Can Urinary Tract Infections (UTIs) be transmitted through sexual intercourse?

From the Guidelines

Yes, urinary tract infections (UTIs) can be transmitted through sexual intercourse, though they are not classified as sexually transmitted infections. Sexual activity can facilitate the movement of bacteria, particularly E. coli from the anal region, into the urethra and up into the bladder, as noted in a study published in the Journal of the American College of Radiology 1. Women are more susceptible due to their shorter urethras, which provide bacteria an easier path to the bladder. To reduce the risk of UTIs related to sexual activity, it's advisable to:

• Urinate before and after intercourse to flush out bacteria
• Stay well-hydrated
• Practice good hygiene
• Wipe from front to back after using the bathroom
• Using condoms can also help reduce bacterial transfer during sex, as suggested by a guideline published in The Journal of Urology 1.

If you experience UTI symptoms like burning during urination, frequent urination, or pelvic pain, seek medical attention. Treatment typically involves antibiotics such as nitrofurantoin (Macrobid), trimethoprim-sulfamethoxazole (Bactrim), or ciprofloxacin for 3-7 days, depending on the severity and your medical history. Recurrent UTIs after intercourse may warrant preventive strategies like taking a single dose of antibiotics after sex, as prescribed by a healthcare provider, as recommended in a rapid review published in The Journal of Urology 1.

Key factors to consider in preventing UTIs include:

• Maintaining adequate hydration
• Voiding after intercourse
• Avoiding prolonged holding of urine
• Avoiding sequential anal and vaginal intercourse
• Controlling blood glucose in patients with diabetes
• Avoiding disruption of normal vaginal microbiota with harsh cleansers
• Avoiding prolonged antibiotic courses (more than 5 days), broad spectrum or unnecessary antibiotics, as noted in the studies 1.

From the Research

UTI Transmission Through Sexual Intercourse

• UTIs can be transmitted through sexual intercourse, as certain risk factors are associated with sexual activity 2.
• The predominant UTI risk factors in young women are sexual intercourse and the use of spermicidal contraceptives 2.
• Other important UTI risk determinants in selected age groups include anatomic and physiologic factors, such as obstructing lesions and estrogen deficiency; genetic factors, such as blood group secretor status; antibiotic exposure; functional status; and possibly receptive anal intercourse and HIV infection 2.

Treatment and Prevention of UTIs

• The treatment of UTIs typically involves the use of antibiotics, with the choice of agent depending on various factors such as the severity of the infection, patient characteristics, and local resistance patterns 3, 4, 5, 6.
• It is essential to use antibiotics wisely to avoid the development of resistance, and to consider the pharmacokinetic characteristics of the molecule to optimize clinical benefit and minimize the risk of antibacterial resistance 5.
• Preventing UTIs through safe sexual practices and good hygiene can help reduce the risk of transmission 2.

Key Findings

• Studies have shown that UTIs are more common among women than men, although the prevalence in elderly men and women is similar 2.
• The use of certain antibiotics, such as fluoroquinolones, has been associated with an increased risk of UTIs, and their use should be avoided when possible 3, 4.
• The choice of antibiotic agent for treating UTIs should be based on the pharmacokinetic characteristics of the molecule, as well as local resistance patterns and patient characteristics 5, 6.