If you were a woman and you were even somewhat susceptible to urinary tract infections (UTIs) — which, thanks to some pretty glaring design flaws in female anatomy, you probably would be — there’s a good chance you’d spend a decent portion of almost every sexual encounter thinking about UTIs and how to prevent them.
Why? Because UTIs are extremely common in women, and having sex is one of the easiest ways to get one. One in two women will get a UTI in their lifetime, and one in five will experience recurring UTIs, according to Dr. Sherry Ross, an OBGYN and medical advisor for Uqora, a biotechnology company specializing in urinary tract health.
“Sexual activity is the most commonly reported cause of UTIs, especially in younger women,” Dr. Ross tells InsideHook. “During sexual activity, bacteria, most commonly e. coli, are transferred from the vagina, anus or sexual partner’s skin to the urinary tract. Sexual activity physically moves or transplants bacteria to the urethra, where they can travel up and establish an infection.”
Women are significantly more susceptible to developing UTIs during sex than men are, both because a woman’s urethra is much shorter than a man’s, and because the vagina, anus and urethra are basically all next-door neighbors, making it easy to transfer bacteria from one to the other.
But since you, a man, have been spared the cruel joke of female anatomy and are thus probably not particularly susceptible to UTIs, what does any of this have to do with you? Take it from me, a woman who has endured her share of UTIs after having sex with men: the flames of hell hath no pain like a UTI, nor no fury like a woman who has just developed one after having probably mediocre sex with you. When we get a UTI after sleeping with you, we know that it’s not your fault per se, but we will probably never find it in our hearts to fully forgive you.
So, if you’re a man who has sex with women and would rather those women not remember you solely as a source of unimaginable pain and inconvenience, it’s in your best interest to remain informed about UTIs. For your edification, I’ve graciously compiled this comprehensive man’s guide to female urinary tracts and the ways having sex with you is putting them in jeopardy. If you care at all about the urinary tracts and/or emotional, mental and physical wellbeing of your sex partners, here’s what you, a man, should know.
1. UTI pain is a pain like no other
It is impossible to describe the pain of a UTI. The closest approximation I’ve ever seen is the below video of a tree internally engulfed in flames.
I don’t know why they’re so painful or so all-consuming, but they are, and the pain seems to get worse and escalate more rapidly with each infection. I am a person with a relatively high pain tolerance, and I have, on at least one occasion, been driven to literal, visible tears by a UTI in the middle of CVS while waiting for a pharmacist to fill my prescription. It’s that bad.
2. Treating UTIs is inconvenient and often pricey
Speaking of crying in a CVS while waiting for a pharmacist to fill my prescription, there’s no quick, over-the-counter fix for a UTI. To get treated for one, you have to go to a doctor and have your urine tested so they can confirm that your urinary tract is, in fact, infected before they prescribe you the necessary antibiotics — even though once you’ve had a UTI, you know what it is beyond a shadow of a doubt if you’re unlucky enough to ever get one again. It doesn’t matter how long it’s been since your last one; the pain and the smell (yep, there’s a smell! We don’t have to talk about it, but there is one!) are unmistakable.
This often means spending time trying to get an appointment, then spending more time waiting for that appointment, probably forking over a copay, then waiting some more in a CVS (probably crying) until someone finally fills your prescription. Sounds inconvenient, right? Now picture doing all of that while in some of the worst pain you can imagine.
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3. They can lead to other health problems
However inconvenient that whole process may sound, skipping it wouldn’t be an option even if the pain were bearable. Left untreated, UTIs can spread to the bladder and kidneys, causing more serious infections that may lead to hospitalization or life-threatening complications.
Even if a woman does treat a UTI, however, she’s not necessarily safe from developing other health problems. The vagina is home to a frustrating, extremely finicky ecosystem that depends on a delicate balance of bacteria. Taking antibiotics to treat a UTI can throw off that balance in some women, leading to other irritating, hard-to-treat conditions like bacterial vaginosis and yeast infections.
