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Forum Name: Urology Topics

Question: Urinary trackt infections after sex


 camara - Sun Apr 10, 2005 3:54 pm

Hello, could anyone please explain why after I have sex with my husband I get re-occurent urinary tract infections? We have sex about 3-4 times a week and when we have sex it may last for over an hour. I have been with my husband now for 4 years and both of us are monogomus, so I don't think there are any diseases involved.

I was watching Sue Johanson Talk sex show and she said that most women, if they have sex more than three times a week, they get UTI, but she didnt explain why and I would definitely like to know why this is?
It is very painful and i usually have to get Antibotics to cure it and take away the pain.
Because of this I end up not wanting sex because i get affraid that when I do, I will get another UTI.

Any ideas?

Thank you -

C
 Kazzy - Mon Apr 11, 2005 7:57 am

Hi,

Sex is a very common cause of urinary tract infections in women. From what i understand it's not so much the frequency but the act in itself. The fact that you have sex often only increases your chances.
The reason sex can cause infections is due to the fact that during penetration you're allowing bacteria to enter.
The best way to help stop this problem occurring is to make sure you urinate as soon as possible after having sex.
Also make sure you don't "hold on" too long even if you haven't had sex. Holding on rather than urinating when you need to encourages bacteria growth.
I'm not an expert on the matter so you may want to check with a professional although due to health problems with my daughter have done quite a bit of research.
I hope this has been of help to you and i wish you all the best.
Kazzy
 camara - Mon Apr 11, 2005 10:48 am

Hello Kazzy,

Thank you for your concearn. So in this case you are saying that UTI's come from the act of penetration and how this can cause bacteria to accumulate and enter the urinary tract?
Would you know where the bacteria comes from?
I will indeed take on your advice to urinate right after sex and try not to hold it too long in general. I already have a weak Urethra from all the times i have had UTIS! Last year I had 4! and one of the times it was so bad I even started bleeding from my urethra. Ouch! not good.
This does indeed put me off sex - as you can imagine, i start to associate sex with pain instead of pleasure :(

But thank you so much for your reply - I hope your daughter also never has to suffer from these again!

C
 Dr. Anthony Solomon - Mon Apr 11, 2005 10:05 pm

It is necessary to explain the anatomical and medical reasons why you experience frequent urinary tract infections after sex.

Comparatively, females are more prone to urinary tract infections (UTI) due to the anatomy of the female genitourinary tract. The female urethra is short (4cm in length) and opens very near and just anterior to the opening of the vagina. The short urethra facilitates the ascent of infective organisms from the vaginal opening into the bladder. Due to the inward and outward movements during a sexual act, a copious amount of secretions and organisms present in the vagina is made available at the vaginal opening for ascent into the bladder.
There are female-specific factors that cause some women recurrent UTI. Women with recurrent UTI
(a) have more binding sites for infective organisms on the linings of the vagina and urethra.
(b) lack an enzyme in the secretions of the linings of the vagina and urethra, which normally masks these binding sites, making these binding sites more available for infective organisms.

Therefore, it is not the frequency of sex that causes recurrent UTI, but in
all women, the proximity of the short urethra to the vagina; and in
some women the abundance of binding sites for infective pathogens and the lack of an enzyme blocker.

In general, women who have recurrent episodes of UTI must be evaluated to determine if they have an uncomplicated or a complicated UTI. This is mandatory in your case and the first line of action.

In uncomplicated UTI, the urinary tract has no structural abnormality, the renal function is normal and there is no associated disease which impairs defence mechanisms.
In complicated UTI, the urinary tract is abnormal due to obstruction or kidney disorders, or there is an associated disease that predisposes to it, such as diabetes mellitus.

It is important to establish the presence of UTI at the onset of symptoms before commencing antibiotic use. This is done by subjecting a fresh, middle stream specimen of urine to microbiological and sensitivity tests. Taking antibiotics without identification of the causative bacteria and their sensitivity may not eradicate the infection, and this usually results in bacterial resistance.

The following are recommended preventive measures to be adopted by women with recurrent UTI, irrespective of the cause. This regimen should be started after a curative course of treatment, based on results of microbiological tests.

