UTIs After Sex: Understanding & Prevention

Being scared to have sex because every time you do, the resultant urinary tract infection is unbearable, is a disaster for your sex life. There are a few reasons you may get a UTI after sex, and some treatments you can do to prevent this.

In a urinary tract infection, bacteria live on your epithelial cells – the most outward-facing cells in the urethra and bladder. When your body sheds these cells (normal programmed cell death, apoptosis), the bacteria are kicked off, along with the cell.

The bacteria can then free itself from the cell, and find a new fresh cell to attach to, and multiply. These new bacteria then attach to the fresh epithelial cells underneath.

Biofilms also protect the bacteria, and they can hide underneath, sometimes buried between cells deeper in the epithelial layers.

Bacteria may hide, largely dormant, inside urethral epithelial cells, whereby you may feel fine after successful treatment for a UTI, but then get flare-ups regularly. The same thing happens when you have sex, but in a more mechanical way, with more shedding of epithelial cells.

The epithelial cells shed more during friction, like sex, and the same process can occur. If you are prone to UTIs, one reason you get a seemingly ‘new’ infection is because the bacteria have just been sitting around waiting.

The infection may not be that new; it is just your UTI colonisers doing their thing. When you have chronic UTIs, the tests may come back negative. It’s advisable to get comprehensive urinary microbiome testing.

What we know about diagnosing chronic UTI infections

Dipstick tests are not an effective diagnostic tool
An active infection may not show anything on culture
A culture may show normal growth of pathogens and healthy flora, even when you are showing clear UTI symptoms
Urine may not have many white blood cells (pus cells) despite still having symptoms
Bacteria can embed themselves in epithelial cells, remaining dormant
Urine samples that have delayed testing are ineffective at detecting white blood cells in urine, since white blood cells lyse (break up) after 45 minutes in a jar

Treatment and prevention of UTIs after sex

Avoid semen in the vagina – semen is high in fructose, an energy source for UTI-causing bacteria.
Use a probiotic vaginally after sex as a prophylactic (preventative) – remember a UTI typically takes 48 hours to appear after sex due to the incubation period, so use the probiotic right after and use for 1-2 days if needed. But, one probiotic can be enough.
Use the Oral UTI Herbal Blends for 1-2 days as per the acute dosing instructions on the label to treat or prevent a UTI after sex.
Methenamine (Hiprex) can be used short-term
If you have recurrent UTIs, see a My Vagina specialist practitioner for 100% holistic, effective care to interrupt the cycle by identifying and treating the root cause of your infections.

References^1–4

1.
Gill K, Kang R, Sathiananthamoorthy S, Khasriya R, Malone-Lee J. A blinded observational cohort study of the microbiological ecology associated with pyuria and overactive bladder symptoms. Int Urogynecol J. Published online February 17, 2018:1493-1500. doi:10.1007/s00192-018-3558-x
2.
Kupelian AS, Horsley H, Khasriya R, et al. Discrediting microscopic pyuria and leucocyte esterase as diagnostic surrogates for infection in patients with lower urinary tract symptoms: results from a clinical and laboratory evaluation. BJU International. Published online January 10, 2013:231-238. doi:10.1111/j.1464-410x.2012.11694.x
3.
Brubaker L, Wolfe AJ. The Female Urinary Microbiota/Microbiome: Clinical and Research Implications. Rambam Maimonides Med J. Published online April 28, 2017:e0015. doi:10.5041/rmmj.10292
4.
Khasriya R, Khan S, Lunawat R, et al. The Inadequacy of Urinary Dipstick and Microscopy as Surrogate Markers of Urinary Tract Infection in Urological Outpatients With Lower Urinary Tract Symptoms Without Acute Frequency and Dysuria. Journal of Urology. Published online May 2010:1843-1847. doi:10.1016/j.juro.2010.01.008