- Is it safe to hold your pee? Five possible complications
- 7 Surprising Risk Factors for Urinary Tract Infections
- Causes and Risk Factors
- Complicated UTIs and Antimicrobial Resistance
- New IV Antibiotics
- Antibiotics For UTI Treatment – What Are My Options?
- What is a urinary tract infection (UTI)?
- Which antibiotic should be used to treat a UTI?
- Common side effects with antibiotic use
- What about antibiotic resistance?
- Latest antibiotics for UTIs
- Are there any over-the-counter antibiotics for UTIs?
- What if I have frequent, recurring UTIs?
- Can I treat a UTI without antibiotics?
- Does cranberry juice prevent a UTI?
- More Resources
- Symptom Checker
- See Also
- Further information
- More News Resources
- 11 Sneaky Causes of Urinary Tract Infections
- 1. You eat a lot of sugar
- 2. You have diabetes
- 3. You wipe from back to front
- 4. You have lots of sex
- 5. You don’t pee after sex
- 6. You hold it too long
- 7. You’re using certain methods of birth control
- 8. You’re using condoms
- 9. You don’t drink enough water
- 10. You’ve got a cold, the flu, or allergies
- 11. You’re pregnant
- Is Your Toilet Paper The Cause Of Your UTIs?
- 5 Bathroom Mistakes You Don’t Know You’re Making
- Sitting on the Toilet Too Long
- Using the Air Dryer
- Wiping in the Wrong Direction
- You’re Too Clean Down There
- Can Thongs Cause UTIs and Yeast Infections?
- Is Cotton Underwear The Key to Preventing UTIs?
- 8 Underwear Rules to Live by for a Healthy Vagina
- 1. Overall, choose natural fabrics — specifically cotton
- 2. Aim to change your underwear every day, even more than once if you want!
- 3. Go commando at night to air out the moisture
- 4. Well-fitting, moisture-wicking underwear is best for working out
- 5. Thongs really aren’t bad for your vaginal health
- 6. Wash your underwear in hypoallergenic soap
- 7. Consider replacing your underwear every year
- 8. The style of underwear can affect your mood
Is it safe to hold your pee? Five possible complications
Below, we look at five potential side effects of holding in pee:
People who regularly ignore the urge to pee may feel pain in the bladder or kidneys. When a person finally does reach the bathroom, urinating may also hurt.
The muscles may also stay partially clenched after the urine is released, which can lead to pelvic cramps.
2. Urinary tract infection
In some cases, holding in pee for too long can cause bacteria to multiply. This may lead to a urinary tract infection (UTI).
No research has shown that holding in pee causes UTIs, but many doctors recommend avoiding it, especially if a person has a history of frequent UTIs.
People who do not drink enough liquids may be more likely to develop a UTI because the bladder is not telling the body to pee often enough. This can cause bacteria to spread through the urinary tract, leading to infection.
Symptoms of a UTI include:
- a burning or stinging feeling during urination
- pain in the pelvis or lower abdomen
- a constant urge to empty the bladder
- strong- or foul-smelling urine
- cloudy, off-colored urine
- consistently dark urine
- bloody urine
3. Bladder stretching
In the long term, regularly holding in pee can cause the bladder to stretch. This may make it difficult or impossible for the bladder to contract and release pee normally.
If a person has a stretched bladder, extra measures, such as a catheter, may be necessary.
4. Damage to pelvic floor muscles
Frequently retaining urine may harm the pelvic floor muscles.
One of these muscles is the urethral sphincter, which keeps the urethra closed, to prevent urine from leaking out. Damaging this muscle could lead to urinary incontinence.
Doing pelvic floor exercises such as Kegels may help to strengthen these muscles and prevent leakage or repair muscle loss.
5. Kidney stones
Holding in pee may cause kidney stones to form in people with a history of the condition, or people who have a high mineral content in their urine. Pee often contains minerals such as uric acid and calcium oxalate.
Whether it was from the taco before the business presentation or the extra-large beer while watching the big game, everyone has had a time when they tried to hold back a bodily function—for their sake or for everyone around them.
While some bodily functions like sneezing can be disruptive, others like gas can be downright embarrassing. Depending on the circumstances, letting it out may even be rude.
“We’re all guilty of holding back bodily functions to be polite,” said Susan A. Werner, M.D., a Geisinger family medicine provider. “What you may not realize, however, is that it can have negative effects on your health. Bodily functions are supposed to be let out, and holding them in can cause infections or serious health issues.”
Here are four bodily functions you should just let go.
For most people, sneezes are far from subtle—which is understandable since you’re expelling air at around 40 miles per hour.
People hold in sneezes to avoid being disruptive, but the effects of holding in a sneeze might be more than you bargained for.
“There are cases of people rupturing their throats after holding in a sneeze,” said Dr. Werner. “The force is enough to break through your windpipe and push the air through the soft tissue in your neck. In these cases, it may be necessary to stay at the hospital for a week to heal completely.”
While this is a rare event, it does still happen. Luckily, it’s completely avoidable if you let the sneeze out.
Just be sure to sneeze into a tissue or your elbow (for everyone’s sake).
While you can sneeze anywhere you want, it’s not so easy when you have to urinate. Holding your urine is sometimes necessary, but if you find yourself doing a dance, it’s time to make a pit stop.
As liquid waste builds up in your body, you get the urge to urinate. It’s not harmful to hold it for a few minutes until you get to the bathroom, but if you wait too long, the effects can be unpleasant and even dangerous.
Holding your urine for too long can weaken the bladder muscles over time. This can lead to problems such as incontinence and not being able to fully empty your bladder.
Holding your urine for extremely long periods of time can also cause urinary tract infections due to bacteria build-up. In addition, it can increase your risk of kidney disease and in rare cases even risk your bladder bursting—a condition that can be deadly.
There are plenty of reasons to hold back a bowel movement. For most people, it’s not just a matter of finding a bathroom, it’s about finding the right bathroom and some peace and quiet.
As a result, some people may hold their bowel movements for too long.
“Don’t hold back bowel movements,” said Dr. Werner. “The longer you wait, the more water your body removes from the waste. Eventually, this can lead to constipation and impactions, which may require laxatives or even surgery to remove.”
Belches and flatulence are embarrassing, especially when they happen at the wrong moment. And because gas can smell or make a noise, most people try to hold it in until they find a secluded place.
Luckily, holding gas does not have serious or harmful side effects. However, it can cause bloating and discomfort.
“Interestingly, some early studies show that holding gas can lead to bad breath, too,” said Dr. Werner. “When you hold gas in, the bubbles can break down and go elsewhere throughout the body—which in some cases can end up making your breath smell.”
If you have the chance, it’s best to let gas go.
Susan A. Werner, M.D., is a primary care physician at Geisinger Nanticoke. T, call 570-258-1304 or visit Geisinger.org.
7 Surprising Risk Factors for Urinary Tract Infections
RELATED: 7 Tips to Help You Stay Hydrated
3. Taking certain drugs: As previously mentioned, whenever your bladder holds on to urine, rather than emptying completely when you pee, bacteria have more of a chance to grow and your risk of getting a UTI increases. Some medication — including antihistamines, antipsychotic drugs, decongestants, and anticholinergic drugs — can cause you to retain urine. That doesn’t mean you should stop taking them, Dr. Rabin says. Just be aware of the extra risk, drink lots of water, and try to void completely when you visit the restroom.
