If you’ve ever had a urinary tract infection, you’ll know how miserable they can be. The burning sensation, the constant urge to urinate, the disruption to your daily life—it’s not something anyone wants to repeat. The good news is that while not every infection can be prevented, there are practical steps you can take to reduce your risk significantly.

This guide covers the evidence-based strategies for preventing bacterial cystitis and UTIs, from simple hydration habits to when it’s worth talking to your GP about preventative antibiotics.

Hydration: The Foundation of Prevention

Water is your bladder’s best friend. Staying well-hydrated helps flush bacteria out of the urinary tract before they can multiply and cause infection. But how much is enough?

The often-quoted “eight glasses a day” is a reasonable starting point, though individual needs vary based on climate, activity level, and body size. A more reliable indicator is the colour of your urine—pale straw colour suggests good hydration, while dark yellow indicates you need more fluids.

What counts as good fluid intake:

Plain water (the gold standard)
Diluted squash
Herbal teas
Foods with high water content (cucumber, watermelon, soups)

What to limit or avoid:

Alcohol irritates the bladder lining and causes dehydration
Pure fruit juices can be acidic and irritating
Strong tea and coffee act as diuretics and can irritate the bladder
Fizzy drinks, particularly those with artificial sweeteners

A 2018 randomised controlled trial published in JAMA Internal Medicine found that women with recurrent UTIs who increased their water intake by 1.5 litres per day had 48% fewer infections over 12 months compared to those who didn’t change their habits 1. That’s a substantial reduction from something as simple as drinking more water.

Toilet Habits That Matter

Some advice around toilet habits has been passed down for generations, and much of it holds up to scrutiny.

Urinate When You Need To

Holding on when you need to urinate allows bacteria more time to multiply in the bladder. While occasionally holding on for a short period is unlikely to cause problems, making a habit of it increases infection risk. If you’re prone to UTIs, don’t ignore the urge.

Wipe Front to Back

This advice applies primarily to women due to the anatomical proximity of the urethra to the anus. Wiping from front to back after using the toilet helps prevent bacteria from the bowel being transferred to the urethra. It sounds basic, but it’s one of the most effective preventative measures.

Wash the Anal Area After Bowel Movements

Good hygiene after bowel movements reduces the bacterial load in the perineal area. Some people find that using a bidet or wet wipes (the flushable kind, though even those are questionable for plumbing) helps them feel cleaner.

Empty Your Bladder Completely

Try not to rush when urinating. Incomplete emptying leaves residual urine where bacteria can grow. If you have difficulty emptying your bladder fully, this is worth mentioning to your doctor, as conditions like detrusor underactivity or bladder outlet obstruction might be contributing.

Sexual Activity and UTI Prevention

There’s a reason UTIs are sometimes called “honeymoon cystitis”—sexual intercourse can introduce bacteria into the urethra. This doesn’t mean you need to avoid intimacy, but a few precautions can help.

Before and After Sex

Wash the genital area before sex. More importantly, urinate within 15 to 30 minutes afterwards. This helps flush out any bacteria that may have been pushed towards the bladder during intercourse. Some studies suggest this simple habit can reduce UTI incidence by up to 50% in susceptible individuals.

Contraception Choices

Spermicidal products can be problematic for some women. Spermicides alter the vaginal pH and destroy lactobacilli—the “good bacteria” that help maintain a healthy vaginal environment and provide a natural defence against harmful bacteria. If you’re using spermicides (whether in condoms, foam, or a diaphragm) and experiencing recurrent UTIs, it may be worth discussing alternative contraception with your GP or sexual health clinic.

Diaphragms can also increase UTI risk by putting pressure on the urethra and potentially interfering with complete bladder emptying.

Clothing and Personal Care

What you wear and how you care for your genital area can influence your infection risk.

Natural Fibres and Loose Fits

Cotton underwear allows better air circulation than synthetic materials, helping keep the genital area dry. Bacteria thrive in warm, moist environments, so anything that promotes dryness can help. Avoid thongs, which can facilitate the transfer of bacteria from the anus to the vagina and urethra.

Tight-fitting trousers and leggings can create a similar warm, moist environment. While you don’t need to overhaul your wardrobe, being aware of this and opting for looser fits when possible—particularly during hot weather or exercise—is sensible.

Avoid Irritating Products

The genital area doesn’t need special soaps, douches, or deodorant products. In fact, these can disrupt the natural balance of bacteria and actually increase infection risk. Plain water or a mild, unperfumed soap is sufficient for external cleaning. Never douche—there’s no medical benefit, and it’s associated with increased risk of infections and other complications.

Similarly, avoid using perfumed products like bubble baths, bath salts, or scented toilet paper in the genital area.

Diet and Nutrition

Your diet affects more than your waistline—it can influence your urinary tract health too.

Cranberries: The Evidence

Cranberries have been recommended for UTI prevention for decades, and there’s reasonable scientific support for this. Cranberries contain compounds called proanthocyanidins (PACs) that can prevent certain bacteria, particularly E. coli, from adhering to the bladder wall.

A 2023 Cochrane review (an updated analysis of multiple trials) found that cranberry products reduced the risk of recurrent UTIs in women by about 26% 2. The effect was modest but real. Cranberry juice, tablets, and capsules all showed benefit, though you’d need quite a lot of juice to get an effective dose—and the sugar content of commercial cranberry juice drinks is a consideration.

