Understanding Chronic Urinary Tract Infections and Sex

Avoiding Infections That Can Interrupt Your Sex Life

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There can be few things more frustrating to a relationship than when a urinary tract infection (UTI) interferes with sex. It is one thing when it happens every once in awhile; it's another when it becomes an ongoing, chronic condition.

A UTI can develop in men and women, involving the lower tract (bladder and urethra) and/or the upper tract (kidneys and ureter). Women are more prone to getting a UTI — 10 times more likely, in fact — with lower tract infections being the more common problem when it comes to having sex.

Causes of Urinary Tract Infection

Bacteria, such as E.coli, can easily enter the urinary tract through the urethra, which is situated close to the genital area in both men and women. It can then travel up through the urethra and into the bladder where infection can develop. If the kidneys are involved, it becomes an even more serious condition called pyelonephritis, which requires immediate attention.

Honeymoon cystitis is a term used to describe a UTI that was a person gets after having sex with a new partner. It is most common in younger women who are just starting to have sex or for anyone just entering a new sexual relationship.

It is believed that women get UTIs more frequently because their urethra is shorter, making a bacteria's entry into the bladder all the simpler.

A chronic UTI is different from an acute UTI in that it either doesn't respond to traditional treatment or recurs frequently.

Tips for Preventing a Urinary Tract Infection 

To better reduce your risk of getting a UTI, there are several things you can do:

  • Always wash your hands before and after sex, and try not to touch your genitals after you touch your or your partner's anus. The rectum, anus, and groin have a high density of bacteria that can easily be transferred to the urethra. 
  • Urinate as often as needed, especially after sex, as this can help clear bacteria from the urinary tract. Drink plenty of water to flush bacteria out of the system. Women should wipe from front to back after urinating.
  • Speak with your doctor if you use a diaphragm or spermicide for contraception and are getting frequent bouts of UTI. A diaphragm can make it harder to empty your bladder completely (leaving bacteria behind to infect), while a spermicide can alter the natural bacterial makeup of the vagina (allowing foreign bacteria to flourish more readily). Alternate methods for contraception may need to be considered. 
  • Wash your foreskin before and after sex if you are uncircumcised, and use condoms regularly.
  • Reduce your number of sex partners.
  • Drinking cranberry juice daily is sometimes recommended for persons with a chronic UTI.
  • Low-dose antibiotics are sometimes given as a daily preventive routine (although overuse can increase UTI risk by altering the bacterial flora of the vagina). In some cases, they are recommended only after you have sex.

While most studies investigating chronic UTIs have focused on younger age groups, there is now compelling evidence that shows a strong relationship between recent sexual intercourse and UTIs in postmenopausal women.

It is, therefore, just as important for older women to take the same preventive measures as younger ones, irrespective of how often you have sex or how many sexual partners you may have.

UTIs and Sexually Transmitted Infections

A number of sexually transmitted infections (STIs) are known to cause UTIs, including trichomoniasis and chlamydia. Oftentimes a person will assume that the UTI is bacterial in nature (and treat it as such) and fail to identify the underlying STI.

It is, therefore, vital to consider your risk of STIs when any infection of the genitals or urinary tract is involved. This is especially true if you have multiple sex partners or have gotten a UTI after having sex with a new partner.

Current pediatric guidelines recommend that doctors take a comprehensive sexual history of any adolescent with urinary tract complaints and to routinely test them for STIs.

Meanwhile, sexually active men under the age of 35 who don't use condoms can experience a condition called epididymitis. It is an infection of the epididymis (the coiled tube to the back of the testicles) that can be caused either by a bacteria or an STI (most often gonorrhea or chlamydia). Treatment varies based on the cause and severity.

Safer sex practices, which includes the consistent use of condoms, are always the best plan for reducing the risk of these and other STIs.

Sources

  • Flores-Mireles, A.; Walker, J.; Caparon, M.; et al.  "Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews | Microbiology. May 2015; 13(5):269–284.
  • Musacchio, N.; Gehani, S; and Garofalo.R. "Emergency department management of adolescents with urinary complaints: missed opportunities." J Adolesc Health. 2009; 44:81-83.

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