Circumcision Doesn’t Cause Women’s UTIs. What Does?

Is Circumcision A Factor in Women’s Urinary Tract Infections?
Is Sex?

I started writing this as a response to a Facebook post about a women who doesn’t want to have sex with her uncircumcised partner as she believed his intact penis was causing her to get recurrent urinary tract infections. I don’t know if she wants him to get circumcised but that won’t solve her problem. She has my sympathies—urinary tract infections are painful and their association with sex is distressing. Unfortunately, few people seem to actually understand why they occur or how to prevent them.

To start with since the instigation of this post focused on the status of the male member, let me say clearly—whether a male partner is circumcised or intact is not a factor in UTIs.

Sex Is NOT The Cause of Urinary Tract Infections

UTI’s are almost exclusivity caused by anal bacteria that enter and proliferate in the urinary tract. How do the little buggers get from the butt to the urethra? We transport them there by ourselves or with the help of our sexual partners. So, while sex doesn’t cause UTIs, it does tend to transfer the bacteria where they don’t belong.

Prevention

The most important thing to prevent urinary tract infections is super-great sexual hygiene to prevent any bacteria from getting in at all.

Sexual hygiene starts with the basics of good hand, genital and butt washing prior to sexual activities.

However, it’s not our before-sex behavior that’s the main problem. It’s what we’re doing while we have our erotic romps that’s really at fault. The most significant UTI prevention strategy is to keep the butt bacteria where they belong! Take care during sex! Nothing that enters in or touches near the anus should then touch in or near the vulva, vagina and urethral opening.

Sex—It’s Messy!

Let’s face it—sex is often a wet, messy business and all of the pleasure parts are quite close together. How do we keep the butt bugs where they belong? Here are a few strategies for avoiding contamination (and the possible urinary infections that can result). Try using different hands for front and back. Gloves are a great help as they can be removed after anal play. Similarly, use condoms for anal sex then remove before vaginal contact. Dental dams work great for analingus (and prevent the giver from getting other potential infections.) What to do if you’ve used a body part for anal play and now want to employ it on the vulva? Go take a break and have a good wash.

Is the Standard Advice Useful?

In addition to doing our best to keep the bacteria segregated, we can also decrease their opportunity to flourish. The standard advice of peeing before and after sex, maintaining good hydration and using generous lube can help reduce the risk of infection, should bacteria be inadvertently transferred from back to front.

However, these measures will often be inadequate to prevent an infection, especially if the bacterial load is substantial and the environment welcomes the invaders. Inflamed tissue leads to more adherence, increasing the risk of infection if bacteria have to have been accidentally introduced. An inflamed urethra is more susceptible to infection, but only if there’s a cause of infection, that is, the presence of anal microbes. If there’s no bacteria than you only have inflammation, which is still irritating and can be painful but is likely to resolve without treatment.

It certainly makes sense to stay away from irritants to prevent inflammation and irritation with the concomitant increased susceptibility to infection. Irritants can include friction, spermicides, feminine hygiene products and for some women, certain types of lubricants. Also, if the woman is not adequately aroused and adequately lubricated, penetration can cause irritation, which make her more likely to be unable to fend off bacteria. The health of the women can also be an underlying or co-existent factor.

For sexual lubricants I strongly advise natural lubricant products, like aloe-based Aloe Cadabra or Good Clean Love (water-soluble and latex-compatible) or coconut oil (NOT latex-compatible). If you’re using condoms, extra lubrication is strongly advised. Also, lubricants are very helpful for intercourse with circumcised men since the lack of the foreskin itself increases friction. The week before menstruation, the post-partum and post-menopause phases of a woman’s life are times that the genitals drier and more fragile. Personally, I think extra lube is pleasure-enhancing at any time, even for women with abundant natural juice.

In addition, unsweetened cranberry juice (liquid or concentrate capsules), Vitamin C and a variety of herbs such as Uva Ursi can naturally kill bacteria. Their use can help in prevention efforts.

Female Ejaculation Prevents UTIs

Finally, I have found that women who ejaculate rarely get UTIs. While peeing after sex may help reduce the number of bacteria, and lessen the chances of getting an infection, the actual flow of fluid through the urethra is only mildly helpful because bacteria adhere to cells. That’s why when you have a UTI and are urinating frequently, all that peeing doesn’t cure the infection. You can’t pee out all those sticky little bacteria. Yet, anecdotally, for myself, in my clinical practice and my teaching, I’ve discovered that abundant ejaculation seems to significantly or even completely prevent urinary infections. (Plus excellent sexual hygiene, of course.) I have a theory that female ejaculate is anti-microbial—I think it’s Mother’s Nature’s UTI prevention strategy.

No More UTIs!

Urinary tract infections are awful, painful and can have dramatic impacts on our sex lives. Some basic knowledge and simple measures can easily be put to use to prevent them once we understand where they come from and how to thwart them. Great sexual hygiene and learning to work with the body’s natural defenses can stop this common problem in its tracks and keep badly behaving bacteria from colonizing our urinary tracts as well.

Circumcision Doesn’t Cause Women’s UTIs. What Does?

Is Circumcision A Factor in Women’s Urinary Tract Infections?
Is Sex?