Are Urinary Tract Infections Sexually Transmitted Diseases?

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Question: Are Urinary Tract Infections Sexually Transmitted Diseases?

Not all infections that are associated with sex are sexually transmitted diseases. For example, yeast infections and bacterial vaginosis are associated with sex. However, they are not generally considered to be sexually transmitted. (Bacterial vaginosis may be sexually transmitted in lesbians. It is, however, still not considered to be a sexually transmitted disease by most doctors.) 

As for the question of urinary tract infections (UTIs), they are certainly associated with sex. In fact, they are common enough after sex that doctors often refer to sexually associated UTIs as "honeymoon cystitis." Still, the question is... are they sexually transmitted diseases?

Answer: Sometimes

The term honeymoon cystitis has been around for over 30 years. It's a compelling one. It refers to the fact that UTIs are quite common in newly married women. They're also often seen in women in the early stages of a sexual relationship. In other words, UTIs occur more frequently in women who are having a lot of sex.

The association between sex and UTIs may be due to any one of a number of factors, including:

  • Intercourse can push bacteria already in the urethra up into the bladder. There, these bacteria can cause an infection.
  • Bacteria that are normally present in the vagina or on the surface of the vulva can move into the urethra during intercourse.
  • Urine can get trapped in the bladder or urethra during sex. This provides an opportunity for bacterial growth. Some contraceptive methods, such as diaphragms, put pressure on the urinary tract. This increases the risk of trapping bacteria in the bladder.
  • Sexual partners can unknowingly pass bacteria that can cause a UTI, such as E Coli.

    In other words, although UTIs are associated with sex, they are not necessarily sexually transmitted diseases. In fact, the mechanical act of sexual intercourse probably explains far more of the interaction between sex and UTIs than does the transmission of bacteria during sex. The sexual partners of people with recurrent UTIs do not necessarily experience such infections themselves. There are times when UTIs are contagious. However, that doesn't explain the majority of UTIs. 

    More About UTIs

    Urinary tract infections are not a single disease. In some individuals, the bladder is the primary site of infection. Other people experience more serious infections that ascend to the kidneys. Furthermore, although honeymoon cystitis is most commonly seen in women, those are only a fraction of UTIs. UTIs can occur anywhere along the female or male urinary tract.

    A number of factors other than sexual intercourse are also associated with an increased risk of UTIs. These include anatomical factors - such as the length of the urethra - and bathroom hygiene.

    More controversial associations include a lack of sufficient water consumption and the use of tampons and condoms. 

    Managing UTI Risk

    There is one very common suggestion for reducing the risk of sexually associated urinary tract infections. Always urinate after sex. It is thought that peeing after sex may flush any bacteria from the urinary tract. There is limited research support for this suggestion,  but it is unlikely to do any harm.

    Women who experience frequent UTIs are also sometimes advised to drink cranberry juice on a regular basis. The thought is that this could acidify their urine and reduce the number of bacteria. However, this suggestion is also not particularly well supported by current research. Two randomized controlled trials have failed to demonstrate a significant reduction in UTIs for women who regularly drink cranberry juice. However, several in vitro studies have found that cranberry juice may affect the way that bacteria interact with the lining of the urinary tract. Therefore, some women may still consider the method worth a try.

    That said, women who experience significant, recurrent problems with UTIs should definitely discuss the condition with their doctors. Symptom relief with over-the-counter products is not the same as a cure. Furthermore, it's possible that what you think is a UTI may actually be a different infection in disguise.

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