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Q&A with J: Protecting Yourself from Infection

Today’s question’s involves infections that sometimes happen to women post-sex. Here’s what the wife asks:

I am a 44-year-old newlywed. My husband I both waited for each other all those years, and I’m so glad we did! Marriage is a blessing and he was definitely worth the wait.

[Wow. Insert applause here! Well done, you.]

Because I was never sexually active, I didn’t really think about it, or even know about what new brides bodies go through (I felt so naive for such an old lady!). Consequently, I’ve suffered UTI’s and the latest Urethritis. I’ve felt so bad for so many months that I’m afraid I’ll never feel normal again. I have a great Christian doctor, so there is hope! So, my question to you is, how do I protect that part of me while having sex? I’ve experienced some pain while going through this and don’t want to neglect my husband out of fear it will return. Besides the normal, hygiene, cranberry pills, lots of water advice; is there anything you can tell me to help me in the actual mechanics of sex? And how to keep away (or at least protect) that part of me?

Q&A with J: Protecting Yourself from Infection

For those who don’t know the tried-and-true suggestions, here’s a quick run-down:

  • When using the bathroom, keep your wiping separated. Doctors recommend wiping front to back, to keep harmful bacteria from the rectal area from reaching your more delicate urethral opening.
  • Empty your bladder before and after intercourse. There’s conflicting advice on this one, some saying only after. I simply have my own experience of a gynecologist suggesting before as well and me noticing an improvement. But ask your doctor.
  • Drink plenty of liquids, especially water. You need to flush our your urinary tract regularly anyway, but even more so with the possible introduction of irritants.
  • Keep his and her areas clean. Bacteria causes infection, and good washing and hygiene prevent the appearance of bacteria. You could shower before, even together, or simply clean your genitals with a damp cloth or cleansing cloths you can buy (like these from healthy hoohoo).
  • Drink cranberry juice, and keep cranberry pills around just in case. Cranberries somehow prevent bacteria from attaching to the urinary tract. It’s not a cure-all, but it is a prevention technique and it can ease painful urinating if you do get an infection.

Those are the basics for preventing urinary tract infections. But you might get infections anyway. Let’s look at why and some suggestions for the “actual mechanics of sex” to help you avoid this unpleasant experience.

Potential Contributors

The reason we wives get more urinary tract and bladder infections is that our urethra is closer to our vagina and anus than for men. It’s easier for bacteria to navigate where it doesn’t belong and get trapped. Women also have a shorter urethra, so the bacteria doesn’t have to travel as far. That may not sound fair, but there it is.

(And since we can have multiple orgasms, maybe things balance out somehow.)

In addition to our anatomy challenges, and the causes implied in the above advice, here are a few other potential contributors:

Your birth control method. Although the diaphragm was my favorite form of birth control, it is linked with a higher incidence of UTIs for some women. That’s also true of certain oral contraceptives, spermicides, and female condoms. These can irritate the urethra, making an infection more likely. So if you’re on contraception, check with your doctor to ensure that your method is not contributing to your infections.

You’re up against menopause. At age 44, I doubt this is the issue. However, I feel I should mention that menopause, and perimenopause, can affect women in various ways — including an increase in UTIs. From the little bit I read, extra estrogen could clear that up. But I’m not a doctor, so — once again — chat with your physician if you believe this could be an issue.

He’s uncircumcised. I’m well aware of the ongoing debate about whether to circumcise infant boys, and I’m not getting into that. I simply want to point out that uncircumcised males have a higher risk or UTIs themselves and of passing on bacteria to their wives (American Academy of Pediatrics; “Study: Uncircumcised Boys Have a Higher Risk of UTI”.) There’s some contradictory research, of course, but the upshot is that doctors recommend extra-careful cleaning for uncircumcised adult males. Bacteria can get trapped around that foreskin, so why not take additional time to make sure that’s not a contributing issue?

You have allergies. You could have an allergy to ingredients included in soaps, lotions, bubble baths, etc. If you have a sensitivity to such products, you should stop using them and find alternatives. See an allergy doctor to find out if this is an issue, or run your own test by cutting things out and seeing how your body responds. Then make changes accordingly.

You’re new at this. For most wives, UTIs are more common early on. We are more sensitive to sexual friction and bacteria at the beginning, and it gets better over time. Indeed, bladder infections have been called “honeymoon cystitis” due to their prevalence in formerly virgin newlyweds. As your body grows more used to the activity and gets a little tougher, so to speak, you might find that your infections decrease in frequency.

