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That burning feeling when you pee: Urinary tract infections 101

UTIs can be related to sex and birth control, but no worries: you can stop them in their tracks.

by Valerie French, MD
over 2 years ago

You just peed, yet you feel like you have to go back to the bathroom. No matter how many times you sit down on the toilet, you can’t shake that feeling. And when you do pee, it burns. We’ve all been there. Most likely, you have a urinary tract infection (UTI).

A UTI most commonly refers to an infection of the bladder—the part of your body that holds your pee. UTIs are very common: Some experts estimate that half of sexually active women will have a UTI at least once in their lifetime and each year over 10 million people in the U.S. go to a health care provider for help with a UTI. Luckily, UTIs are usually easy to treat.

What causes a UTI?

A UTI happens when bacteria from the vagina or rectum get up into the bladder and cause an infection. Some bacteria are more likely to cause UTIs than others, but the most common culprit is the bacteria E. coli. UTIs related to sex can happen because bacteria gets rubbed across the opening of the urethra (the tube that lets your pee out of your bladder).

How do I know if I have a UTI?

Some of the most common symptoms of a UTI are burning or pain with urination, the feeling that you have to pee all the time, frequent urination, and occasionally blood in the urine. Sometimes a laboratory test called a urinalysis is done to check for white blood cells in the urine—these are your body’s natural response to an infection. When needed, your health care provider may send your urine to a lab to see if bacteria grow in it (known as a urine culture). FYI, if you have a penis it can be more complicated to figure out whether you have a UTI or something else.

What do I do if I have a UTI?

If you think you have a UTI, don’t panic. The treatment is easy and you can take some simple steps to prevent future UTIs. The first thing you should do if you have UTI-like symptoms is contact a health care provider—even if you’re not sure. An untreated UTI can spread from the bladder up the tubes that connect it your kidneys, and kidney infections are serious business. Just don’t go there.

Sometimes your provider may offer you treatment over the phone and sometimes your provider will want to see you in person. The usual UTI treatment is antibiotics for 3 to 7 days, depending on the type of antibiotic. Note: It’s important to take all the antibiotics you get, even if you start feeling better, to make sure the infection is completely gone.

Eff. My UTI is back.

If you have three or more UTIs in a year, your health care provider may tell you that you have “recurrent UTIs.” Recurrent UTIs are common. One study found that just over one in four women had a recurrent UTI within six months of their original infection. A few things increase the risk for recurrent UTIs, including having frequent sex, having a new partner, and using spermicide or a diaphragm. If you think spermicide or diaphragm use might be a factor for your recurrent UTIs, consider exploring other birth control options. It’s also possible that you may be more likely to get UTIs just based on your anatomy, like if your have a shorter distance between the urethra and the anus.

Can UTIs be prevented?

There is good news if you have recurrent UTIs: You can take some simple steps to help prevent them. These suggestions aren’t necessarily driven by science, but they do make common sense.

  • After going to the bathroom (number 1 or number 2), wipe from front to back.

  • Avoid douches and using soaps with fragrance down there.

  • Don’t hold it! Head to the restroom as soon as you have the urge to pee.

  • If you can, pee before and after sex. Wear cotton underwear.

  • Drink plenty of fluids to flush out bacteria—caffeinated and alcoholic beverages don’t count.

If the above steps don’t work, talk with your health care provider about other options. Your provider may recommend taking a very low dose of an antibiotic, a strategy known as prophylaxis. Some women take the antibiotic every day, and some take it only after having sex, also known as post-coital prophylaxis. Taking the antibiotic after sex is more likely to work if your UTIs are related to sex and not some other factor. Either way, we have lots of research showing that antibiotics are really good at preventing UTIs and can reduce recurrent infections by up to 95%.

What about cranberry juice? Probiotics?

While certainly not harmful, the science behind drinking cranberry juice or taking cranberry tablets to prevent UTIs hasn’t clearly shown that it helps. Some studies suggest that probiotics might reduce the frequency of UTIs, but this hasn’t been proven. Like with cranberry juice, it doesn’t hurt to take a probiotic, but it might not help you avoid future UTIs either.

Onward and upward

A UTI is a drag, recurrent UTIs can be frustrating, and both are surprisingly common. The good news is your provider can help set you on a path to comfortable peeing. So grab your water bottle and call your health care provider to get rid of and prevent those pesky pee symptoms.

Valerie French, MD, MAS, completed a fellowship in family planning before joining the Ob/Gyn faculty at the University of Kansas. She loves working at a teaching hospital and sharing her passion for family planning with learners. Dr. French is interested in improving access to reproductive health services in under-served areas, as she herself had difficulty obtaining birth control in college.

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