Fiona Veitch Smith

It’s sometimes called Honeymoon Sickness, as young brides, overdosing on sex, often book themselves in for a doctor’s appointment the minute they get back home. But urinary tract infections (UTI) are not just the domain of the recently married (although sex is a major factor), and with burning urine, aching backs and sometimes high temperatures; they’re far from romantic.

New brides

New bride Jane, 30, is a classic victim of Honeymoon Sickness. She wasn’t sexually active before she was married, and since her wedding night, has had six infections in eight months. “It’s very frustrating being newly married when sex causes so much pain. It doesn’t matter what position we do it in, or whether we use condoms or not. My doctor says that some women are just more prone to it than others (for example ones with a narrow urethra). I’m on a three-month course of Puromylon (an anti-septic of sorts) – I’ve only been on it a month, but so far it seems to be working.”

Research suggests that some women are indeed more prone to it than others, and a recent study indicates that it may have something to do with blood type. Further trials are needed for this theory to be proved, but if it is the case, then scientists believe that a type of vaccine may be developed to help chronic urinary tract infection sufferers like Jane.

Problems with the plumbing

Most women will have problems with the plumbing at some time in their lives, and it is listed as the second most common reported infection by British GPs. For some women it will be a mild or one-off occurrence, but for others it’s a long-term condition that needs to be managed. Men and children may also suffer from urinary tract infections, but they are far less common, although in men (particularly older ones), they are often quite serious.

Urinary tract infections are classified as either upper or lower tract infections. Lower urinary tract infections may be of the urethra (the tube which you urinate through), the ureters (the tubes that carry urine to the bladder) or the bladder itself – this is known as Cystitis. Upper urinary tract infections involve the kidneys (Pyelonephritis) – this is more serious than Cystitis, and will need to be treated with antibiotics. In more serious cases, you may have to spend time in hospital. Urinary tract infections spread from the bottom up, so typically, the kidneys are the last area to be infected.

Symptoms of urinary tract infections

The key is to catch it early. Common symptoms of urinary tract infections are frequent, burning urination (this sometimes just dribbles out even though you were desperate to go), lower back pain, abdominal pain or pain along the ureters, and cloudy, bloody or foul-smelling urine. If kidney infection has occurred, you may have severe pain in the kidney area, a high temperature, headaches, nausea or vomiting.

Causes of urinary tract infections

So what causes it? The urinary system is normally sterile, so when bacteria enter the tract and multiply, infection occurs. Because the outside opening of the urinary system (the meatus) is located near the vagina and the anus, bacteria that occur normally in those areas can enter the meatus and contaminate the urethra. Since the urethra in women is very short, it is easy for such bacteria to enter the bladder and begin an infection. The most common bacteria involved in a urinary tract infection is E-coli, that naturally and harmlessly lives in the bowel, but causes all sorts of problems if it gets into the wrong place.

Other vaginal infections such as thrush mimic the symptoms of a urinary tract infection – these are sexually transmitted and need to be treated separately. A doctor can test to see which infection is present and treat you accordingly. It is not uncommon to have a vaginal infection and a urinary tract infection at the same time, or back-to-back, and many women report that antibiotics used to treat a urinary tract infection can cause thrush. Urinary tract infections may occur when the urinary tract is irritated, bruised or inflamed – this causes bleeding of the tract wall, which in turn leads to an infection.

That’s why sex is one of the major causes. Vigorous sex may bruise the urethra or bladder, particularly when the man is on top. If this is your problem try changing positions. For some women, pregnancy may be the first and last time they experience a urinary tract infection. They are particularly common in early pregnancy when the urethra relaxes and infections spread more easily, and later, when pressure from the enlarging uterus may cause a small amount of urine to remain in the bladder and become stagnant.

Pregnancy and urinary tract infections

Anne, 43, says she has only had two urinary tract infections in her life – immediately after her two pregnancies, and each time after a dose of mastitis. She says: “It was awful – I’ve never had anything that affected my whole body so badly – particularly the pain around the back and raging temperature. But the doctor prescribed antibiotics which cleared it up completely.”

If you are pregnant and suspect a urinary tract infection you should go to see your doctor immediately, as it can possibly cause complications. But for other women, it is not always essential to see a doctor in the early stages of an infection. Most urinary tract infection sufferers learn to manage an infection on their own, by applying a range of self-help methods that are often discovered through trial and error.

Prevention of urinary tract infections

Christine, 60, says that over the years she has learnt to control her urinary tract infections. “During the first 10 years of marriage I had lots of infections, but I learnt to prevent them, and if that wasn’t possible, to treat them. The worst episode was triggered by wearing leggings – I only wear ‘body free’ tights and cotton undies and avoid bubble bath and biological washing powders.

If I do have an attack I drink lots of water, cranberry juice and citra soda. I even spread yoghurt (natural, of course) over the affected area, although this works more for thrush. Alcohol makes it worse and so do sugary things.”

Wearing tight, synthetic clothing is a common trigger, as they don’t allow your nether region to breathe and allow bacteria to fester. Bubble baths, perfumed douches and sanitary pads cause irritation, though for some women tampons have been found to be the culprit. Either way, frequently changing your pad or tampon will minimise the risk of infection.

If you are prone to urinary tract infections, horseriding and cycling can aggravate your condition, as can swimming in a chemically treated pool. Using a diaphragm may also trigger an attack and recent research has shown that spermicidal gel also causes problems.

If sex is your trigger, you should remember to empty your bladder before and after intercourse and wash thoroughly. And speaking of cleaning down below, wiping your anus from front to back will prevent those E-coli getting up the wrong tube.

The bottom line is that if you’re prone to urinary tract infections you need to learn to live with them. But by taking some precautions and treating symptoms aggressively when they first appear, you shouldn’t be heading to the doctor too often.

Home remedies for urinary tract infections

• Drink a glass of water every half hour to flush out bacteria.
• Drink cranberry juice – a urinary antiseptic (can also be drunk before and after sex as a preventative measure).
• Make your urine alkaline by drinking milk, bicarb in water or citra-soda.
• Avoid acidic food and drink including alcohol, coffee and fruit juice.
• For pain relief take paracetamol not aspirin (makes urine acidic).
• Keep warm – a hot water bottle helps.
• Avoid perfumed soaps, deodorants etc and shower rather than bath.
• If symptoms don’t disappear in 48 hours, see your doctor.