*Fluid intake of at least 2 litres per day
*Regular emptying of bladder : 3-hourly intervals by day and before bedtime
*Complete emptying of the bladder at each micturition
*Double micturition before retiring for the night: empty the bladder and then attempt to empty the bladder a second time 15 minutes later.
*Empty bladder before and after intercourse

I hope this information is helpful.


Dr Anthony Solomon
MB BS DTM&H DIP.VEN FRSM
Connsultant Physician, Tropical & Genitourinary Medicine
 camara - Tue Apr 12, 2005 10:29 am

Dear Dr Anthony Solomon,

Thank you for your very, very informative reply post.
Would you know how a doctor would check for complicated UTI? Would it be done by simply having a Urine test? Or Would the doctor need to examine my urinary tract and kidneys? In the past when I have had UTI, i happened unfortunately to get them while on holiday in a foreign country, so I would end up taking pain killers to forget about the pain as I wouldnt not be able to see a doctor right away -there were two such incidences where i got UTIs abroad and waited 4-5 days in agony until i got back to my own country to get some antibiotics. I am afraid that having left it for so many days - both times, that the infections may have damaged any interior organs?

Camara [/b]
 Dr. Anthony Solomon - Thu Apr 14, 2005 6:10 am

The urinary tract can be evaluated by urine tests, renal function tests, and imaging procedures.
Imaging procedures may be conducted by
(a) an ultrasound of the urinary tract - kidneys, ureters and urinary bladder - which is safe and non-invasive or
(b) an intravenous urogram.



Dr Anthony Solomon
 lexie123 - Mon Nov 02, 2009 6:01 am

I've had the same problem as yours. As a matter of fact, it's 5:48 a.m. my time now and I am on my laptop writing this post...and right at this moment, I am suffering from pain from UTI. Like you, I always get UTI after my husband and I would have sex. The pain usually starts about a day after we have sex. I do urinate before and after sex...and wash before and after sex but I still get it. Eversince I first had it (when I was 12 weeks pregnant), I've had it so frequently that my doctor would always give me Macrobid to treat it.

I've been evaluated for it last year. I saw a urologist and did a VCUG (Voided Cystourethrogram) where they've injected a dye in my bladder and while I was going, they were taking pictures of my bladder and urethra to see if there was some kind of reflux going on, but everything was perfectly normal. I've done the Cranberry Juice treatment a lot of times, even took cranberry fruit pills everyday and would still get it. Like you, I have been scared now to have sex because I'm afraid that the next day, I would feel the pain when urinating. I couldn't count how many times I've had UTI this year alone. I've had one just two months ago and here I go having another UTI again. The urologist has even put me on Macrobid 100mg that I took once a day for the entire 3 months. I haven't had infections while in the medication, but a couple of months after that, I would get it again and is always triggered by sex. My primary care doctor has also asked me to have a CT scan of my kidneys to make sure that my kidneys are not the primary reason why I'm getting the frequent UTIs, but my results all came back normal.

I am very frustrated...I have done everything possible but I still couldn't prevent it. It has become a part of my life now. I will have to call my doctor's office first thing in the morning to see what they can do for me. The past couple times, I would always get it on a weekend and I could just call my doctor and he would call my pharmacy for Macrobid. I started feeling the symptoms last night and it has escalated already...the pain is really sharp even after taking AZO which I always have with me at home.
 nbkg1sb - Wed Feb 03, 2010 2:53 am

