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Question:

Why Do I Get a Urinary Tract Infection Every Time I Have Sex?

Answer:

Here’s Why, and Here’s How You Can Prevent It

UTI’s are so miserable and so common. It’s all because of a design flaw, if you ask me. The female urethra is very short, which makes it easy for bacteria to get into the bladder. Honestly, I don’t know why this doesn’t happen to everyone. Symptoms include painful, frequent and urgent urination, and pain above the pubic bone. There may also be blood in the urine.

By the way, I’m only talking about cystitis, an infection of the bladder. Pyelonephritis, which involves the kidneys, is much more serious and has more severe symptoms, including fever, aches, and pain. If you have those symptoms, you need to see a physician right now.

Lots of conditions can cause symptoms that can mimic cystitis, including vaginal infections, herpes, irritation from spermicides, and painful bladder syndrome. But if you don’t have any vaginal or vulvar symptoms, and If you’ve been diagnosed with a UTI before, and if this feels the same, and if this happens every time you have sex, then prevention is in order!

UTI Prevention

First, drink lots of water, urinate frequently, and always wipe from front to back.

Second, if you use spermicide, consider using another form of contraception.

Third, consider antibiotic prophylaxis (1). I’ve successfully prevented UTI’s in hundreds of women with intercourse-associated UTI’s by recommending they take one single low-dose antibiotic tablet (most often nitrofurantoin; sometimes trimethoprim/sulfa) right before (or, if you forget, right after) sex. For most women, this works incredibly well! It’s definitely worth a discussion with your doctor.

For postmenopausal women, vaginal estrogens may be effective in preventing UTI’s (2)

What about cranberries?

In theory, cranberry products should be helpful in the prevention of UTI’s because they contain a substance that can prevent bacteria from sticking to the walls of the bladder. In order to drink enough cranberry juice for this to work, though, you’d have to drink way too much juice for it to make any sense. Supplements are problematic because they’re not regulated (don’t even get me started on that), which means you don’t know how much active ingredient there is. Having said that, one study (3) found that in young women who took a supplement (BKPro-Cyan) containing two types of (good) bacteria and cranberry extract, they dramatically lowered their risk of recurrent UTI.

In summary, you don’t have to suffer from recurrent intercourse-associated UTI’s. And that goes for when you travel. Remember when you used to do that. Well, someday, we’ll all be able to travel again. When that happens, I recommend that you bring a dose or two of medication with you. It may save your whole trip!

 

References

(1)Abou Heidar NF et al. Management of urinary tract infection in women: A practical approach for everyday practice. Urol Ann. 2019; 11(4):339-346.

doi: 10.4103/UA.UA_104_19. PMID: 31649450; PMCID: PMC6798292.

(2)Ferrante KL et al. Vaginal Estrogen for the Prevention of Recurrent Urinary Tract Infection in Postmenopausal Women: A Randomized Clinical Trial. Female Pelvic Med Reconstr Surg. 2019. doi: 10.1097/SPV.0000000000000749.

(3) Koradia P et al. Probiotic and cranberry supplementation for preventing recurrent uncomplicated urinary tract infections in premenopausal women: a controlled pilot study. Expert Rev Anti Infect Ther 2019; (9):733-740.

doi: 10.1080/14787210.2019.1664287.