Antibiotics were life saving when they were first introduced- and they still can be. However we overuse them, and resistance is a rising problem.
In addition to the wider societal implication of antibiotic overuse, there is also a personal cost. Usually antibiotic therapy is not targeted to a specific causal “bad” bacteria causing the problem. Instead they are “broad spectrum” which means they wipe out all bacteria, good and bad. As we have a large range of essential commensal bacteria, that help with everything from creating neurotransmitters (like serotonin that makes us feel happy), to digesting our food and even synthesising some of our essential vitamins, any action to kill these bacteria can have a negative effect on a number of different areas. It is also not as easy as taking a probiotic to recolonise, as probiotic bacteria often does not persist in the gut when you stop taking it, and the strains are also different – it doesn’t mean it’s not beneficial, but a bottle of probiotics after an antibiotic won’t fix everything.
Gut health is a whole different topic, and if you need support with this then please see a Naturopath for a comprehensive look at your current situation and lifestyle and a plan moving forward.
We have a much greater understanding now of how our bodies function, we have better nutrition, clean water and sanitation, and supplements to support our bodies readily available, which means we have options to use before resorting to antibiotics. Be sure to check out my posts from the last three years to find out about skin infections, dental and ear infections, and respiratory infections. Today’s post on other options for antimicrobial therapy: Urinary Tract infections and Bacterial Vaginosis. As always, see a qualified Health Professional for diagnosis, advice and support.
Urinary Tract Infections (UTIs)
Symptoms of a UTI include an increased urgency to urinate and frequency, as well as pain on urination, there can also be pain above the pubic bone, and blood in the urine (although this can be due to other causes, and if it doesn’t resolve with the UTI should be investigated further). Pain in the lower back, fever and chills, nausea or feeling lightheaded can indicate a more severe infection or that it is now in the kidneys, and also needs to be investigated by a doctor.
Most UTIs are from E Coli, and women are much more prone to UTIs because of the proximity of the ureter to the anus.
Conventional treatment of UTIs is antibiotics, first line is Nitrofurantoin, with Trimethoprim as second line treatment in New Zealand. For uncomplicated UTIs, in women between the ages of 16 and 65, trained Pharmacists are able to offer antibiotics. For recurrent infections, men, symptoms indicative of a more severe infection, or women outside these ages a doctor should be consulted.
Preventatively hygiene is really important with urinary tract infections, wiping front to back.
Drinking plenty of water is important also, as is urinating when you feel the urge and not holding on.
It is often recommended to urinate after sex, especially if UTIs are related to sexual activity. Research from a few years ago showed no benefit to doing this, but it also does no harm.
Supplements:
Specifically for urinary tract infections consider Cranberry extract, or the isolated d-Mannose from cranberries (and some other fruits) which stops bacteria adhering to the walls of the bladder. Be wary of cranberries in other forms; dried cranberries and cranberry juice often come with a lot of sugar, and sugar feeds the bacteria.
Homeopathic options:
Cantharis is a remedy for cystitis with a sudden onset, with persistent urging to urinate, but it can be difficult to pass urine or only come in small drops, and the urine burns. Cantharis is sudden and violent in nature, and the burning pain is the strongest symptom. .
Apis can have similar symptoms to Cantharis, with burning but this is usually less intense, or may be more of a stinging sensation. Apis have scanty urine and it is often darker in colour or may have blood. There is also increased frequency and urgency and there may be some incontinence.
Nux Vomica has constant urging to urinate, but difficulty passing more than a small amount. At the same time they may have constipation or an urge to defecate at the same time.
Staphisagria is indicated for “honeymoon cystitis” which comes on after sex, or if cystitis comes on after catheterisation.
Benzoic Acid can be needed if the urine has a strong smell, and this can linger in the bathroom after the toilet is flushed.
