Effects of Increased Water Intake on Uropathogenic Bacterial Activity of Underhydrated Menstruating Premenopausal Females

Urinary tract infections (UTIs) disrupt military women’s service obligations and health. Females are more susceptible to UTIs due to their unique anatomical features and hormone fluctuations affecting vaginal flora. During phase 1 of the menstrual cycle (onset of bleeding, menstrual cycle days 1-5), estrogen levels significantly decrease and inhibit the growth of lactobacilli, good bacteria that are essential in warding off harmful bacteria and infections, particularly pathogens of UTIs. To reduce UTI onset, it is recommended to frequently urinate with sufficient urine void volume to facilitate washing out harmful bacteria from the bladder and urethra. While menstruating, increased fluid consumption to support urination frequency and void volume may be critical, as the urethra and urinary tract are more predisposed to pathogenic bacteria found. Yet, there is a lack of research investigating the impact of hydration on urinary tract health during menstruation. The study sought to examine the effects of increased water fluid intake on the uropathogenic bacterial activity of underhydrated menstruating premenopausal females. Thirteen females underwent a 2x2 randomized crossover trial to evaluate the effectiveness of a) additional 1.89 L of water fluid intake and b) maintain habitual fluid intake on two subsequent phase 1 menses. At each phase 1 menses, fluid intake was gathered on days 2 and 5 to determine the fluid amount consumed. First-morning urinations on days 3 and 6 assessed urogenital bacterial activity. Combining data collection days 2 and 5 per intervention (INT) and control (CON), the mean±SD for total fluid intake was INT 2.99±1.05 and CON 1.85±0.89, resulting in a 62% increase, p< 0.001, η2= 0.459. For days 2 and 5, a 48% and 80% increase in total fluid in from CON to INT was found, ps< 0.01. However, only four cultures detected uropathogenic bacteria from four participants, with no patterns between conditions or days, making it difficult to determine the effectiveness of the intervention. Though the intervention results were undetermined, military women’s hydration, menstruation, and urinary tract health remain prominent health concerns. Efforts to assess their fluid consumption and urination behaviors during menstruation and UTI risks are warranted.