Dear Alice,
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Alice,
I'm a sexually active college female in a monogamous relationship, where we use condoms and spermicide. What's bothering me is that I keep getting urinary tract infections, practically once a month. Every time I go into the health center at my school, they take a urine sample, and take a culture, since it's been reoccurring so often, but nothing else has become of that. I feel as if I drink cranberry juice religiously. Is there anything else I can do to stop this?
Dear Reader,
Urinary Tract Infections (UTIs) are so common that most women and some men get them at some point in their lives. For some women, UTIs are a recurring problem, leading to hours or days of discomfort and pain, countless courses of antibiotics, feelings of frustration, and negative feelings toward intercourse or penetration.
In your case, it's important that your diagnosis has been confirmed by rigorous testing each time. For example, if you had a positive urine analysis result (i.e., many white blood cells, the presence of bacteria, possibly a large number of red blood cells), was a 48-hour culture then done to count the number of bacterial colonies, the type of bacteria involved, and which antibiotics the bacteria are sensitive to? You can ask someone at your school's health center about what specific tests have been done. Also, have your infections ever been treated with antibiotics?
If your diagnosis is being made solely on the basis of your symptoms, then what you have is likely not caused by a urinary tract infection. Irritation to spermicide and/or condoms is one possibility. Others include a vaginal infection that is irritating to the urethra, or an anatomical predisposition that causes the urethra to get compressed during intercourse. A pelvic exam, rarely done when diagnosing a UTI, can identify the presence of these two possible causes.
Since you wrote that you get a UTI on a monthly basis, perhaps your symptoms are cyclical and related to your period. Intercourse during menstruation often precipitates a UTI because blood is a medium where bacteria thrive.
Your health care provider can help you to find out if your UTIs are recurrent infections, meaning infections with the same organism that are inadequately treated, or re-infections after adequate treatment and a cure. One reason why otherwise healthy women get repeated infections is because previous infections can damage the internal lining of the bladder, called the mucosa, which may necessitate longer courses of antibiotic treatment. The mucosa is an essential barrier to the bacteria that normally enter the bladder. Treatment in this manner allows healing so that simpler measures will work more effectively the next time there's an infection.
At this point, it may make sense to see a urologist, who can figure out exactly what's going on with you. The urologist may perform a cystoscopy, to rule out interstitial cystitis, and/or put you on prophylactic or post-intercourse antibiotics or some other treatment. It's important to treat infections as soon as you have symptoms. Frequent UTIs are not normal and need to be rigorously evaluated. Being vigilant can be key to managing frequent infections.
In the meantime, while you take care of yourself medically, these prevention strategies help decrease the number of bacteria in the bladder and/or can boost immunity to those bacteria that do make it in:
- Drinking 6 - 8 glasses of water a day is thought to be helpful in flushing out the bacteria, as frequent passing of water by urination can help prevent bacteria from reaching infectious numbers in your bladder. (By the way, bladder irritants, such as caffeine, alcohol, and spicy foods, can aggravate symptoms, but won't cause an infection.)
- Changing sexual positions so that a penis or finger is not rubbing or "knocking boots" directly against your urethral opening (pee hole). Sexual intercourse and/or penetration can push bacteria into the bladder.
- Emptying your bladder before and after sex could help flush out bacteria, which can reduce your risk.
- Learning about alternatives to spermicides, including condoms coated with non- spermicidal lube, other contraceptive options, and safer sex techniques, and discussing them with your partner and health care provider, are good ideas. Spermicides can alter the variety of bacterial flora in the vagina, killing off friendly bacteria and allowing pathogenic ones to flourish, causing an infection.
- Boosting your immune system, by eating plenty of fruits and vegetables rich in antioxidants, vitamins, and fiber; exercising; refraining from or quitting smoking; and, getting enough sleep. Similar to how we are more prone to colds when we are run down, the same applies to UTIs.
- Taking antibiotics after sex prescribed for you by your health care provider can be useful when other methods prove ineffective.
When you get a UTI, your body will try to acidify your urine to stop bacteria from growing, causing the burning feeling when you urinate. Continue drinking unsweetened cranberry juice, as cranberries contain an acid that lowers the pH of the urine, making it more acidic. Cranberry tablets (a.k.a. CranActin), available at many health food stores, also can be taken as an effective supplement/alternative. If you are a Columbia student, log on to Open Communicator to make an appointment with a provider from Medical Services.
Hope you feel better soon!
September 13, 2006
Dear Alice,
I had the same issue for months, but it was only mildly irritating and always seemed to occur after oral sex or intercourse. My partner and I took steps to ensure we were extra clean before and after play time, but I kept getting the symptoms on a monthly basis.
It started to get really bad, lasting for days, and once I realized I was passing a little blood in my urine, I went to my gynecologist. All we were able to do is determine is that I didn't have a UTI, STD or vaginal bacterial infection. She recommended I eat, exercise, and sleep better to boost my immune system, and if I ever saw blood again, to see a urologist.
I never did see the urologist because at the same time I switched from BC pills to an IUD and the episodes never came back. I don't know if it was a cyclical thing that was remedied by stopping the pill, or the change in my lifestyle habits, or both.
I hope my experience can help others figure out what's going on with them and what may help. I know it can be terribly frustrating and scary!
October 31, 2003
Dear Alice,
I've been reading the questions on Urinary Tract Infections (UTIs) and I have some great advice to offer. I am a female that at one time in my life had a UTI almost Every Single Month....
Dear Alice,
I've been reading the questions on Urinary Tract Infections (UTIs) and I have some great advice to offer. I am a female that at one time in my life had a UTI almost Every Single Month. The tests showed common E. coli. bacteria, which it was clear came from the anus... Even though I didn't have anal sex, I showered regularly, and I never wiped but washed myself down there after going to the bathroom — I still kept getting these E. coli. in my urinary tract!! Numerous times I've been on antibiotics, drank cranberry juice every day, had radiology exam for infection, peed after intercourse — none gave any permanent solutions. My next decision was washing thoroughly with soap and water all the area between my legs — before and after sex. It worked like Magic!!! Bacteria are very, very small — and even if you think you are clean down there because you've washed perhaps a couple hours ago — it is always good to wash right before/after intercourse. After I've established this washing protocol, I had UTIs only when I was too lazy/tired to wash myself before and after, or if I skipped the soap. And that's my success story in conquering the UTIs.