4. Wiping the wrong way: There’s a reason your mother taught you to wipe from front to back after you pee or have a bowel movement. (If she didn’t, she should have.): Going in the opposite direction can help bacteria travel from your anus to your urethra and into your bladder, Rabin says. In fact, when researchers evaluated the behavior patterns of premenopausal women who are susceptible to recurrent urinary tract infections, they found that wiping from back to front increased the risk by 64 percent and that the vast majority of infections (66 percent) were due to E. coli (a bacteria that normally lives in the intestines), according to a study in a 2018 issue of the journal Urologia Internationalis.
RELATED: Excessive Sitting May Harm Your Urinary Tract, Study Finds
5. Going through perimenopause or menopause: As estrogen levels start to drop with age, midlife women may experience some thinning of the tissues in the vagina and bladder, and the nerves and muscles may not function as well, which can cause difficulty emptying the bladder fully, Rabin explains. These changes can in turn foster bacterial growth, increasing the risk of UTIs.
RELATED: Bladder Symptoms Can Hamper Your Sex Life, Study Suggests
6. Having diabetes: Believe it or not, having diabetes can increase your chances of suffering from UTIs. In fact, research has found that the frequency of UTIs increases in women with type 1 diabetes who have poor blood sugar control. And people, especially older women, with type 2 diabetes who have high levels of hemoglobin A1C (a marker of average blood sugar levels over the previous three months) have a higher risk of UTIs, research has found. Adding insult to misery, UTIs tend to be more common, more severe, and harder to treat in people with type 2 diabetes, partly because higher levels of sugar in the urine can promote the growth of bacteria, experts note.
7. Wearing little lingerie: Wearing a thong, a teddy, or string-bikini underwear may make you feel sexy, but it can trap bacteria in the vaginal area and compress the sensitive tissue down there, making you more susceptible to vaginal infections and UTIs. “There are only a couple of inches of space between the openings to the urethra, the vagina, and the rectum,” Rabin notes. “Tight underwear can act as a superhighway for bacteria from the anus to travel to the vaginal area.”
US Pharm. 2016;41(4):18-21.
ABSTRACT: Urinary tract infections (UTIs) are very common in women and may be classified as acute (uncomplicated), recurrent, or complicated. Due to increasing antibiotic resistance, beta-lactam therapy has become less effective. There have also been recent reports of drug-induced UTIs related to sodium-glucose cotransporter 2 (SGLT2) inhibitors. Treatment of complicated UTIs (cUTIs) has become increasingly complex because of the rising prevalence of multidrug-resistant gram-negative bacteria. Two new IV antibiotics (Zerbaxa, Avycaz) have the potential to overcome some of the antibiotic resistance noted with oral medications. Both of these drugs combine an antibiotic with novel beta-lactamase inhibitors and have shown promise in eradicating gram-negative resistant infections.
Urinary tract infections (UTIs) represent a significant health problem in both community and hospital-based settings. Approximately 11% of women in the United States report a minimum of one physician-diagnosed UTI per year, and the lifetime probability of UTI in females is 60%.1
These infections may involve the lower urinary tract, the upper urinary tract, or both. The presence of bacteriuria without symptoms is termed asymptomatic bacteriuria. Cystitis refers to infections limited to the lower urinary tract presenting with dysuria, frequent and urgent urination, and occasional suprapubic tenderness. Acute pyelonephritis refers to infection of the upper urinary tract accompanied by fever, flank pain, and significant bacteriuria. Complicated UTI (cUTI) occurs in patients with predisposing factors including obstructed urinary flow (i.e., congenital causes), prostatic obstruction or urinary stones, incomplete bladder emptying due to anatomical or neurogenic causes, foreign bodies within the urinary tract (e.g., catheters, drainage tubes), systemic illness (e.g., diabetes), and pregnancy.1
Causes and Risk Factors
Urine is normally sterile, but infection may occur due to bacterial entry from the periurethral area. The most common causative organisms include Escherichia coli, Klebsiella pneumoniae, Staphylococcus aureus, Candida species, and Mycobacterium tuberculosis. Risk factors for UTIs include previous UTI, sexual activity (particularly with new sexual partners), use of spermicides, menopause, pregnancy, reduced mobility (i.e., after surgery or bed rest), urinary incontinence, kidney stones, and prostate enlargement. Other risk factors include age (older adults are at higher risk) and gender. Female patients are at higher risk compared to males because of shorter urethra length and proximity of the urethra to the anus, increasing the risk that bacteria will enter the urinary tract.2 Elderly patients may present with atypical symptoms including changes in mental status, lethargy, weakness, and abdominal pain.3,4
A new class of drugs for the treatment of type 2 diabetes has been linked to increased cases of UTIs in patients. Sodium-glucose cotransporter 2 (SGLT2)inhibitors or “flozins” are oral hypoglycemics that work by increasing the amount of glucose spilled into the urine. This class of drugs includes canagliflozin (Invokana), empagliflozin (Jardiance), and dapagliflozin (Farxiga). The FDA recently highlighted this risk in a Drug Safety Communication in May 2015, reminding prescribers to evaluate patients for signs and symptoms of UTI, treat promptly if indicated, and counsel patients on how to recognize the signs and symptoms related to UTIs. Unfortunately, in some patients these UTIs may develop into life-threating renal complications or failure, as well as urosepsis.5
Historically, the treatment for uncomplicated acute cystitis has consisted of 7 to 10 days of antibiotic treatment. However, studies have shown that a 3-day course of antimicrobials has equivalent efficacy to longer treatment courses, with eradication rates of >90%.6 Due to increasing antibiotic resistance, beta-lactam therapies such as first-generation cephalosporins and amoxicillin have become less effective than other agents listed in TABLE 1.1
Recurrent UTIs are defined as two or more UTIs within 6 months, or three or more UTIs within a 12-month period. Strategies to prevent recurrent UTIs in women include continuous prophylaxis, postcoital prophylaxis, and acute self-treatment. A continuous prophylaxis strategy consists of using antibiotic treatment once daily, every other night, or 3 nights per week.7 This strategy may reduce recurrent UTIs by 95%, but may be associated with uropathogen resistance.8 The postcoital prophylaxis option consists of a single dose of antibiotic taken within 2 hours of intercourse and may be most beneficial for women who experience UTIs within 24 to 48 hours after intercourse. Reliable patients who have experienced well-documented, recurrent infection and are in good communication with their healthcare provider may benefit from an acute self-treatment approach with initiation of treatment when symptoms occur. In these situations, patients receive a prescription for a 3-day dosage regimen and start therapy when symptoms develop.1
Complicated UTIs and Antimicrobial Resistance
Treatment of cUTIs has become increasingly complex due to the rising prevalence of multidrug-resistant (MDR) gram-negative bacteria. The CDC has identified specific serious public health threats including extended spectrum beta-lactamases (ESBLs) and the organism Pseudomonas aeruginosa, and has labeled carbapenemase-resistant Enterobacteriaceae (CRE) an urgent threat.9
Clinicians are advised to consider local resistance patterns during selection of antimicrobial therapy (TABLE 2), particularly for E coli since this microbe is responsible for 75% to 95% of uncomplicated cystitis and pyelonephritis. However, treatment of uncomplicated UTIs based upon data from hospital antibiograms remains an “imperfect science.” For example, these data may be skewed due to inclusion of samples from inpatient populations or patients with complicated infections. In addition, local in vitro resistance rates may change over time or be unknown. Thus, additional options for optimal care include identification of predictors of resistance unique to an individual patient, such as use of trimethoprim-sulfamethoxazole (TMP-SMZ) in the preceding 3 to 6 months or travel outside the U.S.10
Methods to prevent UTIs include urination before and after sexual activity, hydration, regular urination, taking showers instead of baths, and avoidance of douching or use of sprays and/or powders in the genital area. In addition, females should be taught to wipe from front to back during toilet training activities.2
A recent study published in 2015 highlighted the role of diet in the prevention (or treatment strategy) of UTIs.11 This study identified two factors important in a patient’s ability to resist bacterial growth. First, urine with higher pH (i.e., increased levels of alkalinity) was shown to be of importance. The pH of urine may be increased by intake of certain drugs (such as calcium supplements), and alkalinizing agents are available as OTC options in other countries such as the United Kingdom. A second finding in the study involved the protein siderocalin, which is produced by humans during UTIs and blocks bacterial iron uptake. Foods rich in polyphenols such as tea, coffee, wine, and cranberries affect siderocalin’s antibacterial activity and may be helpful as a strategy to prevent UTIs or treat these infections without antibiotics.11
Patients who wish to utilize alternative treatments such as cranberry juice may approach pharmacists for advice. In these situations, counseling points include selection of products with reduced sugar and calories, such as a “light” juice or cocktail. Cranberry tablets or capsules may provide an alternative for patients who wish to avoid cranberry juice.
