Management of urinary tract infections on the way

I’ve been waiting a long time to make this post. I’ve gotten them my whole life and I wasn’t prepared for the process of figuring out how to handle them while I was on the road. I think more people should talk about it, because honestly, it was a major limitation for me and my ability to complete miles.

The first time I hiked the Pacific Crest Trail in 2023, I had UTIs all over Washington State walking south. No joke, I kept trying to delete every section of my system. I stopped at Trout Lake, took some medication (finally), and still had symptoms until Cascade Locks. I took three days off, hoping to heal, and it finally stopped. That is, until I was hiking in the Sierra and ended up in the emergency room in Mammoth.

When I hiked the Continental Divide Trail, I had no UTIs in most of New Mexico; As soon as I started climbing elevations in Colorado, I got the first one and then another. I’ve had them so many times that I can tell you that most have always been in the summer, with higher elevation, or when I’m close to my period (pre/post).

So… what do I do?

Image source: Paige Combs, “High Elevation, Colorado,” June 2025.

UTI treatment and prevention

What worked

On the way

• hoe – to ease the pain until we reach the city
• grow fabric – unless you have a UTI, then switch to wipes
• Disposable feminine hygiene: tampons work best for me
• Baby Wet Wipes / PACT Wipes
• Hydration/Electrolytes: LMNT, DripDrop, LiquidIV
• Cleanse the body every night.
• Changing underwear (every day): Clean and dry the old pair in the bag during the day.
• Probiotic pills – Find some that are right for you, but I tend to look for those that have the specific strains you need for your urinary tract.
• Walk when it’s cooler

in the city

• Hydrate and shower
• Medication (GoodRx or local doctor if insured)
• take two days off

What didn’t work

On the way

• Vintage Records / Thinx Underwear
• Wear underwear again
• Do not cleanse the body at night.
• Not hydrating enough/drinking enough electrolytes
• Uqora (mainly I couldn’t justify the cost/weight/regularity)
• D-mannose (cost/weight/regularity could not be justified)
• Cranberry pills
• Hiking during heat waves/extreme conditions

in the city

• Skip showers
• Don’t take zeros
• No medications/probiotics

I wish I didn’t have to carry disposable feminine hygiene products, but I have to. Otherwise I always end up with a disaster and a UTI. Cleansing at night is very important and honestly, you should make it a regular habit. In desert areas, this is more difficult to do, but PACT wipes and baby wipes also work if you don’t have a river or stream nearby.

My conclusions

Overall, the biggest learning for me is this: I can’t just walk because I have a goal to finish a walk. I have to be aware that my body has limits. I’ve read a lot about why you might get them when you do. Some suggest that my pH levels change around my period, which can cause a change in bacteria. Some suggest it has to do with hydration and lack of fluids. This makes sense as at higher elevations you could be at higher risk because we lose more water at higher elevations. This also explains why you are more likely to have them during the peak summer months.

Image source: Paige Combs, “Night Hiking in Southern California to Avoid the Heat,” November 2025.

GoodRx

The best thing I learned during my research was GoodRx. You don’t always have access to doctors in mountain towns. Being able to take a call and get a prescription has made my travels so much easier. As long as there is a pharmacy nearby, you can submit a request, complete the phone call with a doctor and he will prescribe your medications. I do my best to stay in the city for at least two days and then slowly put in some miles.

Note: I am not a doctor, so always follow your doctor’s recommendations, but as a hiker, I have found that these options have worked best for me.

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