Sexual Mechanics

Anal contact. I have strong concerns about anal sex, because God did not create our anus to be responsive the way a vagina is. It’s simply not the same. Health workers also report more injuries and infections for those who engage in anal activity. Likewise, I have no idea what your sexual repertoire entails, but if doctors say not to wipe with toilet paper from your rectum toward your urethra, then it hardly sounds like a great idea to involve that area in sexual activity. Particularly if you tend to have infections. Consider that as you and your husband decide what you will or won’t do in your marriage bed.

Friction. Take it easy. “Harder and faster” probably shouldn’t be your clarion call in the middle of sex. Until your UTIs are more under control, he should be easing in and rhythmically thrusting, rather than pounding it in and out. To that end, you may need to help things out by making sure he’s comfortably sliding in. You can reach down and guide his penis and/or use your hands to spread your vaginal lips so that things don’t get, well, folded and scrunched up down there. When he’s inserted correctly, the contact should be with your inner vaginal lips and vagina and should feel like a good fit. Then let the rhythm begin.

Lubrication. Given that high friction can be issue, you should also attend to lubrication. You either need to take sufficient time in foreplay to produce ample lubrication to reduce unnecessary friction or use a personal lubricant. You might fare better with natural coconut oil or an organic product (like Sliquid or Good Clean Love).

Sexual positions. I found conflicting information on whether specific sexual positions are tied to urinary tract infections. But in my mind, it stands to reason that if the issue is partly the distance bacteria has to travel to reach the urethra, couldn’t your sexual position play into that? I certainly know that some positions stretch out your body more down there, and others bunch it up. In my research, the one position named as a potential culprit is woman on top. But I suspect sitting positions might be more problematic in general than standing or lying down. If someone has experience proving or disproving this theory, be sure to say so in the comments.

Sexual frequency. One of the reasons why UTIs are more common when you first start having sex is that you’re usually having a lot of sex. Now I am all for having frequent sex. Daily sounds just fine to me! But what happens for many couples is that frequency eases off a bit when you get deeper into the marriage.

When couples first start having sex, they’re usually like, This is great! Let’s do this all the time! It’s fresh, new, and exciting, so you go at it a lot. But like all that romantic stuff you did in the beginning, you typically settle into that being among the things you do together, but not as centrally focused. The last time I looked, the average happy marriage had sex around three times a week. That’s still pretty good.

But for women I’ve known who struggled with UTIs early on, their schedule often went more like: Sex every day for a week, UTI arrives, no sex for a week while recovering, then sex again every day for a week . . . and so on. Truth is, you’re not getting any more sex this way than if you went to every other day to see if that helps your body become less irritated. This doesn’t mean you’d have to keep up the every-other-day plan forever. Your body may just need some time to acclimate.

There will likely be some trial-and-error in figuring out what works for you. But I hope it helps having a few more suggestions here.

And now let’s see if my readers have any of their own suggestions. Chime in, y’all!

26 thoughts on “Q&A with J: Protecting Yourself from Infection”

  1. I too struggle with frequent vaginal yeast infections, UTIs, even ecoli infections in my bladder. I have tried everything and I do mean everything! My husband and I have been married almost 24 years and are monogamous, we have never had anal sex, and I have struggled with vaginal health since I started menstruating regularly as a 13 year old (yes, my Momma taught me to wipe from front to back). I think that because I have to use sanitary pads during menstruation (it’s a long story) that bacteria from menstral blood works it”s way into my urinary tract. Combine this with warmth from sexual stimulation, lubrication, his sweat, my sweat, and yea it is a breeding ground even with showering before and after. I’m almost 50 years old and though I love being serially intimate with my husband it’s very discouraging to constantly struggle with this problem. My doctors do think it would help me to lose weight but I have struggled to do that. I don’t like sounding negative but I do believe that this is a serious problem for some women whose bodies never do adapt. I hope that the woman who asked the brave question isn’t like me and is able to adapt.

    1. I have a friend who has struggled a lot too. She does everything she can think of, and has lowered the incidence of UTIs, but they still crop up sometimes. I’m wondering if it’s structural — that she has a particularly short urethra or something. Saying a prayer for you, bless your heart.