4. A UTI is not a sexually transmitted infection (STI)
Yes, women often develop UTIs through sexual intercourse, but the infection is not sexually transmitted. You can’t “catch” a UTI from your partner the way you can STIs like herpes or chlamydia, nor can your partner “catch” a UTI from you. The infection isn’t spread from person to person; it develops when bacteria is introduced to the urethra. Oftentimes the bacteria is from another part of a woman’s own body — her partner probably just helped it travel to infection-causing territory during sex.
This is not to suggest that UTIs are somehow “better” or should be considered less taboo than STIs. Neither UTIs nor STIs should be stigmatized at all. UTIs aren’t morally superior or more socially permissible than STIs; they’re just a different kind of infection. (And just so we’re clear, that’s all an STI is: an infection.)
5. Trying to avoid getting a UTI during sex requires a lot of planning and mental energy
If there’s any good news to be shared about UTIs, it’s that many women can prevent them by peeing after sex.
“One of our best defenses against newly introduced bacteria is the physical act of urination, which flushes bacteria out,” says Dr. Ross. “This is why peeing after sex is always a good idea.”
But of course, it’s never that easy. For many women, executing this seemingly simple UTI prevention hack means carefully planning and scheduling both pre- and post-sex hydration so that we can pee as soon as possible after sex, without chugging so much water that we’re bloated during the actual sex part of the sex.
If that weren’t complicated enough, we’re also operating on a timer that begins the second sex does. “The longer the time the bacteria have to travel up the urinary tract, the more likely an infection is,” says Dr. Ross. This means that after sex, while men and their long urethras get to lie around in a lazy post-coital daze, women have to rush off to the bathroom immediately and/or drink a ton of water so we can pee ASAP.
Even if we manage to pull all of this off perfectly, any woman who has endured the agony of a UTI will probably still end up spending the better part of the next 48 hours in constant fear that her urinary tract is going to erupt in flames at any moment. And yes, if you were wondering, all of this anxiety and mental calculation does have a tendency to kill the mood during sex.
6. There’s stuff you, yes you, can do to help
Sure, this all sounds pretty bad, but what do I expect you to do about it? It’s true that for the most part, a woman is kind of on her own when it comes to preventing UTIs. Again, if a she develops a UTI during sex with you, it’s not actually your fault — you didn’t give her the infection, you were probably just an unwitting accomplice. That said, there are certain things you can do (and not do) during sex that may help reduce your partners’ risk of infection.
For the love of god, watch where you’re putting your dick
Again, UTIs occur when bacteria travels from one part of the body to the urethra. This means that if your penis comes anywhere near a woman’s asshole and you then try to put that penis in her vagina, there’s a good chance you’re spreading bacteria to places it shouldn’t be.
There’s a prevailing suspicion, popularized by a somewhat controversial episode of The Mindy Project, that men who “miss” a woman’s vagina and end up knocking on a different door do so on purpose because they’re trying to con their way into anal sex. I’m willing to give you guys the benefit of the doubt and assume this is not true (if it were, it would be rape, by the way). I genuinely believe that sometimes you guys just aren’t sure where you’re putting your dicks. That’s okay. Sex is hard, and certain positions definitely make it more difficult to locate the desired entry point (or slip out of it), especially when you’re with a new partner whose body you may not be familiar with yet. That is also okay! But if you’re not sure where you’re going, just slow down or ask your partner to help you guide your penis to where it’s supposed to be. Don’t just go poking around down there.
If you are switching between different orifices, proceed with caution
“Be careful when switching from anal or oral to vaginal sex as this increases the likelihood of bacteria entering the urinary tract,” says Dr. Ross.
One way to reduce the risk of spreading bacteria to the urethra while switching orifices is to use condoms, and change them before entering a new part of the body. Be mindful of where you’re putting your hands too; wash them before sex and again any time you’re transitioning from one kind of play to another. And, as always, remember the golden rule: if your dick has come anywhere near an asshole, whether accidentally or on purpose, don’t even think about putting it anywhere else until you’ve cleaned yourself up and (ideally) put on a fresh condom.
Now, with this newfound wisdom in mind, I urge you to go forth and get busy, leaving nary an infected urinary tract in your wake.
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