Sexually Transmitted UTI and How to Prevent It

Urinary tract infections after sex are common phenomena (honeymoon cystitis got its famous name after all those loved up couples post wedding fever). A lot of the bacteria that can cause UTI’s live around the anus, and the physical act i.e. thrusting, of sexual intercourse, can shift bacteria from the back passage toward the urethra, where they can travel up and make themselves home. Females have a shorter urethra (tube passing from the outside of the body to the bladder), which makes it much easier for bacteria to travel up into the bladder and cause an infection.

One of the risk factors for UTI’s is sexual intercourse, which is of course a risk for catching STIs. Chlamydia, Gonorrhoea, Mycoplasma and Herpes can all infect the urinary tract and hence, cause pain when passing urine.

When gonorrhea symptoms occur, they usually appear 1-14 days after infection [1]. The difference is, that in addition to painful urination, symptoms for women include vaginal bleeding between periods, pain during sex, bleeding after sex, abdominal or pelvic pain and/or unusual vaginal discharge. Additional symptoms for men may include painful, swollen testicles, and/or yellow, white, or green discharge from the penis.

With chlamydia, if symptoms appear at all, they typically occur 1-3 weeks after infection [2]. When they do, symptoms for women in addition to painful urination can include similar symptoms to that of Gonorrhoeae, including painful sex, bleeding after sex, vaginal bleeding between periods and/or abnormal genital discharge. Men may experience those same symptoms as well as potential pain or swelling in the testicles. Chlamydia can also infect the rectum in men and women, in which case rectal pain, discharge and bleeding may occur (ouch!).

At least 85-90% of people infected with Chlamydia and Gonorrhoea do not experience any symptoms however [3][4]. This is different for UTI’s where most people will experience symptoms, unless older, where symptoms can be less localised and present with things like confusion, and decline in function.

There are different types of UTI’s, based on which part of the urinary tract is infected. This includes bladder infections (cystitis), kidney infections (pyelonephritis) and urethral infections (urethritis).

Whilst there is a lot of crossover between the two, there are some symptoms that do not occur in a standard UTI. Testing is also slightly different to isolate the causative bacteria between UTI’s and STI’s, which are different.

According to a 2013 review  [5] , UTIs will likely affect at least 50 to 60 percent of women in their lifetime.

This is due to:

1- shorter urethral length ((fancy speak for tube running from the outside in to the bladder)

2- the external urethral meatus (hole urine comes out of) in women is mostly mucosa, or ‘moist’ tissue, like that which is lining the inside of the vagina. This entrance skin is thinner and more sensitive than in men, with irritation predisposing to damage and a potential home for bacteria to make their way up the urethra

3- the female urethra is located closer to the anus, which carries waste and bacteria such as E. coli out of the body, with E.Coli the number 1 culprit bacteria for UTI’s overall.

4- hormonal changes, specifically pre menstrually and in the menopause, can change the microbiome and immune defenses, as well as integrity of the vaginal mucosa of the area (think drier, and thinner), allowing culprit bacteria to replicate and cause infection more easily

UTI’s in men however (specifically cystitis or infection of the bladder) occurs in a very small proportion of males between 15 and 50 years of age, with an incidence is approximately five to eight urinary tract infections (UTIs) per year per 10,000 young to middle-aged males [6,7]. This is due to:

1- longer urethral length

2- a drier periurethral environment (with less frequent colonisation around the urethra)

3- antibacterial properties of prostatic fluid.

UTI’s and STI’s that affect the urinary tract, present similarly in women and men, with some differences based on differences in anatomy.

Prevention is better than cure, and thankfully, some simple practices can reduce the chances of both STI’s and UTI’s.

1- Use condoms: condoms are the only method of contraception that prevent UTI’s. Try our super cute and hydrating beret condoms that don’t just look cute, but perform their job, eliminate confusion in the heat of things, and minimise irritation.

2- Wipe front to back: this is an obvious one for ladies, but important to reduce the chance of bacteria from the back passage moving forward towards the urethra. It’s always handy to have some of our personal wipes in your purse/bag to stay fresh on the go, wherever you are.

3- Get regular STI screening with your GP: Current RACGP (Royal Australian College of General Practitioners) guideline [8] recommend that all people aged 15-29 get STI screening for chlamydia and gonorrhoea at least once a year, with approximately 1 in 20 of those currently testing returning positive tests for chlamydia, often with no symptoms! The frequency of testing, and types of test required (HIV, Hep B, Syphillis etc) also change based on populations and sexual activity e.g. men who have sex with men are recommended to get tested every 3 months.

4- Avoid potentially irritating feminine products: avoid douches, feminine deodorants and powders, they smell nice, but these can irritate the area and disrupt the pH which will predispose to UTI. Rather, wash between the legs with warm water only and no soap. This will ensure the pH of the area is not disrupted.

5- Consider alternative birth control: ditch the diaphragma, unlubricated condoms and spermicide, and talk to your doctor about alternative contraceptives, like our hyaluronic acid condoms.

6- Always, always pee after sex: try to make sure you go to the toilet and urinate shortly after, as this flushes out any bacteria that may have travelled to your urethra from your love making. Follow this with a healthy guzzle of water. Studies frequently show that women, who urinated within 15 min of intercourse, had a lower likelihood of developing a UTI than women who did not urinate afterward [9].

7- Do not share sex toys: this is a no brainer, as this can act as a home for bacteria. Ensure you clean your toys, like our flexible and fun Double Entendre regularly. And don’t forget, if using sex toys in the bedroom, pop one of our cute beret condoms on top, you will hardly notice the difference but have all the protection!

8- Wear loose clothing and cotton underwear: this will reduce changes to the flora in the area that can predispose to UTIs.

9- Use pH friendly lubricants: many lubricants on the market are not pH friendly to the acidic environment of the vagina and contain irritant ingredients, both factors can predispose to UTI’s, so look for one like our Oh La La Love Lube that has been specifically formulated to be kind and gentle to your skin.

1. https://www.nhs.uk/conditions/gonorrhoea/symptoms/#:~:text=Symptoms%20of%20gonorrhoea%20usually%20develop,go%20untreated%20for%20some%20time.

2. https://www.nhs.uk/conditions/chlamydia/symptoms/#:~:text=Most%20people%20who%20have%20chlamydia,disappear%20after%20a%20few%20days.

3. https://sti.guidelines.org.au/sexually-transmissible-infections/chlamydia/

4. https://sti.guidelines.org.au/sexually-transmissible-infections/gonorrhoea/

5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749018/

6. Wilson ML, Gaido L. Laboratory diagnosis of urinary tract infections in adult patients. Clin Infect Dis 2004; 38:1150.

7. Lipsky BA, Ireton RC, Fihn SD, et al. Diagnosis of bacteriuria in men: specimen collection and culture interpretation. J Infect Dis 1987; 155:847

8. https://www.racgp.org.au/download/Documents/Guidelines/Redbook9/17048-Red-Book-9th-Edition.pdf

9. Beisel B, Hale W, Graves RS, Moreland J. Clinical inquiries. Does postcoital voiding prevent urinary tract infections in young women? J Fam Pract. 2002;51:977. [PubMed] [Google Scholar]