Expert Answers Factual Answers to Your Sexual Health Questions

Anonymous on September 29, 2011

I self-cath...is that why I keep getting urinary tract infections?

I’m a female, C5 quad and have never had a sexually transmitted disease. I self-cath and haven't had serious urinary tract infections before. My boyfriend and I are in a monogamous relationship and recently became sexually active. We don’t use protection...could this be why I’ve been getting more frequent urinary tract infections lately?

answered by Lisa Oldson, MD on September 29, 2011

Thank you for writing in. The problem you’ve shared is actually quite common for all women. 

Recurrent urinary tract infections or recurrent UTIs, occur most among young women. In fact, some women are so prone to UTIs, their doctors prescribe antibiotics for them to take whenever they have sex.

However, people who self-cath are more likely to wind up with a UTI. Why? When the catheter is placed, it’s possible for it to catch some bacteria and force it into the bladder. To help avoid bladder infections, you can make sure that you’re drinking lots of water, and that you empty your bladder often (at least every 6 hours). This helps ensure that the bacteria doesn't have enough time to grow in your bladder. Because you’ve been having more problems lately, the University of Washington’s Northwest Regional Spinal Cord Injury System recommends increasing how often you void your bladder to every 2-4 hours and increasing your fluid intake. 

However, because you didn’t experience problems with UTIs prior to your sexual activity, it could be that your recurrent UTIs are linked to sex. For example, in one study, the Group Health Cooperative of Puget Sound found that the strongest “risk factor” for recurrent UTIs was how often women had sex. Another risk factor that might apply to you is having a new sex partner during the past year.

Regarding your decision not to use condoms or birth control...that probably isn’t a factor in your UTIs. Some research even indicates that using condoms can increase the risk of UTIs in women. 

You also mentioned you’re in a monogamous relationship, which is great...as long as you’ve both been tested for STDs. If you haven’t both been tested ⎼ and treated if necessary ⎼ for STDs, you’re putting yourself at risk by having sex without protection. 

People with STDs usually don’t have any symptoms. For example, the Centers for Disease Control and Prevention (CDC) report that about 50 million Americans have genital herpes...but surprisingly only about 10% of those people are aware of their infection. That means you can’t tell by looking if someone has an STD.

Also keep in mind that your spinal cord injury doesn’t necessarily mean that you can’t get pregnant. If you don’t want to get pregnant, talk to your doctor about possible birth control methods that are right for you. 

And for more information about STD prevention, symptoms and treatment, please see our Expert Guide to STD Basics.

Thank you again for writing. I wish you and your boyfriend the best for a happy, healthy future together.

Related info:

Lisa Oldson, MD

Dr. Oldson is Medical Director of the Analyte Physicians Group. She is on staff at Northwestern Memorial Hospital, as well as Clinical Instructor at the Feinberg School of Medicine, Northwestern University. Her areas of expertise include STDs (with a particular clinical emphasis on herpes), women's health, preventive medicine, diabetes, obesity and weight management, and mood and anxiety disorders. Dr. Oldson was educated at Rush Medical College and completed her residency at Rush-Presbyterian-St. Luke's Medical Center in Chicago, IL.

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