New IV Antibiotics
In December 2014, the FDA approved a new drug to treat cUTIs. Zerbaxa (TABLE 2) combines an antibiotic to eradicate bacteria (ceftolozane) and a beta-lactamase inhibitor (tazobactam) to combat the enzymes produced by bacteria to resist the antibiotic. A recent study (ASPECT–cUTI phase III trial) compared Zerbaxa to levofloxacin and found that Zerbaxa was superior to levofloxacin in achieving the primary outcome of clinical cure and microbiologic eradication. This combination was also highly effective against multiresistant and levofloxacin-resistant pathogens. Specifically, only 2.7% of gram-negative pathogens were resistant to Zerbaxa, compared to 26.7% resistant to levofloxacin. Common adverse effects include nausea, diarrhea, headache, and fever.12
The FDA also approved another fixed-combination antimicrobial agent, ceftazidime-avibactam (Avycaz), with multiple indications including cUTIs (TABLE 2). This is the fifth antimicrobial agent approved under the Generating Antibiotic Incentives Now (GAIN) title of the FDA Safety and Innovation Act.13 The inclusion of avibactam restores the ability of ceftazidime, a third-generation cephalosporin, to show activity against numerous beta-lactamase producing gram-positive bacteria.9 Avycaz is effective in treating cUTIs caused by gram-negative microorganisms including E coli, Klebsiella species, and P aeruginosa. As part of an effort to reduce further emergence of drug-resistant bacteria and to retain the effectiveness of these new IV antibiotics, pharmacists should advise prescribers that both Zerbaxa and Avycaz be reserved for patients with infections proven (or strongly suspected) to be caused by susceptible bacteria.14,15
The release of two new IV antibiotics with activity against MDR bacteria is a welcome addition to the pharmacologic treatment of UTIs. Pharmacists must maintain vigilance when counseling patients about antibiotic adherence and drug-induced causes of UTI, as well as increasing their efforts to reserve these new antibiotics for infections caused by designated susceptible microorganisms.
1. Treatment of urinary tract infections in nonpregnant women. ACOG Practice Bulletin. Obstet Gynecol. 2008;111(3):785-794.
2. CDC. Get smart: know when antibiotics work. Urinary tract infection. www.cdc.gov/getsmart/community/for-patients/common-illnesses/uti.html. Accessed January 31, 2016.
3. Matthews SJ, Lancaster JW. Urinary tract infections in the elderly population. Am J Geriatr Pharmacother. 2011;9:286-309.
4. Nicolle LE. Urinary tract infections in the elderly. Clin Geriatr Med. 2009;25:423-436.
5. FDA Drug Safety Communications. FDA revises labels of SGLT2 inhibitors for diabetes to include warnings about too much acid in the blood and serious urinary tract infections. December 4, 2015. www.fda.gov/Drugs/DrugSafety/ucm475463.htm. Accessed January 31, 2016.
6. Iravani A, Tice AD, McCarty J, et al. Short-course ciprofloxacin treatment of acute uncomplicated urinary tract infection in women. The minimum effective dose. Arch Intern Med. 1995;155(5):485-494.
7. Epp A, Larochelle A, Lovatsis D, et al. Recurrent urinary tract infection. J Obstet Gynaecol Can. 2010;32:1082-1090.
8. Lichtenberger P, Hooton TM. Antimicrobial prophylaxis in women with recurrent urinary tract infections. Int J Antimicrob Agents. 2011;38(suppl):36-41.
9. Mawal Y, Critchley IA, Riccobene TA, et al. Ceftazidime–avibactam for the treatment of complicated urinary tract infections and complicated intra-abdominal infections. Expert Rev Clin Pharm. 2015;8(6):691-707.
10. Gupta K, Hooton TM, Naber KG, et al. International clinical practice guidelines for the treatment of acute uncomplicated cystitis and pyelonephritis in women: a 2010 update by the Infectious Diseases Society of America and the European Society for Microbiology and Infectious Disease. Clin Infect Dis. 2011;52(5):e103-e120.
11. Shields-Cutler RR, Crowley JR, Hung CS, et al. Human urinary composition controls antibacterial activity of siderocalin. J Biol Chem. 2015;290(26):15949-15960.
12. Edwards JK. Ceftolozane-tazobactam gives a new ASPECT to the fight against antimicrobial resistance. Nat Rev Nephrol. 2015;11:388.
13. FDA approves new antibacterial drug Zerbaxa. FDA news release. December 19, 2014. www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm427534.htm. Accessed January 31, 2016.
14. Avycaz (ceftazidime and avibactam) package insert. Cincinnati, OH: Forest Pharmaceuticals, Inc; September 2015.
15. Zerbaxa (ceftolozane and tazobactam) package insert. Whitehouse Station, NJ: Steri-Pharma, LLC; July 2015.
16. Lexi-Drugs . Hudson, OH: Lexi-Comp, Inc; 2016. http://online.lexi.com. Accessed January 31, 2016.
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Antibiotics For UTI Treatment – What Are My Options?
Medically reviewed by Leigh Ann Anderson, PharmD Last updated on Jun 4, 2019.
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What is a UTI | Which antibiotic to use | Common side effects | Antibiotic resistance | New antibiotics | OTC antibiotics | Recurring UTIs | Treatment without antibiotics | Cranberry juice | More resources
What is a urinary tract infection (UTI)?
If you have ever experienced the frequent urge to go the bathroom with painful and burning urination, you have probably experienced a urinary tract infection (UTI). UTIs are one of the most common types of infections, accounting for over 10 million visits to health care providers each year. Roughly 40% of women experience a UTI at some time, and in women, it is the most common infection. Healthcare costs related to UTIs exceed $1.6 billion per year.
A urinary tract infection (UTI) can happen anywhere along your urinary tract, which includes the kidneys (the organ that filters the blood to make urine), the ureters (the tubes that take urine from each kidney to the bladder), the bladder (stores urine), or the urethra (the tube that empties urine from the bladder to the outside). Most UTIs occur in the bladder and urethra. Common symptoms include frequent need to urinate, burning while urinating, and pain in lower abdomen area.
