I’m 53, and likely at the beginning of menopause. I’m still on the Mirena IUD, so I haven’t had a period in years, just erratic spotting. My problem is recurring UTIs — three in a row in the past three months! They’ve come after oral sex, even though we’re both showered and I always pee after sex. What can I do?
—Utiqueen
This is so crummy! I am sorry you are experiencing recurrent urinary tract infections (UTI). Unfortunately, postcoital urinary tract infection — that is, a UTI associated with having sex — is fairly common. More than 50% of women will have at least one UTI in their lifetime, and about 26% of those women will experience a recurrence within six months. Sexual intercourse is a significant risk factor for many of those women.
There is no data regarding specific sexual practices, such as oral sex, and the likelihood of UTI. I suppose you could try avoiding oral sex to see if it changed the frequency of infections, but I am always reluctant to tell someone to stop doing something they enjoy if there are other options. And there are.
You mentioned using postcoital voiding — peeing right after sex — and indeed this a commonly recommended technique for preventing UTIs after sex. The data on its efficacy is mixed, but it is not harmful, so it is worth trying. It doesn’t seem to be doing the trick for you, though.
Some contraceptive methods are associated with increased frequency of UTIs, in particular those that use spermicides, including diaphragms and condoms. If you are using one of those methods, it is worth considering a change.
As you say, based on age alone, you are likely peri- or even postmenopausal. Vaginal estrogen has been shown to reduce the incidence of UTI in general in postmenopausal women, so it would be worth discussing this option with your doctor.
There are two other evidence-based options you could consider. First, you could take a single dose of antibiotics preventatively after having sex. Alternatively, your doctor can give you a prescription for antibiotics to start the minute you start having symptoms — this is often referred to as self-starting antibiotics.
Postcoital UTIs are common. While urinating right after sex can help, if that isn’t working for you, vaginal estrogen or preventative antibiotics would be reasonable options to discuss with your doctor.
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38yr old here- I have had ongoing UTI battles my whole sexual life and have done all of the suggestions, western and holistic. The only actions that have consistently reduced my occurrences are- #1 staying hydrated!! (Half body weight in oz per day plus more when adding exercise), clean hands and genitals before sex for both partners, peeing within 15 min after all sex (oral, intercourse & hand play), and staying hydrated!! Must have clear pee for 2 days after the encounter. Super annoying but better than antibiotics.
These are small studies about D-mannos, available in health food stores or online, but take a look:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8944421/
. I would recommend NOT taking it as a capsule but dissolving it in a glass of water and drinking it. You can buy it as a powder, or buy capsules and empty them.
I have been using D Mannose preventatively after frequent UTIs for years and haven’t had a single reoccurrence. Definitely worth a try!