Q. My husband and I both travel on business, so we sometimes have long breaks between sex. I don't mind the separations so much, since it allows each of us time alone with our new baby, but every time we make love after a break, I get a urinary tract infection. Why does this happen? Is there any way to prevent it?
A. You're not alone. About 75 percent of the time, urinary tract infections in women are triggered by sexual intercourse, says Nicolette Horbach, MD, associate clinical professor of obstetrics and gynecology at George Washington University: "Some women may only have one in a lifetime, while others are susceptible to recurring infections."
In fact, it's estimated that urinary tract infections (UTIs) result in 8 million doctor visits per year, and four out of five women who develop one will have another within 18 months. This has nothing to do with your hygiene. Recent studies reveal that most women who suffer frequent infections have bladder cells designed to attract and hang onto the bacteria that cause them. Pregnancy can also be associated with a higher rate of UTIs because of hormonal surges and changes in anatomy that make it easier for bacteria to gain access.
Moreover, intercourse promotes UTIs because the back-and-forth motion literally massages bacteria from your anus into the bladder. This is especially true if you've just had a baby or you're breastfeeding, since your vaginal tissue may be drier, scarred, or more easily irritated. In addition, if you make love infrequently, you may suffer from what doctors call "honeymoon cystitis," a UTI that occurs when women have a lot of sex in a short period and experience additional trauma to the tissues.
Luckily, there are ways to steer clear of infections. Make sure there's enough lubrication in the vaginal area to prevent irritation, suggests Dr. Horbach. Any water-based, over-the-counter product will probably do the trick. If not, ask your doctor about a prescription for an estrogen cream, such as Premarin. These creams can replenish vaginal lubrication and relieve irritation. It's also important to empty your bladder both before and after intercourse.
"You don't have to hop up to pee the minute you're finished making love," Dr. Horbach explains. "But urinating within 30 minutes afterward will usually wash out any bacteria that has crept in during sex." Also make sure to wipe yourself dry from front to back whenever you urinate.
Finally, if you get more than three infections a year, "ask your physician for a preventative antibiotic," says Dr. Horbach. Typically, urologists suggest that you take an antibiotic such as Bactrim or Macrodantin daily for up to a year, to allow the bladder to heal completely.
Your healthcare provider might also direct you to take a single dose of one of these antibiotics following intercourse, she adds. "For many women, a single dose of postcoital antibiotic can effectively knock out any bacteria that latches on before it can multiply."
Holly Robinson lives with her husband and their five kids outside of Boston.
Originally published in American Baby magazine, December 2004.