Can probiotics put a plug in urinary incontinence?

When it comes to staying healthy, it seems like all roads lead back to your microbiome. Everything from anxiety to Parkinson’s to diabetes to depression to multiple sclerosis to cancer has been linked to the microbes you have (or don’t have) in your body. And now there’s another common condition in which your microbiome may make a huge difference… urinary incontinence.

For a long time, the medical community believed that there was no microbiome in the urinary tract and that urine was totally sterile (you may even come across doctors who still think this today). But recent research shows this is far from the truth.

As technology has progressed, researchers have used more advanced urine cultures and DNA sequencing to detect microorganisms in urine that didn’t show up using old testing methods. As a result, it’s becoming more widely accepted that, just like everyone has a unique microbiome in their gut, everyone has a unique microbiome in their urinary tract. This urinary microbiome most likely impacts your urinary health… and according to new research, it may even impact whether you become incontinent or not.

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Incontinent women have major differences in their urinary tract microbiome

A recent study published in the American Journal of Obstetrics and Gynecology found that women with urinary incontinence have big differences in their microbiomes from women without incontinence. The study also found that women with different types of urinary incontinence even have important differences in their microbiomes from each other.

The study included 309 adult women who fell into one of three categories: continent, suffering from stress incontinence or suffering from urgency incontinence.

In case you don’t know, stress incontinence refers to urine loss that happens during physical activity, and urgency incontinence refers to a sudden urgent need to urinate followed by urine loss. These women’s symptoms were gauged through a questionnaire, and urine cultures were taken to look for microbes. Here’s what researchers determined…

Women with urinary incontinence had different microbes in their urine than women without incontinence. Women with incontinence also had more microbial diversity in their urine than women without incontinence.

The fact that there were microbial differences in women who had stress incontinence versus urgency incontinence is another interesting finding from the study.
Although it’s long been suspected that these two different types of incontinence have different causes, we didn’t know those differences happened in the microbiome.

Probably the most important information to take away from this study is the specific strains that seem to make up a healthy urinary microbiome and the ones that don’t. In this study, women who were continent had these bacterial strains most abundantly in their urine:

  • Lactobacillus iners (12.7%)
  • Streptococcus anginosus (12.7%)
  • L crispatus (10.7%)
  • L gasseri (10%)

Women with both types of incontinence had far more Streptococcus anginosus in their urine than continent women, plus they had a variety of other bacterial species that weren’t present in the urine of continent women.

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Can probiotics help?

All this evidence connecting urinary incontinence to microbiome imbalances raises one important question… can probiotics help?

It’s possible. But there hasn’t been a lot of research into it yet. Right now, all we know is that Lactobacillus-based probiotics may have the potential to prevent urinary tract infections based on the results of a couple of recent studies. And there is a connection between incontinence and UTIs. Incontinence can happen as a symptom or side effect of UTIs, and people with incontinence are more likely to develop UTIs.

Related: 5 probiotic strains that restore balance to your vaginal microbiome

There are a variety of probiotics on the market that were designed specifically with urinary tract health in mind, so, if you suffer from incontinence, those may be worth a try. You can also turn to other natural remedies for incontinence like Kegel exercises (here’s a video to get you started) and bladder training (here’s more information on bladder training). Diet and lifestyle changes can make a big difference too, especially if you avoid potential bladder irritants, like the following:

  • Alcohol and caffeine are bladder stimulants and diuretics, meaning they trigger the urgent need to urinate. Avoid them when possible.
  • Carbonated drinks, tea and coffee (with or without caffeine), artificial sweeteners, corn syrup and foods and beverages that are high in spice, sugar and acid, such as citrus and tomatoes, can irritate your bladder.
  • Heart medications, blood pressure drugs, sedatives, muscle relaxants and other medications can contribute to bladder control problems. Talk to your doctor to see if it’s possible to switch to a medication that’s less irritating to your bladder.
  • Pumpkin seed extract may help reduce urgency for an overactive bladder.

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  1. An emerging link between the urinary microbiome and urinary incontinence — Harvard Health Publishing
  2. Randomized, placebo-controlled phase 2 trial of a Lactobacillus crispatus probiotic given intravaginally for prevention of recurrent urinary tract infection — Clinical Infectious Diseases
  3. Use of Lactobacillus spp. to prevent recurrent urinary tract infections in females — Medical Hypotheses
  4. Bladder bacterial diversity differs in continent and incontinent women: a cross-sectional study — American Journal of Obstetrics and Gynecology
  5. The Human Microbiota in Health and Disease — Engineering
Jenny Smiechowski

By Jenny Smiechowski

Jenny Smiechowski is a Chicago-based freelance writer who specializes in health, nutrition and the environment. Her work has appeared in online and print publications like Chicagoland Gardening magazine, Organic Lifestyle Magazine, BetterLife Magazine,, and