Sex, Drugs & Cranberry Juice: What You Need to Know About UTIs

It’s true that urinary tract infections (UTIs) are the most common form of bacterial infection among women. And also true that some of our favorite activities — sex anyone? — increase our odds of getting a UTI.

But don’t despair; there are ways to reduce your risk. 

What are the symptoms of a urinary tract infection?

The defining symptoms of a urinary tract infection are a painful burning sensation when you pee, feeling an urgent need to pee, and frequent urination. “In order to call it a UTI, you need to have at least one of these symptoms,” says Ann Stapleton, M.D., an infectious disease specialist who practices at University of Washington Medical Center-Roosevelt.

What causes a urinary tract infection?

Most UTIs are caused by E. coli, bacteria that normally live in your intestines, where they help to break down and absorb nutrients from your food. But when E. coli bacteria get into parts of your body where they don’t belong — like your bladder — they can cause infection. 

E. coli is the most common cause of urinary tract infection, but other bacteria, too, can travel from your rectum to your bladder, where they may cause an infection. 

What should you do if you have a urinary tract infection?

If you have a urinary tract infection, you should get it treated. UTIs can be treated at a primary care clinic, urgent care clinic or virtual clinic.  UTIs account for more than 20 percent of UW Medicine Virtual Clinic visits.

What is the recommended treatment for a urinary tract infection?

This is where the drugs come into play. A healthcare provider will prescribe an antibiotic to treat a urinary tract infection. Be sure to take the entire course of the prescription, even if your symptoms resolve before you finish.

You may also receive a second drug prescription for pain medication that numbs your bladder and urethra and relieves the burning sensation when you pee.

What could happen if you leave a urinary tract infection untreated?

The primary concern is that the infection could spread from your bladder to your kidneys, where an infection can do irreversible damage. You could also develop sepsis, a life-threatening complication of infection.

What are the symptoms that a urinary tract infection is getting worse and what should you do if this happens?

Fever, chills, blood in your urine, severe back or side pain, nausea or vomiting, and the feeling that you are getting sicker all warrant a visit to the healthcare provider or even the emergency room if the symptoms are severe,” says Stapleton. These symptoms all indicate that your infection is worsening, and could be spreading to your kidneys. “Vaginal discharge that is smelly, blood-stained, green or yellow, or frothy or chunky in texture also merits a visit to the doctor as you could be dealing with a vaginal infection,” she says.

What does blood in the urine mean?

While scary, blood in the urine does not mean that you are about to die on the spot or even that your urinary tract infection is particularly bad. But you should see a healthcare provider if you have this symptom, known as hematuria, as it can also be a sign of diseases other than UTI. 

Sometimes sexually transmitted infections, kidney stones, overactive bladder or pelvic floor dysfunction can share some of the same symptoms as UTIs.

Does sexual activity contribute to UTIs?

Yes, many types of sexual activity can lead to UTIs. Bacteria from the colon and vagina can get into the urethra during oral sex, finger play, use of sex toys and sexual intercourse.  That’s because bacteria that is in or near your vaginal opening can be introduced into the urethra during these activities.

Can spermicide use increase the risk of UTIs? 

Our skin, gut and urogenital system are all normally inhabited by a variety of bacteria, which are part of our natural microbiome and play a beneficial role, including helping to protect us against harmful microbes. Like other microbial systems of our body, the urogenital microbiome is a balance of “good” and “bad” bacteria.

"Spermicide, specifically nonoxynol-9 spermicide, kills lactobacillus, a good bacterium,” says Stapleton. 

By killing good bacteria, spermicides alter the microbiome balance, allowing bad bacteria to gain a foothold.

“If you’re using spermicidal condoms or a diaphragm with spermicide and also getting UTIs, you may want to try alternative birth control methods and see if that makes a difference,” she says.

What should you do if you keep getting urinary tract infections?

It’s best to see a healthcare provider and get a culture of your urine if you have a recurrent infection – one that comes back after treatment. The type of bacterial infection you have will influence how a healthcare provider treats it. It’s also a good idea to get checked out to be sure that nothing else is going on, says Stapleton.

Can you pass a UTI to a sex partner?

“We don’t know for sure if that can happen. But we do advise you to wait until your UTI has cleared before resuming sexual activity as this will give your own bladder a break from a new influx of bacteria and allow inflammation to resolve,” says Stapleton.

Why do some women get more urinary tract infections than others?

“There may be subtle genetic factors that influence why some women get more urinary tract infections than other women, but we don’t yet have the full picture,” says Stapleton.

Regardless of your genes, your behaviors also influence the frequency of urinary tract infections, and there are preventive steps you can take.

What can you do to prevent a urinary tract infection?

The preventive measures that you can take are:

Pee before and after sexual activity. Urine helps to flush bacteria from your urinary tract.

Don’t use douches, deodorant sprays, scented soaps or powders. Products such as these disrupt the bacterial balance of your urogenital microbiome, contributing to the likelihood of a urinary tract infection.

Don't soak in tubs. Don't sit in hot tub or bathtub for long periods of time. Soaking for extended periods of time allows bacteria — from your body or someone else’s — time to enter your urethra.

Use a birth control method that does not require spermicide. If you use spermicidal condoms or spermicide with a diaphragm, change your birth control method.

Stay hydrated. Drinking plenty of water ensures that you’ll urinate more often. This helps to flush bacteria from your urinary tract before an infection begins.

Drink cranberry juice. The debate about whether cranberry juice may help prevent urinary tract infection has gone on for years. Most research seems to debunk the theory, but some suggests that cranberry juice may help to prevent UTIs. Anecdotally, many women report that drinking cranberry juice seems to help prevent UTIs, says Stapleton.

Take a probiotic. Probiotics may help to maintain the natural bacterial environment of your vagina. "We know that if we look at people around the time of a UTI, and right before that, the good bacteria are gone from the vagina. That suggests that replenishing them might stop a urinary tract infection from happening again."

Wipe from front to back. Wiping from front to back will help to prevent bacteria from your anus from spreading to your urethra.

Clean your sex toys. Clean sex toys with hot water and soap after each use, before switching to use on a partner, and before switching from anal to vaginal use.

Don’t switch from anal to vaginal sex without a wipe-down or new condom. Wipe down a penis just like you would a sex toy when switching from anal to vaginal sex. If he’s wearing a condom, put a new condom on first.

Eat a healthy diet. “While we don't know the exact correlation between good nutrition and our immune system, we know that there is a link, and that eating well is good preventive medicine,” says Stapleton.