There are different types of UTIs based on where the bacteria goes. A lower urinary tract infection occurs when bacteria gets into the urethra and is deposited up into the bladder — this is called cystitis. Infections that get past the bladder and up into the kidneys are called pyelonephritis.
Urinary tract infection symptoms may include:
- Pain or burning upon urination
- A frequent or urgent need to urinate
- Passing small amounts of urine
- Blood in the urine or or pink-stained urine
- Urines that looks cloudy
- Strong-smelling urine
- Pain, cramping in the pelvis or pubic bone area, especially in women
Upper UTIs which include the kidney (pyelonephritis) may also present with symptoms of fever, chills, back or side (flank) pain, and nausea or vomiting.
Older patients may have an atypical presentation that includes altered mental status, lethargy, and weakness.
An infection of the tube that empties urine from the bladder to the outside is called urethritis, or an inflammation of the urethra. Urethritis symptoms can include burning with urination and a discharge. Urethritis is often caused by a sexually transmitted infection and may require a different antibiotic than those used to treat UTIs.
Most UTIs in women (roughly 85%) are caused by a bacteria known as Escherichia coli (E. coli). Other types of bacteria, such as Staphylococcus saprophyticus may infrequently be present.
UTI symptoms in women and men are similar. However, urinary tract infections occur more frequently in women than in men. This is because a woman’s urethra (the tube that empties urine from the bladder) is shorter and closer to the anus than in men, allowing easier entry of bacteria like E. coli into the urethra.
Menopause, lowered levels of estrogen, and elevated vaginal pH also increase the risk of a UTI. Women are also more likely to get an infection after sexual activity or when using a diaphragm and spermicide for birth control.
Other risk factors for the development of UTIs include catheter use, urinary tract structural abnormalities, diabetes, and a suppressed immune system.
Which antibiotic should be used to treat a UTI?
There are multiple types of antibiotics used to treat urinary tract infections (UTIs). Different treatments may be recommended in different areas of the country based on regional patterns of antibiotic resistance.
Most patients with an uncomplicated UTI will begin treatment without any special diagnostic test, although a urinalysis may be performed by taking a urine sample. In a urinalysis, the chemical components of the urine are determined, and the doctor may look at urine color, clarity, and a view a sample under the microscope. A urine culture may be order, too, but is not always needed to start treatment. A urine culture can define the specific bacteria causing the UTI in more complicated cases or in the case of treatment failure.
Symptoms like burning and stinging while urinating will usually clear up in within one day after starting treatment. Be sure to finish your entire course of medication. If symptoms are still present after 2 to 3 days, contact your healthcare provider.
More extensive diagnostic procedures or imaging tests like an X-ray may be required if you continue to have frequent UTIs.
What oral antibiotics are used to treat an uncomplicated UTI in women?
The following oral antibiotics are commonly used to treat most uncomplicated UTI infections (acute cystitis):
- nitrofurantoin (Furadantin, Macrobid, Macrodantin)
- fosfomycin (Monurol)
- sulfamethoxazole-trimethoprim (Bactrim DS, Septra DS, others)
Your doctor will choose your antibiotic based on your history, type of UTI, local resistance patterns, and cost-considerations. First-line options are usually selected from nitrofurantoin, fosfomycin and sulfamethoxazole-trimethoprim. Amoxicillin/clavulanate (Augmentin) and certain cephalosporins, for example cefpodoxime, cefdinir, or cefaclor may be appropriate options when first-line options cannot be used.
Length of treatment for cystitis can range from a single, one-time dose, to a course of medication over 5 to 7 days. Kidney infections may require injectable treatment, hospitalization, as well as a longer course of antibiotic, depending upon severity of the infection.
Sometimes a UTI can be self-limiting in women, meaning that the body can fight the infection without antibiotics; however, most uncomplicated UTI cases can be treated quickly with a short course of oral antibiotics. Never use an antibiotic that has been prescribed for someone else.
In men with symptoms that do not suggest a conplicated UTI, treatment can be the same as women. In men with complicated UTIs and/or symptoms of prostatitis are not present, men can be treated for 7 days with a fluoroquinolone (ciprofloxacin, levofloxacin). Tailor therapy once urine cultures are available.
Are quinolones safe?
The fluoroquinolones, such as ciprofloxacin (Cipro) and levofloxacin (Levaquin) have also been commonly used for simple UTIs; however, FDA safety recommendations strongly suggest that this class be reserved for more serious infections and only be used if other appropriate antibiotics are not an option.
- An FDA safety review found that both oral and injectable fluoroquinolones (also called “quinolones”) are associated with serious and potentially disabling side effects involving tendons, muscles, joints, nerves and the central nervous system.
- These adverse effects can occur soon after administration to weeks after exposure, and may potentially be permanent.
- Patients should discuss the use of fluoroquinolones and their side effects with their healthcare provider.
However, certain oral fluoroquinolones may be appropriate for more complicated UTIs, including pyelonephritis and complicated UTIs in men with prostate involvement. For the outpatient treatment of uncomplicated pyelonephritis, the following quinolones may be appropriate. Based on resistance patterns (>10%), an inital dose of a long-acting parenteral antimicrobial, such as ceftriaxone, may be needed, or a 24-hour dose of an aminoglycoside.
- ciprofloxacin (Cipro, Cipro XR)
- levofloxacin (Levaquin)
Patients should be informed of the most current FDA warnings surrounding the use of fluoroquinolone antibiotics.
Will I need an intravenous (IV) antibiotic for a UTI?
If you are pregnant, have a high fever, or cannot keep food and fluids down, your doctor may admit you to the hospital so you can have treatment with intravenous (IV) antibiotics for a complicated UTI. You may return home and continue with oral antibiotics when your infection starts to improve.
In areas with fluoroquinolone resistance exceeding 10%, in patients with more severe pyelonephritis, those with a complicated UTI who have allergies to fluoroquinolones, or are unable to tolerate the drug class, intravenous therapy with an agent such as ceftriaxone, or an aminoglycoside, such as gentamicin or tobramycin, may be appropriate. Your ongoing treatment should be based on susceptibility data received from the laboratory.
Common side effects with antibiotic use
Each antibiotic is responsible for its own unique list of side effects, and the list is usually extensive. Be sure to discuss your individual antibiotic side effects with your healthcare provider. However, there are side effects that are common to most antibiotics, regardless of class or drug:
- Vaginal yeast infections or oral thrush (candida species): Antibiotics may also change the normal flora balance in the vagina and lead to a fungal overgrowth. Candida albicans is a common fungus normally present in small amounts in the vagina and does not usually cause disease or symptoms. However, vaginal candidiasis may occur when there is limited competition from bacteria due to antibiotic treatment.
- Abdominal (stomach) upset: Antibiotics are frequently linked with stomach upset such as nausea, vomiting, lack of appetite (anorexia), stomach pain, or heartburn (dyspepsia). Taking your antibiotic with a snack or a meal may help to decrease stomach upset, if you do not need to take it on an empty stomach. If your medication causes you to vomit, contact your doctor immediately for an alternative.
- Antibiotic-associated diarrhea: Antibiotics may commonly lead to uncomplicated antibiotic-associated diarrhea or loose stools, that will clear up after the antibiotic is stopped. Broad-spectrum antibiotics can also kill the normal gut flora (“good bacteria) and lead to an overgrowth of infectious bacteria, such as Clostridium difficile (C. difficile). If the diarrhea is severe, bloody, or is accompanied by stomach cramps or vomiting, a physician should be contacted to rule out C. difficile. The most common antibiotics implicated in antibiotic-associated diarrhea are amoxicillin-clavulanate, ampicillin, cephalosporins, fluoroquinolones, azithromycin, and clarithromycin.
