Urinary tract infections (UTIs) can be extremely uncomfortable, so it’s natural to want to know how UTIs are treated. Antibiotics are the standard treatment for most active bacterial UTIs. Because other conditions can cause similar symptoms, it’s important to get diagnosed by a clinician who can recommend appropriate care.
Unfortunately, the risk of getting a UTI is greater in postmenopausal women, so knowing how to treat and prevent them is particularly useful for women. There isn’t one best antibiotic for women because treatment depends on the type of infection you have, your health history, and urine culture results.
We’ll break down how UTIs are diagnosed and treated, at-home care that may ease discomfort, and how midlife women can reduce those dreaded recurrent infections that may happen more frequently during menopause.
How Are UTIs Diagnosed Before Treatment?
A clinician may diagnose a UTI based on common symptoms, such as burning while urinating, urinary urgency, pelvic pressure or discomfort, blood in the urine, and more frequent urination.
They may also run a urinalysis to test your urine for white blood cells, nitrites, or blood not visible to the eye. As part of the evaluation, they’ll screen for fever, chills, flank pain (pain on either side of your back, between your lower ribs and hips), and nausea or vomiting, which could be signs of a kidney infection.
Because UTI symptoms can overlap with other conditions, your clinician might want to rule out vaginal infections, sexually transmitted infections, bladder pain syndrome, and genitourinary syndrome of menopause (GSM).
The testing you need also depends on factors like whether you’re pregnant, whether you’ve reached menopause, kidney health, previous UTIs, and other medical conditions. If UTIs keep coming back, initial treatment doesn’t work, or the diagnosis is unclear, your clinician may order a urine culture to identify the bacteria and help guide treatment.
UTI Treatment and Prevention Options
What Is the Best Antibiotic for a Urinary Tract Infection?
There’s no single best antibiotic for UTIs in women. The right choice depends on several factors, including the bacteria causing the infection, your health history, and local antibiotic resistance, which happens when bacteria no longer respond to certain antibiotics. A clinician will also consider your allergies, kidney function, pregnancy status, and prior culture results.
Common antibiotic options include:
- Nitrofurantoin monohydrate/macrocrystals (Macrobid)
- Trimethoprim-sulfamethoxazole (Bactrim)
- Fosfomycin (Monurol)
- Certain beta-lactam antibiotics, including cephalexin (Keflex) and amoxicillin-clavulanate (Augmentin)
Fluoroquinolones, another class of antibiotics that includes ciprofloxacin (Cipro), can treat some UTIs but usually aren't the first choice for uncomplicated infections because of concerns about bacterial resistance and serious side effects.
The right antibiotic can also differ depending on whether you have a bladder infection or a suspected kidney infection. No matter which antibiotic you’re prescribed, take it exactly as directed, even if your symptoms improve before you finish it.
Home Remedies for UTI Symptoms: What Helps and What Does Not
There are many home remedies for UTIs that may help prevent infections or relieve symptoms, but they won’t eliminate the bacteria causing an active infection.
Some at-home care that may help includes:
- Staying hydrated: Drinking plenty of water and other fluids can help flush bacteria from the urinary tract, unless your clinician has told you to limit fluids.
- Using heat: A warm heating pad may temporarily ease pelvic discomfort or pressure.
- Taking a urinary pain reliever: A clinician may recommend one for short-term relief from burning or discomfort.
- Avoiding bladder irritants: During an active UTI, consider cutting back on caffeine, alcohol, and other drinks that may dehydrate you and irritate your bladder.
- Trying cranberry products: Cranberry supplements may help prevent recurrent UTIs in some women, but they won’t treat an active infection.
Don’t use leftover antibiotics, borrowed medicines, detoxes, or unproven products marketed as UTI cures. Using the wrong treatment can make your infection worse.
Home remedies may help you feel a little better, but they’re not a substitute for medical treatment when you need it and won’t cure a UTI on their own.
Treating Recurrent UTIs During Perimenopause and Menopause
Recurrent UTIs—which happen when you have two UTIs within 6 months or three within a year—become more common with age and after menopause. As estrogen declines in midlife, changes to vaginal and urinary tissues can contribute to dryness, irritation, and those recurrent UTIs.
If UTIs keep coming back or symptoms don’t improve, a clinician—like one of the menopause-trained specialists at Midi—can help. They may order a urine culture to identify the bacteria and help choose the right antibiotic. They’ll also check for factors that may contribute to recurrent infections, including vaginal dryness and tissue changes, incomplete bladder emptying, and constipation.
Low-dose vaginal estrogen can help prevent recurrent UTIs in some perimenopausal and postmenopausal women. Your treatment may also include other options, including non-antibiotic prescription treatments like methenamine hippurate, cranberry products, or low-dose preventive antibiotics taken regularly or after sex.
The best strategy depends on how often you get UTIs, your medical history, potential side effects, and concerns about antibiotic resistance. You and your clinician can weigh these factors together to find the right approach.
Frequently Asked Questions (FAQs)
Can you have a UTI without burning when you urinate?
Yes. Although burning during urination is a common symptom, it is possible to have a UTI with different symptoms, such as frequent or urgent urination, pelvic discomfort, and blood in your urine.
Is a UTI contagious to a sexual partner?
No, UTIs are not contagious and can not be passed on to a sexual partner.
Can sex cause a UTI?
Yes, sex can increase the risk of a UTI because it can move bacteria toward the urethra.
Why do UTI symptoms sometimes return immediately after antibiotics?
UTI symptoms may return after antibiotics if the infection wasn’t completely cleared, the bacteria are resistant to the antibiotic, or another condition is causing similar symptoms. Contact a healthcare professional if symptoms return after treatment.
Can a UTI cause vaginal discharge?
UTIs generally don’t cause vaginal discharge. They’re more likely to cause urinary symptoms like burning when you urinate, urinary urgency, or cloudy urine. Discharge may point to another issue, such as bacterial vaginosis or a yeast infection.
Can menopause cause urinary symptoms without an infection?
Yes. Declining estrogen during perimenopause can change vaginal and urinary tissues, leading to urinary urgency, frequency, burning, or leaking—even without an infection. These symptoms can be part of genitourinary syndrome of menopause (GSM).
If you’re in perimenopause or menopause and want guidance from clinicians who specialize in women’s midlife health, book a virtual visit with Midi today.
Hormonal change is at the root of dozens of symptoms women experience in the years before and after their period stops.
Our trained menopause specialists can help you connect the dots to guide you towards safe, effective solutions.
Whether you need personalized guidance or a prescription routine to tackle symptoms—including brain fog, hot flashes, sleep trouble, mood swings, and weight gain—we’ve got you covered. Learn more here.
Midi’s mission is to revolutionize healthcare for women at midlife, wherever they live and whatever their health story. We believe that starts with education, to help all of us understand our always-changing bodies and health needs. Our core values guide everything we do, including standards that ensure the quality and trustworthiness of our content and editorial processes. We’re committed to providing information that is up-to-date, accurate, and relies on evidence-based research and peer-reviewed journals. For more details on our editorial process, see here.
