Understanding Chronic Urinary Tract Infections and Sex

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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 a while; 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—up to 30 times more likely, in fact—with lower tract infections being the more common problem when it comes to having sex.

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Causes

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 the urethra and into the bladder where infection can develop. If the kidneys are involved, it becomes a serious condition called pyelonephritis, which requires immediate attention.

Honeymoon cystitis is a term used to describe a UTI that a person gets after having sex with a new partner. It is most common in sexually active younger women. 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.

Prevention

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

  • 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.
  • 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.

Diaphragms and Spermacide

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).

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.

Continue Precautions After Menopause

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 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.

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 include the consistent use of condoms, are always the best plan for reducing the risk of these and other STIs.

Frequently Asked Questions

Is it safe to have sex with UTI?

Generally, sex is not recommended until your UTI has completely cleared. A UTI can irritate the tissues of the urinary tract, and sex can irritate them even further.

This may not only make sex uncomfortable but can potentially introduce new bacteria into the urinary tract. Because the urethra tissues are already inflamed, they are even more vulnerable to infection. Sex could inadvertently lead to a second UTI and an even longer recovery time.

As aggravating as UTIs can be, they are neither sexually transmitted nor contagious. This means that you will not "pass" a UTI to a partner if you have sex.

When can I have sex after UTI?

Many doctors will tell you to wait two weeks after the symptoms have fully cleared before having sexual intercourse. Not everyone heeds this advice, however, and will engage in sex the moment that symptoms disappear.

If this is you, take a few precautions by urinating before and after sex (which helps flush any bacteria from the urinary tract) and avoiding sexual positions that place direct pressure against the urethra. Better yet, explore mutual masturbation and erotic touch as an alternative to vaginal or anal sex.

How long after sex can you develop UTI?

Most studies have shown that people who get a UTI from sex tend to do so within 24 hours of sexual contact.

Escherichia coli (E. coli), the bacteria most commonly associated with UTIs, typically resides in the bowels. When introduced into the urinary tract during sex, E. coli will immediately adhere to epithelial cells that line the walls of the urethra and begin to proliferate, triggering inflammation and other signs of infection.

If the infection is severe and left untreated, the infection can move up the urinary tract and affect the bladder, ureters, or kidneys.

How soon can you have sex after starting antibiotics for UTI?

You should generally experience an improvement in UTI symptoms within 24 to 48 hours of starting antibiotics. But, again, the resolution of symptoms doesn't necessarily mean that it is wise to immediately start having sex again.

Moreover, the resolution of symptoms doesn't mean that the bacteria is gone. In order to ensure clearance, you need to take the prescribed antibiotics as directed and to completion. If you don't, there may be antibiotic-resistant bacteria left behind that can multiply and proliferate. If this were to happen, the bacterial may be fully or partially resistant and more difficult to treat.

How to prevent UTI from sex?

UTIs can ultimately affect anyone, but there are a few simple ways to reduce your risk of getting a UTI from sex:

  • Avoid potentially irritating feminine products that can promote inflammation and increase the risk of UTIs.
  • Use condoms during anal sex to avoid infection in the insertive partner.
  • Avoid switching from anal sex to vaginal sex without first putting on a new condom or stopping to wash the penis with soap and warm water.
  • Urinate immediately before and after sex.
  • Keep well hydrated before and after sex to promote urination.
  • Wait two weeks after a UTI clears before having sex to avoid a second UTI.
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