- Stevens Johnson Syndrome (SJS), Toxic Epidermal Necrolysis (TEN): Stevens-Johnson syndrome (SJS) and toxic epidermal necrolysis (TEN) are rare but serious allergic drug reactions. Skin reactions like rash, skin peeling, and mucous membranes sores can occur and may be life-threatening. Antibiotics such as sulfonamides, penicillins, cephalosporins, and fluoroquinolones may result in SJS and TEN.
Related: Common Side Effects from Antibiotics, Allergies and Reactions
What about antibiotic resistance?
Resistance rates for antibiotics are always variable based on local patterns in the community and specific risk factors for patients, such as recent antibiotic use, hospital stay or travel. If you have taken an antibiotic in the last 3 months or traveled internationally, be sure to tell your doctor.
High rates of antibiotic resistance are being seen with both ampicillin and amoxicillin for cystitis (E. coli), although amoxicillin/clavulanate (Augmentin) may still be an option. Other oral treatments with reported increasing rates of resistance include sulfamethoxazole and trimethoprim (Bactrim DS, Septra DS) and the fluoroquinolones. Resistance rates for the oral cephalosporins and amoxicillin/clavulanate are still usually less than 10 percent.
Always finish taking your entire course of antibiotic unless your doctor tells you to stop. Keep taking your antibiotic even if you feel better and you think you don’t need your antibiotic anymore.
If you stop your treatment early, your infection may return quickly and you can develop resistance to the antibiotic you were using previously. Your antibiotic may not work as well the next time you use it.
Latest antibiotics for UTIs
The latest FDA antibiotic approvals for UTIs include:
- Vabomere (meropenem and vaborbactam) is a combination carbapenem antibiotic and beta-lactamase inhibitor. Vabomere was first approved in August of 2017.
- Vabomere is used for the treatment of adult patients with complicated urinary tract infections (including pyelonephritis) due to susceptible Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae species complex.
- Vabomere is given as an intravenous infusion every 8 hours. Dosage adjustments are required in patients with varying degrees of kidney impairment.
- Zemdri (plazomicin) is an aminoglycoside antibacterial for the treatment of complicated urinary tract infections, including pyelonephritis. Zemdri was first approved in February of 2015.
- Zemdri is used against certain Enterobacteriaceae in patients who have limited or no alternative treatment options. Zemdri is an intravenous infusion, administered once daily.
- Avycaz (ceftazidime and avibactam) is a cephalosporin and beta-lactamase inhibitor antibiotic combination used for complicated UTIs, including pyelonephritis, in adult and pediatric patients 3 months and older, and without alternative treatment options. Avycaz was first approved in February of 2015.
- Avycaz is used for complicated UTIs caused by the following susceptible Gram-negative microorganisms: Escherichia coli, Klebsiella pneumoniae, Enterobacter cloacae, Citrobacter freundiicomplex, Proteus mirabilis, and Pseudomonas aeruginosa.
- Avycaz is given as an intravenous infusion every 8 hours. Dosage adjustments are required in patients with varying degrees of kidney impairment.
- Zerbaxa (ceftolozane and tazobactam) is a cephalosporin and beta-lactamase inhibitor combination for the treatment of complicated urinary tract infections including pyelonephritis. Zerbaxa was first approved in December 2014.
- Zerbaxa is given as an intravenous infusion every 8 hours. Dosage adjustments are required in patients with varying degrees of kidney impairment.
See also: Treatment Options for UTIs
Are there any over-the-counter antibiotics for UTIs?
Over-the-counter (OTC) antibiotics for a UTI are not available. You should see your doctor to have your symptoms evaluated.
Your provider may recommend an OTC product called Uristat (phenazopyridine) to numb your bladder and urethra to ease the burning pain during urination. Uristat can be bought without a prescription at the pharmacy. A similar phenazopyridine product called Pyridium is also available.
Take phenazopyridine for only 48 hours, and be aware it may cause your urine to turn a brown, orange or red color which may stain fabrics or contact lenses. It may be best to not wear contact lenses while being treated with phenazopyridine.
Phenazopyridine is not an antibiotic and will not cure a UTI.
See also: Ratings of Urinary Anti-Infectives
What if I have frequent, recurring UTIs?
Within a year of havig a UTI infection, roughy one-quarter to one-half of women will have another UTI. For these women antibiotic prophylaxis (medication to help prevent a UTI) may be recommended by her health care provider. With a recurrent course of UTIs, a urine culture or imaging tests may be required for further analysis.
For recurrent UTIs, there are several antibiotic options for prevention:
- A shorter course (3 days) of antibiotics at the first sign of UTI symptoms; a prescription may be given to you to keep at home.
- A longer course of low-dose antibiotic therapy.
- Take a single dose of an antibiotic after sexual intercourse.
The choice of antibiotic is based on previous UTIs, effectiveness, and patient-specific factors such as allergies and cost. Antibiotics commonly used for recurrent UTIs can include sulfamethoxazole-trimethoprim, nitrofurantoin, cefaclor, or cephalexin.
In postmenopausal women with vaginal dryness that may be leading to recurrent UTIs, vaginal estrogen may be an effective treatment. Treatment options your doctor might recommend include: Estring(a vaginal ring), Vagifem (vaginal tablet insert), or vaginal estrogen creams (examples: Premarin, Vagifem, Yuvafem).
Can I treat a UTI without antibiotics?
UTI treatment without antibiotics is NOT usually recommended. An early UTI, such as a bladder infection (cystitis), can worsen over time, leading to a more severe kidney infection (pyelonephritis). However, a small study has suggested early, mild UTIs might clear up on their own. It’s always best to check with your doctor if you are having UTI symptoms.
Pregnant women should always see a doctor as soon as possible if they suspect they might have a UTI, as this can lead to a greater risk of delivering a low birth weight or premature infant.
Does cranberry juice prevent a UTI?
Some patients may want to use cranberry or cranberry juice as a home remedy to treat a UTI. Cranberry juice has not been shown to cure an ongoing bacterial infection in the bladder or kidney.
Cranberry has been studied as a preventive maintenance agent for UTIs. Studies are mixed on whether cranberry can really prevent a UTI. Cranberry may work by preventing bacteria from sticking to the inside of the bladder; however, it would take a large amount of cranberry juice to prevent bacterial adhesion. More recent research suggests cranberries may have no effect on preventing a UTI
- According to one expert, the active ingredient in cranberries — A-type proanthocyanidins (PACs) — are effective against UTI-causing bacteria, but is only in highly concentrated cranberry capsules, not in cranberry juice.
- However, cranberry was not proven to prevent recurrent UTIs in several well-controlled studies, as seen in a 2012 meta-analysis of 24 trials published by the Cochrane group.
- While studies are not conclusive, there is no harm in drinking cranberry juice. However, if you develop symptoms, see your doctor. Some people find large quantities of cranberry juice upsetting to the stomach.
The effectiveness of many herbal or home remedies may not have been scientifically tested to the same degree as prescription medications — or at all. Over-the-counter herbal products and dietary supplements are not regulated by the FDA. Side effects and drug interactions may still occur with alternative treatments. Always check with your health care professional before using an over-the-counter, herbal or dietary supplement for any condition. In most cases, an antibiotic is the best treatment for a UTI.