If you want to try cranberries, look for products standardised to contain a specific amount of PACs, typically 36mg per day. Be aware that cranberry supplements can interact with blood thinners like warfarin.

For more detailed information, see our article on cranberry benefits and side effects.

D-Mannose

D-mannose is a sugar related to glucose that has shown promise for UTI prevention. It works similarly to cranberry PACs by preventing E. coli from binding to the urinary tract lining. Some small studies suggest it may be as effective as low-dose antibiotics for preventing recurrent infections, though larger trials are needed.

You can read more about D-mannose benefits and side effects.

Probiotics

There’s growing interest in whether probiotics can help prevent UTIs, particularly strains of Lactobacillus. The theory is that maintaining healthy vaginal flora helps prevent harmful bacteria from colonising the area and subsequently causing UTIs.

The evidence is mixed—some studies show benefit, others don’t. If you want to try probiotics, look for products containing Lactobacillus rhamnosus and Lactobacillus reuteri, which have the most research support for urogenital health.

General Dietary Advice

Reduce junk food and increase vegetable intake to support overall immune function
Some people find that certain foods irritate their bladder—common culprits include citrus fruits, tomatoes, spicy foods, and artificial sweeteners
If you notice patterns between what you eat and your symptoms, keeping a food diary can help identify triggers

Special Considerations for Postmenopausal Women

After menopause, falling oestrogen levels cause changes to the vaginal and urethral tissues. The vaginal lining becomes thinner and drier, and the population of protective lactobacilli decreases. These changes make UTIs more common in postmenopausal women.

Topical oestrogen therapy—applied as a cream, pessary, or vaginal ring—can help restore the vaginal tissues and reduce UTI risk. A meta-analysis found that vaginal oestrogen reduced recurrent UTIs by about 50% 3. This treatment is available on prescription and is worth discussing with your GP if you’re postmenopausal and experiencing frequent infections.

The oestrogen doses used vaginally are much lower than those in systemic hormone replacement therapy (HRT), and the hormone acts locally with minimal absorption into the bloodstream. This means vaginal oestrogen is considered safe for most women, even those who cannot use systemic HRT.

Managing Recurrent Infections

If you’re getting UTIs frequently—typically defined as two or more infections in six months, or three or more in a year—you should be referred for further investigation. Recurrent infections sometimes have an underlying cause that needs addressing.

Antibiotic Options for Prevention

For people with confirmed recurrent UTIs, there are several antibiotic strategies:

Self-start antibiotics: Your GP may prescribe a course of antibiotics to keep at home, which you can take at the first sign of an infection. This approach works well for people who recognise their symptoms early and reduces the need for GP appointments. It’s essential to have had previous infections confirmed by urine culture before starting this approach.

Post-coital antibiotics: If your UTIs are clearly linked to sexual activity, a single dose of antibiotics taken immediately after intercourse can prevent attacks. This is highly effective for many women.

Low-dose prophylactic antibiotics: Taking a low dose of antibiotics every day, or three times per week, for three to six months can reduce infection frequency by 80-90%. However, this approach raises concerns about antibiotic resistance and isn’t a long-term solution for everyone.

The Importance of Urine Culture

It’s important to have a urine sample sent to the laboratory to confirm whether an infection is actually present and identify which bacteria are responsible. This ensures you receive the right antibiotic and helps avoid unnecessary antibiotic use, which contributes to resistance.

Many people assume they have a UTI based on symptoms alone, but other conditions—including interstitial cystitis, overactive bladder, and vaginal infections—can cause similar symptoms.

When to See a Doctor

While mild, uncomplicated UTIs in otherwise healthy women can sometimes be managed with increased fluids and over-the-counter pain relief (while waiting for a GP appointment), you should seek medical attention promptly if you experience:

Fever, chills, or feeling generally unwell
Pain in your back or sides (which might indicate kidney involvement)
Blood in your urine
Symptoms that don’t improve after 48 hours
You’re pregnant
You’re male (UTIs in men always warrant investigation)
You have diabetes or other conditions that affect your immune system
You’ve had recent urological procedures

Practical Summary

Prevention doesn’t require dramatic lifestyle changes. The most effective strategies are:

Drink plenty of water—aim for pale straw-coloured urine
Don’t delay when you need to urinate
Wipe front to back and maintain good hygiene
Urinate soon after sex
Avoid irritating products in the genital area
Consider cranberry products or D-mannose if you’re prone to infections
If postmenopausal, discuss topical oestrogen with your GP
Seek proper investigation if infections keep recurring

Nobody can guarantee they’ll never get a UTI, but these measures give you the best chance of keeping your bladder healthy. If you’re struggling with recurrent infections despite following this advice, don’t just accept it as normal—ask for a referral to a urologist for proper assessment.

References

Hooton TM, et al. Effect of Increased Daily Water Intake in Premenopausal Women With Recurrent Urinary Tract Infections: A Randomized Clinical Trial. JAMA Intern Med. 2018;178(11):1509-1515. PubMed
Williams G, et al. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev. 2023;4(4):CD001321. PubMed
Perrotta C, et al. Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane Database Syst Rev. 2008;(2):CD005131. PubMed