UTIs dampen desire for intimacy

Dear Dr G,

I read with interest how honeymoon cystitis can affect the newlywed and raise concerns of trust in a relationship.

My wife and I also have similar concerns due to infections after sex, however, our situation is definitely not in the early honeymoon stages.

My wife and I have been married for more than two decades and we have two wonderful teenagers.

We are both in our mid-forties and enjoy sexual intimacy when we have such opportunities.

In recent months, my wife has been getting urinary tract infections despite us not having sex for a few months.

And this has put a dampening effect on her desire for sex, as she worries about further exacerbation of UTIs.

She went to the doctors for antibiotics, however despite multiple courses of the medications, the infections persisted.

I took my wife to the specialists who worried she might have complex UTI or multidrug resistance infections causing recurrences.

Before embarking on further investigations with the Urologist, I think I ought to put Dr G on the spot for further clarification.

Can you tell me why my wife is getting recurrent UTIs that are not going away?

What exactly does the specialist mean by complex UTI?

Will recurrent UTIs result in the dampening of sexual desire in women?

How do I get rid of this recurrence of infections in my wife and get our sex life back in action?

Regards

Dampened Daniel

Urinary tract infections (UTIs) affect a significant portion of the population. However, it is estimated that around 20-30% of women who experience an initial UTI will also suffer from recurring episodes.

UTIs can be quite the pesky problem, causing discomfort and annoyance. While an isolated UTI may feel like a one-time inconvenience, recurrent UTIs can become increasingly bothersome.

UTIs can generally be divided into simple or complex natures. Simple UTIs usually occur in otherwise healthy individuals and primarily affect the lower or upper urinary tract, resulting in cystitis (infections of the bladder) or pyelonephritis (infection of the kidneys).

Complex UTIs, on the other hand, tend to have underlying factors that contribute to their recurrence, such as structural abnormalities in the urinary tract or weakened immune systems.

Complex UTIs affect individuals with diabetes, those who are immunocompromised, and those with indwelling foreign bodies in the urinary tract such as catheters.

As men do not tend to get UTI due to longer urethral length, any UTIs in men are considered complex in nature.

The pathogenesis of these infections typically involves the invasion of bacteria into the urinary tract, with the most common culprit being Escherichia coli (E. coli).

The recurrence of the infections can occur due to new infections occurring caused by deficiency in the host immune defences.

Inadequate clearance of the initial bacteria due to inadequate or unsuitable antibiotics can also be a source of the repeated infections.

The emergence of multidrug resistance bacteria has become more common, therefore recurrent UTIs due to unsuitable antibiotics usage are also more prevalent.

While UTIs might seem like relentless foes, there are measures one can take to prevent their recurrence. Hydration is by far the most important preventive step, helping to flush out any lingering bacteria.

Consumption of fluid of more than two litres (2l) per day is the minimal hydration that is required for individuals suffering from recurrent UTIs.

On the other hand, proper hygiene is also important in preventing further infections, these include self-cleaning after each void with wiping from front to back after using the toilet.

Additionally, urinating before and after sexual activity can help clear out any potential new infections. Lastly, the consumption of probiotics is also known to be beneficial in maintaining a balanced urinary tract ecosystem, enhancing the host immunity in preventing disease recurrence.

When encountering a recurrent UTI, it's important to consult with a healthcare provider, which will likely resort to taking a course of antibiotics. The completion of the course of the medications is absolutely vital in avoiding relapse of infections.

With the emergence of bacteria with antibiotics resistance, it is also important to send the urine to the laboratory for culture and sensitivity of the bacteria towards the right antibiotics.

When facing more difficulties in preventing further infections, longer-term low-dose prophylactic antibiotic regimen may also be necessary for prevention. Complementary treatments such as cranberry juice or D-mannose may also further enhance the host immune-defence systems to avoid more bacterial invasions.

Although not well-documented in the medical literature, sexual dysfunction is common in women who encounter recurrent UTIs.

The aetiology of dysfunction can be due to pain in the urethra and vagina during active infections. Alternatively, the avoidance of sex is also common in women with recurrent UTIs, as penetrative sex is often the reason for an infection's recurrence.

Reassurance and complete resolution of the infections before engaging in more intercourse is the key to regain confidence in intimacy with no worries.

Recurrent UTIs may be a persistent annoyance, but armed with knowledge, prevention, and appropriate guidance, they can be tamed.

Hydration, good hygiene, and seeking medical advice when needed are often keys to avoid further infections. Although the pain of the infections can deter couples from sexual intimacy for a while, it is important not to let those mischievous bacteria dampen your playful spirit.

The famous English poet and soldier, John Donne once said: “Despair is a damp of Hell, as Joy is the serenity of Heaven!”

When Dr G is put on the spot by couple dampened by the despair of recurrent UTIs, his opinion is: “Healthy lifestyle and a bit of medication can definitely bring out the Joy and Serenity of Heavenly sex, without the Hell of infections!”