Increasing fluid intake like water, avoiding use of spermicides, and urinating after intercourse may be helpful in preventing UTIs, although limited data is available.
- Bladder Infection
- Kidney Infections
- Urinary Tract Infection In Children
- Urinary Tract Infection In Men
- Urinary Tract Infection In Women
- Difficulty Passing Urine
- Loss of Control of Urine in Women
- Painful or Frequent Urination in Men
- Alcohol and Antibiotic Interactions
- Antibiotic Resistance: The Top 10 List
- Antibiotic Shortages: A Serious Safety Concern
- Antibiotics – Common Side Effects, Allergies and Reactions
- Antibiotics and Birth Control Pill Interactions
- Middle Ear Infection FAQs (Acute Otitis Media)
- Why Don’t Antibiotics Kill Viruses?
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.
More News Resources
- Disease Reference
- Medication List
- Q & A
11 Sneaky Causes of Urinary Tract Infections
While all this may sound pretty doom-and-gloom, you can reduce your risk of a UTI by avoiding some of the causes.
1. You eat a lot of sugar
Bacteria that cause UTIs love feeding on sugar, so you run the risk of providing a feast for them whenever your sweet tooth strikes. Kalas V, et al. Structure-based discovery of glycomimetic FmlH ligands as inhibitors of bacterial adhesion during urinary tract infection. DOI: 10.1073/pnas.1720140115
“If you eat tons of added sugars and get a real surge in your blood sugar, you may end up with some of that sugar in your urine,” says Mary Jane Minkin, MD, a clinical professor of obstetrics and gynecology at the Yale School of Medicine.
Some foods and beverages, like coffee, booze, and chocolate, can also irritate your delicate urinary tract and exacerbate an existing UTI.
2. You have diabetes
Research shows that if you have diabetes, you’re more likely to get UTIs. Nitzan O, et al. Urinary tract infections in patients with type 2 diabetes mellitus: Review of prevalence, diagnosis, and management. DOI: 10.2147/DMSO.S51792 Scientists suggest the increased risk may be related to a compromised immune system, incomplete bladder emptying, or fluctuations in blood sugar.
3. You wipe from back to front
Wiping from back to front can transport E. coli, the bacteria that’s behind most UTIs, from the rectal region to the urethra. Moral of the story: Always wipe from front to back. Al-Badr A, et al. (2013). Recurrent urinary tract infections management in women: A review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749018/
4. You have lots of sex
The more sex you have, the likelier it is you might get a UTI, Minkin says. That’s because bacteria may move to the urethra from the vagina and from the perineum, which is the area between your vagina and your anus. Al-Badr A, et al. (2013). Recurrent urinary tract infections management in women: A review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3749018/
Keep in mind that sex toys, oral sex, and anal sex can all introduce bacteria to anyone’s pee parts.
5. You don’t pee after sex
The threat of getting a UTI shouldn’t stop you from getting it on. But that doesn’t mean resigning yourself to the afterburn.
One simple way to cut your risk: Head to the potty after you’ve finished your romp. You’ll possibly flush out the bacteria that may have made their way into your urinary tract. Hickling DR, et al. (2013). Management of recurrent urinary tract infections in healthy adult women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784967/
6. You hold it too long
We’re all busy, but not taking time to hit the loo — and not just post-sex — does more harm than good. You don’t want urine to sit in your bladder for long periods because bacteria in there can multiply if they hang around too long. So don’t hold your pee.
7. You’re using certain methods of birth control
When it comes to UTI prevention, not all birth control methods are created equal. Luckily, only one method is associated with UTIs: a diaphragm.
Because of where the diaphragm sits, it puts pressure on the urethra, which might lead to an increased risk, says Minkin. The good news? There are plenty of other great birth control options.
8. You’re using condoms
Hold up! Hear us out before you throw out your love gloves. Although you should always practice safer sex, unlubricated condoms can increase the risk of UTIs, possibly because of increased irritation to the vagina during sexual activity.
And using spermicide with diaphragms and condoms can increase your risk even more. Hickling DR, et al. (2013). Management of recurrent urinary tract infections in healthy adult women. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3784967/ Try lubricated condoms without spermicide or use unlubricated condoms with a nonspermicidal lubricant.
9. You don’t drink enough water
Guzzling H2O will make you go pretty often. And that’s a good thing. “When you do this, the bacteria gets flushed out before they have a chance to grab hold,” Minkin says.
Consider that your cue to make a giant water bottle your BFF. Hooton TM, et al. (2018). Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: A randomized clinical trial. DOI: 10.1001/jamainternmed.2018.4204
10. You’ve got a cold, the flu, or allergies
You may be tempted to curse your seasonal sneezes, a cold, or the dreaded flu for making your life even more miserable with a UTI, but these ailments aren’t the cause. The meds you take to manage symptoms could be.
Though they’re the bomb at keeping your runny or stuffy nose in check, antihistamines and decongestants might make you go less by causing urinary retention. And — see No. 6 — that may lead to a UTI.
11. You’re pregnant
“Pregnant women have a higher chance of getting a UTI because the hormonal changes cause the bladder muscle to relax, thus delaying emptying,” says Iffath A. Hoskins, an OB-GYN in the Department of Obstetrics and Gynecology at NYU Langone Medical Center.
Is Your Toilet Paper The Cause Of Your UTIs?
Suffering from a urinary tract infection is basically a right of passage for a female. I mean, if you’ve got a vagina, you’ve had a UTI … almost, anyway. According to the World Health Organisation, 50% of women report having a UTI at some point in their lives—and that’s just the reported cases.
UTIs are the most common bacterial infection globally. As anyone who has contracted the infection would know, it’s a seriously unpleasant experience. But for such an epidemic issue, there’s still a lot of unknown. And for those who suffer constantly, do you even know what’s the cause?
Apparently, it could be your toilet paper. According to Zoe Levin, founder of Bim Bam Boom, fluffy toilet paper could be the reason for your UTIs, yeast infections and general irritation “down there.” In case you were confused, she goes on to explain: “With every wipe, small pieces of TP are discarded into your glorious flaps, often leading to irritation and possible infections.”
But that’s not all. The vagina is the most absorbent part of the body. Along with linty leave-behinds, genital irritation and allergic reactions can be triggered by trace amounts of dioxins, chemicals and glues. In fact, when it comes to the vagina, a number of chemicals that are otherwise “deemed safe” can elicit reactions in sensitive individuals.
While you might not have considered it, a lot of conventional toilet paper is full of chemicals. Taking to the lab, Levin and her team found that conventional toilet paper contains chlorine bleach dioxide residues, formaldehyde and itchy glues.
“We were flabbergasted by the muffin crumb trail conventional TP leaves behind in our muffs. So we did something about it!” she says. In short, she created a toilet paper that’s safe for your hoo-haa.
Bim Bam Boom toilet paper is the only pH-friendly tissue formula. Unlike regular TP, which is made from wood pulp, Bim Bam Boom uses sustainable bamboo to prevent irritation and allow your pussy to prosper. Not only this, it’s velvety-soft, hypoallergenic and antimicrobial by nature.
“This means you can (literally) wipe away your worries about irritation and eliminate harmful clitty litter,” says Levin.
Plus, being made from bamboo, it’s just as absorbent as your typical TP (if not more) and much more sustainable so it’s saving the planet as well as a trip to the doctors.
Bim Bam Boom is currently up on Kickstarter. They’ve just reached their goal of $10,000 but according to Levin, they’ll need a lot more to really combat clitty litter and deforestation. So, give them—and a man’s true best friend (the pussy, duh)—a hand by picking up a roll or at the very least, watch the video for the LOLs.
