Several daily options can help prevent UTIs, ranging from simple habits like drinking more water to supplements like cranberry and, for those with recurring infections, prescription options. The 2025 guidelines from the American Urological Association recognize cranberry, increased water intake, vaginal estrogen (for postmenopausal women), and antibiotic prophylaxis as evidence-backed prevention strategies. What works best depends on how often you’re getting infections and what’s driving them.
Cranberry Products
Cranberry is one of the most well-supported daily supplements for UTI prevention. The active compounds, called proanthocyanidins (PACs), work by preventing bacteria from sticking to the walls of your urinary tract. The target dose is 36 milligrams of PACs per day. This is the number to look for on supplement labels, because the amount of PACs varies wildly between products.
Cranberry juice is less reliable than capsules or tablets for hitting that threshold. Most commercial juices are diluted and loaded with sugar, so you’d need to drink a lot to get enough PACs. Concentrated cranberry supplements standardized to 36 mg PACs are a more practical daily option. In one study of girls with recurrent UTIs, only 18.5% of those drinking 50 ml of cranberry juice daily had another infection over six months, compared to 48% of those who did nothing.
Drinking More Water
This is the simplest intervention with real evidence behind it. If your daily fluid intake is below about 50 ounces (1.5 liters), increasing it can meaningfully reduce your risk. A 12-month randomized trial found that women who added an extra 1.5 liters of water to their usual daily intake had fewer recurrent UTIs than those who didn’t change their habits. The logic is straightforward: more water means you urinate more frequently, which flushes bacteria out of the bladder before they can multiply and cause an infection.
You don’t need to force yourself to drink excessive amounts. The goal is consistent hydration throughout the day, especially if you tend to drink very little. Keeping a water bottle nearby and sipping regularly is enough for most people.
D-Mannose
D-mannose is a natural sugar sold as a powder or capsule that works similarly to cranberry. It binds to E. coli bacteria (the cause of most UTIs) and prevents them from latching onto your bladder lining. Clinical trials have tested regimens starting at 1 gram three times daily for two weeks, then tapering to 1 gram twice daily for several months.
However, the evidence here is more mixed than many supplement brands suggest. The 2025 AUA guidelines specifically note that D-mannose alone may not be effective for UTI prevention. It could have a role as part of a broader prevention plan, but it shouldn’t be your only strategy if you’re dealing with frequent infections.
Probiotics
The idea behind probiotics for UTI prevention is that certain Lactobacillus strains help maintain a healthy vaginal environment, which serves as a barrier against UTI-causing bacteria. This makes biological sense, but the clinical evidence hasn’t consistently backed it up. In a head-to-head study of 150 women, a Lactobacillus rhamnosus GG drink taken five days a week for 12 months showed no significant difference compared to doing nothing, while cranberry juice did reduce recurrences.
Probiotics aren’t harmful and may offer other health benefits, but they don’t currently have strong enough evidence to be recommended as a standalone UTI prevention strategy.
Vaginal Estrogen for Postmenopausal Women
If you’re perimenopausal or postmenopausal and getting frequent UTIs, vaginal estrogen is one of the most effective options available. After menopause, declining estrogen levels thin the vaginal and urethral tissues and shift the local bacterial balance in ways that make infections more likely. Topical estrogen reverses these changes.
In a large study, women using vaginal estrogen saw their average UTI frequency drop from 3.9 per year to 1.8, a reduction of about 52%. Over a third of patients had zero UTIs in the year after starting treatment, and more than half had one or fewer. The AUA gives this a moderate recommendation, making it one of the strongest endorsed options for this population. It’s a prescription product, typically available as a cream, tablet, or ring inserted vaginally.
Methenamine Hippurate
Methenamine hippurate is a prescription medication that works differently from antibiotics. In acidic urine, it breaks down into formaldehyde, which kills bacteria in the bladder. The standard dose is one 1-gram tablet twice daily. It’s recognized in current guidelines as a prevention option and has the advantage of not contributing to antibiotic resistance. It’s worth discussing with your provider if you want a daily prescription option but want to avoid long-term antibiotics.
Low-Dose Antibiotic Prophylaxis
For women with recurrent UTIs, defined as two or more infections within six months, daily low-dose antibiotics are an option. This is typically reserved for people who’ve already tried other strategies or whose infections are frequent and disruptive. The AUA lists it as a conditional recommendation, meaning it’s appropriate after weighing risks and benefits.
The most commonly prescribed antibiotic for this purpose, nitrofurantoin, carries real risks with long-term use. It can cause lung problems including cough, chest pain, and shortness of breath, which can develop at any point during treatment. More rarely, it can damage the liver, sometimes gradually and without obvious early symptoms. People on long-term nitrofurantoin need periodic monitoring, and anyone who develops breathing trouble, a lingering cough, yellowing of the skin or eyes, or dark urine while taking it should stop the medication and seek care promptly.
Because of these risks, most guidelines encourage trying non-antibiotic prevention strategies first and turning to daily antibiotics only when those aren’t enough.
Putting a Prevention Plan Together
The most practical approach for most people is to layer several low-risk strategies. Drinking enough water, taking a cranberry supplement standardized to 36 mg PACs, and maintaining basic habits like urinating after sex all work together to reduce your risk without any prescription. If you’re postmenopausal, adding vaginal estrogen makes a significant difference. If infections keep coming despite those steps, methenamine hippurate or low-dose antibiotics become reasonable next options to discuss with a provider.
Recurrent UTIs are formally defined as two episodes within six months. If you’re hitting that threshold, it’s worth getting a proper evaluation rather than relying solely on over-the-counter prevention, since underlying factors like incomplete bladder emptying or anatomical issues can sometimes play a role.