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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.1,3
What we know about diagnosing chronic UTI infections
- Dipstick tests are not an effective diagnostic tool4
- 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 with delayed testing are unreliable for detecting white blood cells, because white blood cells break down quickly in a stored sample, so the count has to be done on fresh urine2
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 Formula 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.
Frequently asked questions
Why do I keep getting a UTI after sex?
Bacteria can sit, largely dormant, inside the cells lining the bladder and urethra. The friction of sex sheds those cells and releases the bacteria, so what feels like a brand-new infection is often the same bacteria flaring up again.
How can I prevent a UTI after sex?
Options include a vaginal probiotic used soon after sex, an oral UTI herbal formula for a day or two, avoiding semen in the vagina, and short-term methenamine (Hiprex). If UTIs keep recurring, it is worth finding and treating the underlying cause rather than repeating antibiotics.
Why do my UTI tests come back negative?
Standard urine tests miss many chronic and embedded infections, so a comprehensive urinary microbiome test can give a clearer picture when symptoms persist despite negative results.
This article is general information and not a substitute for personalised medical advice. If you have recurrent UTIs, please see an experienced practitioner.
- 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. International Urogynecology Journal. 2018;29(10):1493–1500.
- 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. 2013;112(2):231–238.
- Brubaker L, Wolfe AJ. The Female Urinary Microbiota/Microbiome: Clinical and Research Implications. Rambam Maimonides Medical Journal. 2017;8(2):e0015.
- 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. 2010;183(5):1843–1847.