Editor’s note: if you do suffer from recurring UTIs, check out www.liveutifree.com for more information on how to prevent them.
Urinary tract infections account for roughly 8.1 million hospital visits per year. As the second most common infection in the body (behind the common cold), chances are you or a friend has suffered through at least one. In fact – sorry, ladies – the lifetime risk of having a urinary tract infection (UTI) is more than 50 percent. What’s worse, if you’ve had a UTI, you are prone to contract another.
Wouldn’t it be great to stop a Urinary Tract Infections (UTI) before it starts?
Understanding the triggers of UTI can help prevent unnecessary suffering, endless bathroom stops, and another trip to the doctor.
Looking for relief?
Expect relief right away in a 30-minute UTI appointment, with everything needed to make you feel better: urine sample, testing & medications. Make an appointment with any of our board-certified urologists.
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The Top Six Triggers:
If you are prone to UTIs and experiencing inflammation, itching, and general discomfort, you may be allergic to your bath or feminine products. An allergic reaction can result in swelling, redness and in some cases, discharge. Allergy to a product can cause a growth of microorganisms, resulting in a UTI.
- Tip: Avoid powders, deodorants and perfumed soaps and opt for unscented bathroom products including soap, toilet paper, tampons, and feminine napkins. Wear cotton underwear and pass on synthetic fabrics such as polyester and rayon.
2. Birth Control
Certain contraceptives can cause UTIs, while others do not. Options that may leave women more prone to UTIs include diaphragms, condoms and spermicidal foams.
- Tip: If you experience a UTI and believe it may be due to your contraceptive, visit your doctor and explore birth control alternatives.
Dehydration causes your entire body to suffer. Lack of water places undue stress on the heart, immune system and kidneys. If your immune system can’t function properly, bacteria that would have otherwise been flushed out may multiply in your urinary tract.
- Tip: Stay hydrated! Rather than focus on drinking a specific amount per day, focus on the color of your urine. Clear or light-colored urine signifies hydration, while bright or deep yellow urine signals dehydration.
4. Dietary Additives
Food additives have been covered extensively for the threats they pose to physical health, but they can also be the catalyst to an uncomfortable UTI. Chemicals and preservatives give bacteria and organisms a firm helping hand for growth inside the bladder.
- Tip: Stay away from products high in fructose, caffeine, sugar, phosphoric acid, and limit alcohol intake. If you are sensitive to certain products and must indulge, counteract with an acidic beverage including lemon or cranberry, or grab a handful of antioxidant-rich blueberries.
5. E.Coli & Yeast Infections
These types of infections are the most common UTI culprit. Yeast and E. Coli can travel from the rectum or vaginal area during a bathroom visit, then go up the urethra and into the bladder, causing an infection.
- Tip: Don’t wipe back to front as this can easily cause a UTI. Instead, remember to wipe front to back. Utilize the same cleansing technique during bathing.
6. Sexual Activity
If you frequently experience a UTI within 24 hours of sex, your sexual activity is likely the cause. High amounts of friction and certain positions (such as the woman on top) may promote UTIs. In rare cases, the woman may have an allergy to her partner’s sperm.
- Tip: Clean your private area before and after sexual activity. Urination immediately after sex also cleans the urethra and can kill bacteria. If you believe friction may be the cause, try a different sexual position.
5 Bathroom Mistakes You Don’t Know You’re Making
Considering the fact that you go to the bathroom multiple times per day, you’d think you’ve got this ladies room business down. Turns out, there are quite a few things that can go wrong during your trips to the latrine that may increase your risk of infection, irritation, and illness. No thank you!
Here, five bathroom mistakes you may be making and how to correct them with healthy habits.
Sitting on the Toilet Too Long
Spending some extra stall-time scrolling through your Twitter feed is one thing (oh come on, we all do it). But if you’re actually straining, you could be putting yourself at risk for hemorrhoids-painful, swollen veins in your anus that can bleed. “If you’re having a hard time having a bowel movement, get up, walk around, and come back,” says Anish Sheth, M.D., a gastroenterologist and author of What’s Your Poo Telling You? “Walking around can stimulate the intestines to move things downstream, and also help you relax so you don’t have to force things out.” If you regularly strain when going to the bathroom, take a closer look at your diet. Make sure you’re getting enough fiber, about 25 to 30 grams per day, as well as ample water.
When it comes to wiping, less is more and not just because it keeps you from replacing the toilet paper roll every other day. “Overwiping can irritate the perianal skin and lead to small abrasions that trigger inflammation and itching,” Sheth says. One or two wipes are all it takes, he says. If you need to wipe more than that you may not have completely emptied your system or you could be constipated (in which case, up your fiber and water intake like you would to prevent hemorrhoids). If you still require more than a few wipes, consider switching to wet toilet paper or unscented baby wipes. “Moist wipes decrease the friction of wiping and cause less irritation,” Sheth says.
Using the Air Dryer
They might as well be called germ blowers: A recent study found that jet air dryers spread 27 times as many microbes as paper towels and nearly five times more bacteria than warm-air blowers, according to researchers from the U.K. Scientists found higher amounts of germs in the air around both types of dryers-they could still detect the bugs 15 minutes after use-than around paper towel dispensers. Your best bet: Grab a paper towel to dry off your mitts and head for the door ASAP to reduce your exposure to the swirling airborne bacteria. Besides a hand dryer, here are 10 Personal Items You Don’t Want to Share!
Wiping in the Wrong Direction
You’ve been doing it since mastering potty training, but after peeing, many women still wipe in the wrong direction. “Always wipe from front to back,” says Alyssa Dweck, M.D., an ob-gyn and author of V is for Vagina. “Wiping from back to front can bring bacteria from the rectum toward the urethra and increase your chances of a urinary tract infection.” And, since women’s urethras are relatively short (men’s run along the length of their penis), bacteria can easily travel into your bladder and make a miserable UTI more likely. This may not be shocking, but these 4 Causes of Urinary Tract Infections are pretty surprising!
You’re Too Clean Down There
Just because there are products that can make your lady bits smell fresh as a flower doesn’t mean you should use them. “The vagina doesn’t need to be excessively cleansed and refreshed with soaps, washes, sprays and wipes, which can actually disrupt the normal pH balance and lead to itching, irritation, and rash,” Dweck says. Simply wash with mild soap and water when showering or bathing (pssst! Using mild cleansers is one of 7 Ways to Keep Your Vagina Young). One tool that can help? A hair dryer to wick away excess moisture. “Use it on a low, cool setting after bathing if you’re prone to infection or irritation,” she adds. And cleansers aren’t the only things to avoid using on your vagina-here are 10 More Things to Never Put Near Your Vagina!)
- By Paige Fowler
Can Thongs Cause UTIs and Yeast Infections?
In theory, since your thong is just touching your body, you won’t catch anything you don’t already have. In fact, studies have never been able to find a link between thongs and infections. But some women do notice an increase in UTIs and yeast infections when they wear these undies, so you’ll have to decide if it’s worth the risk to avoid visible panty lines.
The potential problem with these undergarments is that fecal bacteria can move more easily from the rectum to your vagina, and then work their way into your urinary tract, possibly causing a UTI. Also, tight thongs may irritate the vagina and surrounding skin, which opens you up to infection.