I understand everyone's pain here. I've had re-current UTIs since I was 3 years old and more recently found out that I have IC as well. Unlike some people who are asymptomatic when having a UTI, I have full blown burning, stabbing pain when urinating; lose control of my bladder to the point that I cannot leave the bathroom for urinating in drops every few minutes which in turn send spasms through my body with each drop. This like someone mentioned before is always within 12 to 18 hours of sex, regardless of urinating before and after sex. After cystoscopes, x-rays, ultrasounds, stretching of my urethra, etc. nothing works completely. I've seen many specialist and not specialist over the years. To add injury to insult, I almost died at age 10 from taking sulfa drugs for the infections when my doctor didn't recognize the symptoms of my body having an allergic reaction to the drug. In my research I found that the bacteria that grows in the intestines is usually the number 1 culprit of UTIs. Thus the sex act helps the bacteria from that area move and be pushed up into the urethra. As the Dr. said in his earlier post, the many causes are the length of the urethra and the binding of these bacteria to the walls of the urethra. There are many drug trials going on and research being done to try and come up with something to help the percent of the population that have the problem of lacking the enzyme to protect the walls of the urethra. Soooo....what works? Well, Macrobid 100mg daily is a starter course until your body gets use to the anti-biotic. Now, Macrobid is used because it isn't a broad spectrum antibiotic (meaning it is not affective for multiple types of infections) Macrobid or Macrodantin are work specifically on the kidneys, bladder, and urinary tract. This is why it is the first preventive drug prescribed by physicians. Ultimately, when these stop working the doctor will have to move to a different antibiotic which unfortunately will have to be a broad spectrum one, as there are only so many antibiotics out there. This causes many problems as you can guess because eventually there will be no antibiotics left to use on you for any infection. Now for the pain, Pyridium 200 mg is the usual drug of choice by physicians. I've found that Pyridium Plus works significantly better for all of the pain and symptoms I have but it has been discontinued. I've also heard rumblings that Pyridium as well is no longer being produced which will be a nightmare for thousands and thousands. Over the counter you can buy Azo-Standard, which is the same drug that is in Pyridium at much lower doses. There is also Cystex which includes an antibacterial that can help to slow the progression of the infection until you can get to the doctors office. It will not however get rid of the infection. Cranberry juice is only helpful before you get the infection.If you already have the infection the lining of your urethra will be so inflamed that the acidity of the juice will increase your painWater water water is a necessity as the more dilute the urine if you have an infection the lesser the pain. Additionally, by keeping your bladder full you force lots of bacteria out of your bladder every time you urinate. Sitting in a tub of warm to hot water (NO SOAP) will help relieve pain until you can get to the Dr or while you are waiting on the antibiotics to do their job. . I've found that the size of your partner can increase infections as well as the positions used during intercourse. Take showers not baths. Drink 48 or more oz of water daily. Wear cotton underwear. Sleep without underwear. Wipe from front to back. Limit or cut out caffeine intake. Reduce milk intake. Wear loose clothing. Use unscented toilet paper. Urinate often. Empty your bladder. Limit alcohol intake. Keep pyridium or something similar on hand. If you are getting infections 50% or more of the time after sex, see a physician for a preventive prescription of Macrobid or Macrodantin. Try taking after sex or if you have trouble remembering to have the antibiotic with you because you're being spontaneous, take Macrobid daily. Urinate before and after sex. Make sure your partner is clean and you are clean before sex. Never switch from anal sex to vaginal sex as this will ensure the bad bacteria is brought in contact with your urethra.

I wish I had better news but all we can do is continue to research the subject and keep aware of new discoveries. Just know you're not alone!
 dliske - Thu Jul 22, 2010 9:33 am

Question,

My wife and I suffer from this dilemma as well. Cleaning both her and I before having sex seems to help, however it is less than romantic. Is there any wipe that I could use and she could use (Along the lines of a baby wipe) that would work well for this issue?
 ausgirl - Sun Jul 25, 2010 6:36 pm

Hi there

Im 21 and have had this problem ongoing since i was about 18. I was getting urine infections every 1-2 weeks, from any little thing (sex, holding on to my urine etc), and was constantly on meds. No one ever really checked out why it was happening, just giving me meds to get rid of it.

They were so bad it would cause the burning and bleeding every time. I tried everything from cranberry juice/tablets to the peeing before and after sex, the proper 'wiping' after going to toilet.

It was only a few months back that a doctor I visited decided it was not on, and ordered scans of my kidneys (this was after the infection this time reached my kidneys - its horrible, you cannot sleep or lay down or walk!)

After having scans done, it was found I had a cyst bigger than a tennis ball that had grown on my ovary. As it was so big, it was pushing on my urethra causing blockages and therefore infections every week.

Since having this removed (along with my ovary), i thought all was well as it had been just about 2 months since my last infection.

Now that i have got back in to having sex, the infections are back! its not just sex though. I can be BUSTING to go to toilet when i wake up from a nights sleep and BANG, infection.

Completely stumped now. May head back to docs. But for the women out there that get them constantly, perhaps get those scans done and check you don't have any issue internally.

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