  2. The supplement D-Mannose works for me. I had constant UTIs despite antibiotics and doing all the usual hygiene stuff. I haven’t had one since I started taking D-Mannose. (I use the powder form. You can get it on Amazon and lots of other sites.) Do your own research, but it’s been a lifesaver for me!

    1. Thank you, that was what I was popping on to say. Ditch the “cranberry” pills and go straight for d-mannose, which is the very thing in cranberries that helps but in a much more potent dose.

      Other than that I agree that BOTH partners washing beforehand, urinating immediately afterward, and reducing frequency so the body can adjust are the other thoughts that came to my mind. I know the reduced frequency is kind of a bummer, but my college roommate got a UTI about a month into her marriage and when they finally had sex again after a week off of at least daily sex, she was surprised to discover sex didn’t hurt anymore! My heart broke for her that she was having painful sex sometimes more than once a day for so long because they never took a break long enough for her body to heal! Our bodies need time to recover and adjust, just like stretching any muscles. You aren’t supposed to work out 7 days per week; you take two off (or at least only do an easy run on those days). Sex is just a different kind of workout. ?

      1. I second (or is it third?) the D-Mannose! Also – there is a type of Homeopathy (one with infection on the label) supplement you can get at the vitamin shop or other places that helps the body fight infections. I couldn’t get rid of mine – and a doctor recommended it (since I was trying to avoid antibiotics) and that helped me turn the corner!

        I had never heard of that before, and never tried it, but loved the results!

  3. I have found eating yogurt daily and taking a probiotic supplement, along with urination before and after, plenty of water and no sugar filled drinks or snacks have helped me.

    1. Ooh, I forgot to mention probiotics! I know some women have had good results with them. Thanks.

  4. You could also try things to boost your general health like:

    Sleeping 7-8 hours a day.
    Exercising at least 3 times a week. Walking is also exercise. You don’t have to go crazy.
    Eating 3-5 servings of fruit and vegetables a day. Especially leafy greens and berries.

    Cutting out, or reducing sugar might help too. I know poorly controlled blood sugar contributes greatly to yeast infections. Yeast loves sugar. Sugar isn’t great for your immune system anyway.

    So just making sure you take care of your health in general. You might check your blood sugar and insulin levels.

  5. Oooh ouch! Cystitis is something I had dreadful trouble with. So much so that my Dr eventually put me on preventative antibiotics. Too many trips to the after hours med centre and so much horrific pain and nearly passing out from the infection. I know not everyone might want to try preventatives, but for me, they put a stop to it. A six month course and no Cystitis for 7 years! (did have to make sure I did the right thing by drinking plenty, going to the loo straight after etc etc).

    Then after I had my baby, I had a C-section involving a catheter and felt a stinging sensation….from then on Cystitis again. After a number of times, I went back to my Dr who at first did not agree to another course of preventatives. But I knew how dramatically they’d helped me in the past so I practically begged for them and she gave in. Ten years later and not another bought of Cystitis!

    BTW Drs now say cranberry juice does absolutely nothing to help prevent cystitis. I used to take a glass a day but haven’t for around 9 years and no cystitis. Hope that helps!

    1. Really on the cranberries? Why do they always change their mind about these things? Lol.

      Thanks for the preventatives suggestion. Glad it worked wonders for you!

  6. “The last time I looked, the average happy marriage had sex around three times a week. That’s still pretty good.”
    Wow, my hubby is lucky if he even gets it once every 2 weeks it so.

    1. I’ve written about how often married couples should have sex. I contend at least once a week; less and your body just don’t respond as well. Anyway, you might take a look at that post! Blessings.

  7. I was a post-menopausal virgin at marriage (I stopped naturally at age 38) and I was just expecting to wind up with a UTI, but in fact I’ve never had one, and we have been pretty active – enough to leave me sore at times. I do urinate before and after, and I also use a baby wipe before and after. My husband always washes himself. It’s not the most romantic thing, and sometimes I laugh to see him rushing to the sink to wash and dry it off, but that may be what’s kept me healthy, so I’m glad. And my husband is circumcized – grateful for that, too!

  8. susan in st louis

    I’m another one who started getting UTIs when I got married and began having sex. Sigh.

    However…just in the past several months I discovered D-Mannose (or “Clear Tract”) and it is helping a TON! It’s a powder that I put in with my water, daily for maintenance when I remember it, and more frequently when I feel a UTI coming on. Since I’ve started using it, I haven’t had a full-blown UTI, which is pretty amazing for me.

