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Ask the Naturopathic Doctor

Menopause and UTIs

Natural Ways to Prevent and Treat UTIs

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Q: After I went through menopause, I started getting a lot of urinary tract infections (UTIs). Cranberry helps a little, but is there something more I can do?

-Roberta L., Jefferson City, MO

A: One of the characteristics of menopause is a thinning of mucous membranes due to lower levels of circulating estrogen. Mucous membranes help create a protective barrier between the outside world and our body’s inner sanctum. Thinner mucous membranes leave women more vulnerable to infections of all kinds.

Bioidentical estrogen may help strengthen mucous membranes. I prefer estriol (E3) for plumping up the vaginal and urethral mucosa. I also suggest vitamin E (400-800 IUs mixed tocopherols daily) to attenuate residual estrogen and help ease vaginal drying. You can also apply vitamin E oil directly to the vaginal area.

Simple Natural Solutions

If you have a UTI, the best way to get rid of it is to neutralize the bug that’s responsible-usually E. coli.

D-Mannose. One of the best agents for eliminating UTIs caused by E. coli is D-mannose, available at most health food stores. D-mannose prevents E. coli from binding to the bladder wall. This bug has tiny thin “fingers” that clutch and hang onto the cells of the bladder wall. D-mannose sticks to the E. coli even more tenaciously than the E. coli stick to the bladder wall, however, and the result is that E. coli/D-mannose complex gets flushed out through urination.

The recommended dose is ¼-½ tsp (depending on your weight) every 4-6 hours, stirred into a cup of water. You should feel relief within 12 hours and experience complete resolution within 48 hours. If not, see a doctor immediately because you definitely want to avoid this infection progressing into the kidneys.

Cranberry.Even though cranberry juice is often recommended to help prevent and treat UTIs, it may not be right for everyone. In fact, some women who suffer from chronic UTIs find relief by avoiding fruit altogether, because fructose can be irritating to the urinary tracts of certain people. So don’t assume that fruit juice alone can cure a bladder infection-it may actually worsen the symptoms.

Herbal Teas. Herbal teas that can help cleanse the urinary tract include dandelion leaf, bearberry (also known as uva ursi; use this herb cautiously if you have kidney problems), and goldenseal. Take 1 cup of strongly steeped tea (about 1 Tbs. herb per 1 cup near-boiling water) 2-3 times daily. If the goldenseal is in powdered form, ¼ tsp. per cup of water will suffice.

And one final note: While E. coli and poor sexual hygiene are responsible for most UTIs, there are other causes. If you suffer from recurrent bladder infections, you need to be evaluated for the presence of other bugs, for example Chlamydia trachomatis, a sexually transmitted disease that is typically symptomless in men.

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Emily A. Kane, ND, LAc, has a private practice in Juneau, Alaska, where she lives with her husband and daughter. She is the author of two books on health, including Managing Menopause Naturally. Visit her online at