Sex With a Urinary Tract Infection

What Is a UTI?

A urinary tract infection (UTI) is an infection that occurs in any part of the urinary system.

This may involve:

• The urethra.

• The ureters.

• The bladder.

• The kidneys.

Typically, the urethra and bladder are affected, but severe urinary tract infections may also occur in the kidneys. The term used for urinary infection of the bladder is cystitis.

Who Is Affected by UTIs?

While both males and females may be affected, females are about eight times more likely to develop a urinary tract infection than males. It has been estimated that a UTI will occur in close to 50% - 60% of women in their lifetime. Women are more prone to developing UTIs lies in the anatomy of the female urinary system. The urinary tract of a female is shorter than that of a male, so bacteria from the vagina and anus may easily travel to the bladder and other parts of the urinary system, causing infections.

What Are the Risk Factors for Developing UTIs?

UTIs occur due to the entrance of bacteria into the urinary tract through the urethra. These bacteria then multiply, leading to a urinary tract infection.

There are several possible risk factors for the development of a UTI:

1. Gender- Women are more likely to develop a UTI than men at some point in their lifetime.

2. Obesity.

3. Menopause- Menopause in women leads to decreasing estrogen levels, increasing the risk of developing a UTI.

4. Multiple pregnancies.

5. Previous history of UTI.

6. Family history of UTI.

7. Sexual Intercourse-

• Being sexually active and having multiple sexual partners are risk factors.

• Sexually transmitted infections like gonorrhea, chlamydia, and herpes can result in urethritis due to the proximity of the vagina to the urethra.

• Sexual intercourse can also cause cystitis due to the pushing up of bacteria further up the urinary bladder.

8. Urinary Tract Issues- People suffering from urinary tract abnormalities that prevent normal urinary excretion or collection and backing up urine in the urethra are more likely to develop a UTI.

9. Urinary Tract Obstruction- The presence of kidney stones or enlarged prostate gland may cause blocked or obstructed urinary tracts, leading to a UTI.

10. Bladder Issues- Unable to empty the bladder fully when urinating can cause UTIs.

11. Bacterial Spread-

• E. coli (Escherichia coli) bacteria may travel from the gastrointestinal tract (GIT) to the bladder and cause cystitis (bladder infection).

• GI bacteria may also travel from the anus to the urethra (due to its close location to the urethra) and cause urethritis (urethral infection).

12. Antibiotics - Frequent antibiotic use can disrupt the normal, healthy bacterial balance in the urinary tract and cause UTIs.

13. Birth Control - Certain birth control methods like diaphragms, spermicides, and condoms treated with spermicidal agents can result in bacteria being pushed through the urinary tract, which can cause UTIs.

14. Immunosuppression - People suffering from diseases that suppress immunity, such as diabetes or cancer, show less defense against germs, which can precipitate bacterial attacks on the urinary system.

15. Urinary Procedures - Urinary system examination using medical instruments or urinary surgery can increase the risks of UTI development (particularly if sterilization practices fall short of the mark).

16. Urinary Catheter - Patients who cannot urinate unassisted and use a urinary catheter for this purpose may demonstrate an increased risk of developing UTIs.

What Are the Signs and Symptoms of UTI?

The most typical symptoms of a UTI are:

• Frequent urge to urinate, with little urine being passed upon urination.

• Pain in the pelvic and abdominal regions.

• Blood in the urine - presents as pink or cola-colored urine.

• Urine with a strong odor.

• Urine with a cloudy appearance.

• Burning sensation on urination.

• Rectal pain has also been noted in men who develop urinary tract infections.

Symptoms specific to the location of infection have also been noted:

Bladder (Cystitis):

• Pain and discomfort in the lower abdomen.

• Pressure in the pelvic region.

• Pain on urination.

• Frequent urination.

• Blood in the urine.

Urethra (Urethritis):

• Burning sensation on urination.

• Discharge.

Kidneys (Acute Pyelonephritis):

• Nausea.

• Vomiting.

• Upper back pain.

• Side pain (abdominal sides or flanks).

• Chills.

• Fever.

Can A UTI Be Sexually Transmitted?