Sarsaparilla has pain at the end of urination instead of the beginning, and they may have tenderness and distension of the bladder. It may be hard to pass urine while sitting, just dribbles out, and easier when standing.
Bacterial vaginosis (BV)
This is a bacterial infection of the vagina – sometimes misdiagnosed as candida or thrush. Where candida has itching with a thick, white discharge, BV has a thin vaginal discharge that may be grey, white or green. There can be a foul-smelling or fish odour, vaginal itching is common and there may be burning during urination.
The most common treatment for BV is Metronidazole, an antibiotic. For some women a single course of metronidazole will clear the infection and it doesn’t return, for others it can be an ongoing problem.
Fleurstat BV Gel is an over-the-counter option for treating BV. It is not an antibiotic, but disrupts the biofilm and attachment of bacteria to the vaginal wall. Like Metronidazole, for some women this is a single treatment, for others they can still get BC recurring.
Other options:
BV indicates an imbalance in the normal microbiome for the vagina. We should have a slightly acidic pH, which keeps the opportunistic bacteria (and yeasts!) from overgrowing. The vagina does not require cleaning and using douches or soaps or detergents can change the pH, and natural bacterial balance and contribute to infections. Even the vulval area needs gentle care, and only a mild, non perfumed soap.
Specific probiotics can be a useful treatment or adjunct in BV. Clinicians Flora-Restore is one product with strains specific for the genitourinary area.
Another option is using prebiotics – food for the naturally occurring good bacteria – to help feed the right strains so they out-compete the bacteria that we don’t want. Lactulose is one pre-biotic that feeds Lactobacilli, and helps to lower the pH. It is readily available from pharmacies, and doses start at 3ml twice daily.
Another interesting study I found compared Metronidazole cream to a topical Calendula officinalis cream. This was a small study of 80 women, and found the calendula cream as effective as metronidazole cream (1), so this is a good option and worth trying.
Now let’s look at some homeopathic remedies:
Arsenicum Album no itching but soreness and inflammation. Discharge is thin and burning and can have an offensive smell. Burning pain is worse from the least exertion and causes fatigue. They can be anxious and need a lot of reassurance.
Kreosotum is indicated when itching is severe, and labia can burn and swell. Discharge can be yellow and acrid, with the odour of “green corn”. Itching of vulva and vagina can be worse when urinating.
Nitric acid has sharp or sticking pains, and discharge can be watery or stringy, brown or flesh-coloured, and offensive. Nitric Acid can be irritable, suspicious, or even vindictive.
Alumina has a prose transparent acrid discharge that can be burning. It is worse during the daytime and better for washing with cold water.
Sepia has yellow or green discharge with much itching. Sex may be painful, or they can have a bearing down sensation. Sepia can be irritable with their family, wanting them to go away so they can have some alone time.
It is important to consider sexually transmitted infections (STIs, or STDs). Many of these are notifiable diseases in NZ and require a diagnosis by a doctor, and if possible notifying any contacts. If you have any concerns this may be a factor in your genitourinary symptoms please see your GP or sexual health professional.
Reminder, always consult a professional if you are in doubt, and do not persist in using a remedy if it is not helping. Remedy suggestions in this post do not constitute medical advice and for diagnosis and information about when to seek further help see your GP or medical Doctor. I try to do acute consults at short notice, as often these conditions cannot wait, if I can’t I will connect you to another NZ Homeopath who can hope, or you can contact a homeopath at www.homeopathy247.com which has Homeopaths available from all around the world and someone there every hour of the day and night.
Reference:
1 – Pazhohideh Z, Mohammadi S, Bahrami N, Mojab F, Abedi P, Maraghi E. The effect of Calendula officinalis versus metronidazole on bacterial vaginosis in women: A double-blind randomized controlled trial. J Adv Pharm Technol Res. 2018 Jan-Mar;9(1):15-19. doi: 10.4103/japtr.JAPTR_305_17. PMID: 29441319; PMCID: PMC5801581.