Oestrogen in the pessary is low dose, plus it only crosses the blood barrier into the body in very small amounts. However, a review summary of available evidence re Vaginal Hormone Treatment for UTI benefits vs risks published by the UK Health Security Agency in 2024 states, there is currently not enough evidence to comment on the efficacy of the treatment either way at present.

So, is there an alternative?

Probiotics for Prevention of UTI in Women and Men

We would always advocate a visit to your GP or Healthcare Provider to discuss symptoms and potential treatments for UTI in the first instance.

However, there are a number of preventative measures we can utilise in the fight against UTI's. Certain strains of friendly bacteria (Pro-biotics), primarily the Lactobacilli species, have been found to be useful in the prevention and treatment of UTI's, and as a possible alternative to antibiotics in some cases (as stated earlier always consult your GP re any severe symptoms).

Lactobacillus taken orally has been highly effective in helping to colonise these good bacteria in the urinary tract, thus inhibiting E-Coli growth. For women, this colonisation can also occur within the Vaginal Microbiome. Most of the micro organisms in the vaginal area stem from the intestines (other than those related to hygiene practice), and clear links have been proven between vaginal flora and UTI.

In healthy amounts, Lactobacillus have been found to bind to the cells that line the urinary tract and prevent harmful pathogens from growing. Specifically, they are recommended for prophylaixs (i.e. to stop the UTI from developing in the first place).

It is important to note that antibiotics still remain the gold standard in treatment for prevention and treatment of UTI in all ages and genders, however, research does point towards using a multifaceted therapeutic treatment strategy of natural supplementation alongside conventional treatments options. Probiotics, D-Mannose (found in Cranberries), Sage and Vitamin C & D, among others, have all been found to be beneficial to avoid re-current UTI and Antibiotic overuse at 50 plus.

Prostate Problems causing UTI?

Another common age related condition is Benin Prostate Enlargement (BPE), it can of course effect men of any age. DHT (Dihydroteosterone) is the biggest factor in prostate enlargement. Once enlarged, the pressure on the bladder and urethra can make emptying your bladder more difficult, meaning any bacteria present doesn't get flushed out, resulting in infection (its important to note that there are other causes of UTI's in men).

Medical document highlighting prostate enlargement (Benign Prostate Hyperplasia) with a stethoscope and red pencil, indicating an important topic in men's health.

Your GP will normally carry out tests such as urine and bloods, plus may ask you to complete a short questionnaire to get more information about your symptoms. You will usually be advised to implement some lifestyle changes, such as exercising more, and reducing alcohol, caffeine, and fizzy drink intake, as this can irritate the bladder. Other treatments include medication for moderate to severe symptoms and surgery (usually as a last resort if medication hasn't helped your symptoms).

Dietary Help

Foods that contain carotenoids like Lycopene (such as tomatoes), cruciferous vegetables, such as Broccoli and Kale and Green Tea have all been found to be useful aids to support prostate health.

As well as the above there are a number of herbal supplements that are recommended to relieve the symptoms of BPE.

Rye Grass Pollen - has been used historically due to its anti inflammatory properties however newer research does not fully support these claims.

Nettle - Contains anti-inflammatory and antioxidant compounds and a 2019 review found it to be effective in reducing BPE (or BPH, Benign Prostatic Hyperplasia, which is the affect on the tissues, BPE is the resulting enlargement).

Saw Palmetto (Serenoa Repens) is a palm that grows in the Americas. It is the primary source of Beta-Sistosterol which is known to inhibit DHT activity which in turn slows prostate enlargement.

Zinc - A healthy prostate should contain high levels of Zinc. Zinc deficiency has been linked to BPE as Zinc is a DHT inhibitor. It can be found high quantities in Pumpkin Seeds. Pumpkin seeds are also rich in carotenoids and phytosterols which as previously mentioned can also support prostate health.

For this reason Pumpkin Seeds are now widely used in prostate support supplements. In combination with Saw Palmetto, the two may work synergistically to increase their anti-inflammatory effects.

Please note, both Zinc and Saw Palmetto can interact with other medications, so it is always important to check with your healthcare provider for any safety issues before you begin taking any supplements containing these.

In conclusion, preventing UTI at 50 plus involves many factors. The good news is, evidence shows that by implementing a holistic approach of small lifestyle and diet changes, plus choosing a multifaceted prevention strategy over antibiotics alone, you can help your body banish UTI's for good!

Disclaimer: This content has been produced purely for educational and informational purposes only. It is NOT intended to replace the advice, diagnosis or treatment of professional medical guidelines.

Next week, in honour of emotional wellbeing week, we will be taking a look at another common issue that affects those age 50 plus, depression and anxiety.