Although sexual activity can lead to the development or worsening of a UTI, sexual transmission of a UTI between partners is not possible. A UTI is not a contagious infection.

Is It Safe to Engage in Sexual Activity With a UTI?

Sexual activity with a UTI is not recommended, as it is detrimental to the affected patient.

• Genital Contact and Bacterial Migration - Any form of genital contact can result in the bacteria being pushed into the urethra, causing or worsening a UTI. While sexual transmission of UTIs is not possible, sexual activity forces the bacteria in and around the genital regions into the urethra. This means that even wearing a condom or engaging in oral sex rather than penetrative sex are equally likely to cause or worsen UTIs. All forms of sex can push bacteria into the urethra.

• Pain and Irritation - Sexual activity while suffering from a UTI can lead to pain and irritation of the urethra. Additionally, the pressure exerted on the vaginal walls due to penetrative sex can increase the pressure on the bladder and worsen the pain.

How Can UTIs From Sexual Activity Be Prevented?

Preventive measures that can be taken against urinary tract infections include:

• Avoid sexual intercourse when already suffering from a UTI to prevent the worsening or recurrence of the UTI.

• Urinate before and after sex (especially after sex) to flush out bacteria and toxins.

• Stay hydrated - drink lots of water to keep the urinary tract clean.

• Avoid participating in sexual activities that can cause the spread of bacteria from the anus to the vagina or urethra. When engaging in anal sex, use condoms and change them as soon as anal intercourse is complete. Never repeat the same condom for penetration of any other body part.

• After urinating or defecating, use a front-to-back wiping motion to prevent the spread of bacteria from the anus into the vagina.

• Use a different birth control method using diaphragms, spermicides, or spermicide-treated condoms.

• Always wash hands before and after sexual activity to reduce the possibility of bacterial spread due to manual stimulation.

• Wash the genital area with warm water before sex.

• Avoid using feminine products like deodorant sprays and powders in the genital area.

• Avoid douching as it alters the normal pH of the vagina and can cause bacterial overgrowth and frequent UTIs.

• Some doctors recommend taking probiotics to prevent the unchecked growth and spread of bacteria.

• Avoid wearing tight clothes or underwear.

• Recurrent UTIs may be prevented through antibiotic therapy after sex. A physician can prescribe antibiotics specifically for this purpose.

How Are UTIs Diagnosed?

• Urine Analysis - A urine sample may be collected for laboratory analysis of red blood cells, white blood cells, and bacteria in the urine.

• Urine Culture - Following a lab analysis, a urine culture may be done to ascertain which bacteria is causing the infection.

• Imaging- A computed tomography (CT) scan, magnetic resonance imaging (MRI), ultrasound scan, or contrast dye may be used to view and assess the urinary tract structures.

• Cystoscopy- A cystoscopy may be done to view the inside of the bladder. A cystoscope is a long tube with an attached lens inserted into the urethra and bladder. It helps view the insides of the bladder for better evaluation.

How Are UTIs Treated?

UTIs can be treated by various medications.

1. Antibiotics- UTIs may usually be treated effectively with antibiotic therapy:

• Trimethoprim/Sulfamethoxazole.

• Nitrofurantoin.

• Ceftriaxone.

• Cephalexin.

2. Analgesics- Painkillers may be prescribed for associated abdominal or pelvic pain or the burning sensation experienced during urination, although these symptoms are typically relieved with antibiotics.

In case of frequent UTIs, the doctor may prescribe:

• A single dose of antibiotics immediately post-sex.

• A course of low-dose antibiotics for six months.

• Vaginal estrogen therapy if the cause is postmenopausal estrogen decline.

• In severe infections, hospitalization with intravenous antibiotic therapy may be indicated.

Conclusion:

Urinary tract infections with sexual activity are pretty common and are treatable in most cases. However, remember to maintain adequate genital hygiene and engage in sexual activity only after a UTI is fully resolved. UTIs will not put a permanent stop to sex - with proper treatment and consistent, safe practices on the patient’s part, it is only a matter of time until the infection clears up and all forms of sexual activity can be resumed.