A UTI can affect anyone and involve either the lower urinary tract (comprised of the bladder and urethra), the upper urinary tract (the kidneys and ureters), or both. Women are more prone to getting UTIs than men—up to 30 times more likely, in fact—with lower tract infections accounting for the majority of sexual difficulties.
Factors that place a person at risk of developing a chronic UTI include:
Bacterial vaginosis during pregnancy Bladder outlet obstruction Bowel incontinence Diabetes Enlarged prostate Kidney stones Neurologic conditions like stroke and multiple sclerosis Obesity Pelvic inflammatory disease (PID) Pelvic prolapse Pregnancy Premenopause and postmenopause Prior history of severe UTIs Sexually transmitted diseases Urethral stricture Urinary catheters Urinary incontinence
Symptoms
A UTI can often be recognized by symptoms involving the lower urinary tract, including:
The persistent urge to urinate Pain or a burning sensation while urinating Frequent urination, albeit with smaller volumes Cloudy urine Strong-smelling urine Blood in urine Pain in the central lower abdomen, just above the pubic bone Odorless vaginal discharge in females White, frothy urethral discharge in males
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 it easier for bacteria to enter into the bladder.
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 Spermicides
Speak with your healthcare provider 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 cause an infection).
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.
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 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 Diseases
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.
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 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.
When to Call a Healthcare Provider
Urinary tract infections require treatment with antibiotics. Even if a UTI is relatively mild, your healthcare provider will likely recommend a one- to three-day course of antibiotics.
If a UTI is causing dyspareunia, it is typically due to frequent or recurrent UTIs that require more extensive treatment. In some cases, a daily, low-dose antibiotic may be prescribed for six months or longer. In postmenopausal women, estrogen replacement therapy may be advised.
If a kidney infection (pyelonephritis) develops, you need to seek prompt medical attention. If left untreated, pyelonephritis can lead to kidney failure and sepsis.
Back or side (flank) painHigh feverChillsVomiting
Avoid harsh feminine products that promote inflammation and increase the risk of UTIs. Use condoms during anal sex to avoid infection. Avoid switching from anal sex to vaginal sex without first putting on a new condom (or stopping to wash the penis with soap and water). Urinate immediately before and after sex. To avoid a second UTI, wait two weeks after a UTI clears before having sex.