    I hope that helps! Thanks, J, for all you do!

  9. I don’t have “allergies” per se, but a few years ago I quit using overly scented shower gel and haven’t had a yeast infection since then. (I know that’s different from a UTI, but thought it might still be helpful) I just use a creamy oatmeal body wash now and spray perfume on later!

  10. I saw some great tips here. One I haven’t read but find useful too is to wear loose fitting clothing. And actually at night even if we don’t have sex I sleep bottomless. This really helps prevent both UTIs and yeast infections. Additionally ensure to keep the area dry. Say for example after exercising make sure to quickly change into dry bottoms. Also if you swim a lot, don’t hang out for hours at the beach in your wet bathing suite, take a spare and change, to ensure you stay dry and aren’t unknowingly creating a breading ground for bacteria.
    Hope she figures it out! It did get better for me, but I still have trouble at times. Especially if I’ve been eating a lot of sugar.

    1. Since you mentioned it, I’ll also share a tip an older woman once told me: She suggested that if a woman can, she should not wear underwear to bed. In her opinion, wearing a nightgown and going commando allowed everything to “air out” (her words). I admit to having wondered how much truth there could be in that recommendation. 🙂

      1. Eve went naked… 😉 I’m a firm believer in sleeping without bottoms too. Of course, that may get harder once you have kids, but if you don’t cosleep you can require them to knock first and just make sure you are covered.

        Also, cranberry works (cause of the D-manose{ie-thingy}), but sweetened cranberry juice does not… too much sugar! Once a UTI has started, you can eat a lot of asparagus to stop it. Cranberry is more preventative.

        For bacterial imbalances like yeast infections or that pesky bacterial vaginosis that shows up every time I give birth… a fresh clove of garlic (peeled and washed), insert one like a tampon every night for up to a week. You will smell like garlic, but no antibiotics needed. 🙂 Just balances out the bacteria without killing the good ones!

  11. My friend has dealt with UTI’s for so long and having sex def makes it worse. She actually had to get on a low dose of antibiotics because of it. She does literally everything they tell you to do. She also doesn’t wear tight fitting pants, skirts only when she travels, only cotton underwear, etc. She might try Echinocea which is an herb that some people use to treat UTI. Hope you can figure it out.

  12. Didn’t see it mentioned so… I always make sure I brush my teeth and rinse with scope before giving my wife oral sex. Yes I do normally brush 2x daily but with all the bacteria in our mouths it just makes sense. I didn’t early in our marriage and my wife would occasionally (+/- 4 x yearly) have a yeast infection but since I started the brush before the fun about 5 yrs ago she has not had any. Not very scientific but it works for us.

  13. Also a daily women’s probiotic can greatly help with uti’s as well as yeast and other vaginal infections. Jarrow makes a great one called Fem Dophilus.

  14. After 15 years of marriage at the age of 42 I got my first UTI and kept getting them every 6-8 weeks for the next year. It was awful. Started seeing a great urologist and she told me to up my preventatives. She said to take these three things daily:
    Cranberry supplements
    A Probiotic
    I’ve been UTI free for almost a year now.

  15. Apple Cider Vinegar can also help with UTIs (not just for women, but also men who have to use a catheter). Just don’t drink it straight–too acidic–you’ll want to mix it with tomato juice or V8 or something else. It’s easily available at most any grocery store, and is quite beneficial for other health concerns too.

  16. No one’s supplied this in the comment section yet, but as mentioned in the Q&A oral contraceptives can absolutely cause urethral and vaginal irritation. I struggled through endless infections and irritations for our first two years of marriage, never had a doctor mention birth control as a suspect, and finally figured it out on my own. Once we switched off of oral contraceptives life got so very much better. I still have to be careful as I think my insides are just sensitive, but I sure wish a doctor had mentioned the possibility of the pill as the cause two months into my search instead of discovering it two years later.

  17. Added on behalf of Michael (who could not post but emailed this comment):

    Couples should brush their teeth. Without respect to whose saliva, the mouth can harbor bacteria to promote a female urinary tract infection.

    It is also my observation that my wife has had more UTI’s as her vaginal lubrication has decreased over the years. That plus mouth bacteria has been a problem in our later years for her to receive OS.

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