No need to switch to granny panties: Just use basic common sense-meaning, good hygiene. Don’t wear the same thong for more than a day, and wear them for limited periods of time. If you start to notice any itching or irritation on your outer skin, switch to a loose cotton pair of undies instead. And if you develop a UTI or yeast infection, don’t wear a thong until the infection is history.
Is Cotton Underwear The Key to Preventing UTIs?
I see London, I see France…I see avoiding UTIs with cotton underpants!
First of all, can you get a UTI from your underwear?
Urinary tract infections occur when harmful bacteria (such as E.coli from fecal matter) travel up your urethra and multiply. Bacteria can flourish when you go too long without changing your underwear, or wear ones made of synthetic materials like lycra or nylon.
How does underwear material and style affect your health down there?
If you’re like me, you might have been scared into buying thongs in middle school out of fear of being tormented for “VPL” or Visible Panty Lines (#everydaysexism y’all). This worry has haunted me up until it was suggested I reconsider thongs altogether. “If you have a little bacteria — E. coli is the most common bacteria in the colon — in the back part of the fabric and you’re physically active, that material may move. All it has to do is move an inch or two and it’s next to the vagina or urethra. That thong may be depositing colonic bacteria into your vagina or urethra.” Dr. Rabin an Associate Professor of Clinical Obstetrics & Gynecology and Women’s Health at Albert Einstein College of Medicine wrote for HuffPost. Still can’t imagine a life without thongs? You’re not alone. But at least opt for cotton ones, and avoid wearing them during physical activity as they tend to shift.
Lycra, nylon, lace, and polyester
These synthetic fabrics are fake friends to your vagina. These fabrics don’t “breathe” and keep the genital area warm and moist which are perfect conditions for bacteria that cause UTIs. Cotton crotches on synthetic fabric panties are not enough, given these fabrics will still trap moisture and bacteria inside the panties. We’re not saying to ditch your sexy undergarments, but just keep in mind that these are designed to wear for foreplay, not all day.
Bridget Jones isn’t the only woman facing a dilemma when it comes to Spanx and shapewear. The tight garments can cause UTIs, albeit indirectly. Shapewear makes going to the bathroom physically demanding (dare I say, torturous?), which makes you less likely to use the bathroom, and more likely to hold in your urine for a prolonged amount of time. Plus there’s the whole “unbreathable” synthetic fabric thing to consider as well. If you continue using shapewear, make sure you’re still urinating frequently, washing them after each use, and not wearing them on the reg.
If you are prone to sweating a lot, that means damp sweaty underwear can put you at risk of a UTI or a yeast infection because it’s a favorable environment for bacteria. The same goes for wearing a damp bathing suit for too long. Whatever you wear to get your workout on (when you look good, you feel good!), just make sure you shower and change to dry, clean, breathable undies post sweat session.
You didn’t know that was a thing?! Neither did we. Berkeley Wellness writes, “Made from textiles with antimicrobial properties, this special underwear is marketed to prevent odors. Though it’s not always clear from the labels, the antimicrobial effect often comes from silver or nanosilver (ultra-small particles of silver).” However, exposure to silver may throw off your body’s natural bacterial balance. Of course, the choice is yours, but we’re not entirely sold on whether this underwear is necessary.
Ding ding ding, we have a winner! It’s natural, breathable, affordable, COTTON! “Cotton wicks moisture away from the skin”, says Jan Sheehan, a writer for MD-reviewed Everyday Health. When your genital area is kept dry, bacteria is less likely to grow, which lessens the risk of a UTI. Whether it’s booty shorts, high rise or hipster, 100% cotton underwear (changed daily and after workouts!) is your best bet. Be sure to make sure they don’t fit too tight, in order to avoid ingrown hairs and to keep from trapping moisture and bacteria.
The best cotton panties for UTIs:
- If you do wanna thong it up: Hanes Women’s Cotton Thong Panties 6-Pack (for $10.25)
- These boy short panties that are 95% cotton and 5% spandex, if you wanna live life on the edge.
- Fruit of the Loom Women’s 6-Pack Assorted Cotton Bikini Panties
- Lace trim cotton hipsters, not 100% cotton, but a good alternative to thongs when you want to avoid panty lines.
One last thing…Be free!
When it’s time for bed, let your vagina breathe. Go full-on commando or wear loose-fitting, breathable pajama bottoms. This is the best way to keep your lady parts dry while you sleep, plus it feels amazing.
Making small changes to your choice of undies can benefit your health big time. Sometimes stocking your underwear drawer with cotton panties isn’t enough to keep UTIs at bay. If you need to call in for backup, stat, Uqora’s got you covered.
8 Underwear Rules to Live by for a Healthy Vagina
Do you ever think to yourself, “Am I doing this underwear thing wrong?” It may be an integral part of our routine, but it’s not something the average person knows much about.
Like, did you know that there are certain fabrics that are healthier for you or certain times that going commando is better or that there’s sort of an expiration date for underwear?
These unspoken underwear rules can have an impact on your vaginal health — and, depending on the style, can even affect your mood!
So we did a lot of research, dug through several underwear hygiene studies, and talked to an OB-GYN to collect eight underwear rules to live by.
1. Overall, choose natural fabrics — specifically cotton
You may have heard this before, but with all the cute styles in a variety of fabrics out there, it’s worth saying again: cotton is the best underwear fabric.
“The vulva is a very sensitive and delicate area, similar to the lips on your face. You want to treat gently,” explains Dr. Alyse Kelly-Jones, board-certified OB-GYN.
And the most simple, gentle fabric to touch your skin? Yep, cotton. It’s also breathable and absorbent, which can help prevent yeast infections.
“Since it is healthy to have a vaginal discharge — similar to the moisture you always have in your mouth — you want your underwear to gently absorb any extra moisture,” explains Kelly-Jones.
Synthetic materials like nylon and spandex don’t allow the area to breathe. Instead, they trap heat and moisture, creating a perfect breeding ground for yeast infections.
2. Aim to change your underwear every day, even more than once if you want!
It seems like we typically wear one pair of underwear a day and then put it in the laundry to be washed. That may not always be necessary. On the other end of the spectrum, you shouldn’t feel restricted to just one pair per day.
Some doctors say that you can get away with wearing a pair of underwear two days in a row if there’s not much discharge or sweat. But if you start to feel uncomfortable because of vaginal discharge buildup, you can change them more than once a day, as Kelly-Jones reminds her patients all the time.
“Many of my patients are bothered by this moisture and wear pantie liners all of the time,” she says. “I think this is not the healthiest of behavior as liners can cause chafing and irritation. Cotton-lined underwear will solve this problem, and it’s OK to change more than once a day.”
After they’ve been worn, toss them in the hamper to wash. Unlike jeans, underwear shouldn’t be reworn just to save on doing a load.
3. Go commando at night to air out the moisture
There’s a lot of debate about whether or not going underwear-free to bed is better for you.
For those who have a healthy vagina, either choice is fine. For those who deal with regular yeast infections, going pantie-free to bed can make all the difference.
Going without a cloth barrier allows the area to breathe overnight and keeps moisture from building up or creating an environment for bacteria to build.
“I believe the vulva area should be exposed to the air, just like any other area of your body,” says Kelly-Jones.
If you really don’t like the feeling of being naked, Kelly-Jones recommends wearing loose-fitting pajama bottoms. Just remember, if you’re going without underwear but are wearing another type of bottom, they need to be washed frequently as well.
Basically, it doesn’t hurt to go without underwear overnight.
4. Well-fitting, moisture-wicking underwear is best for working out
Again, whether to go pantie-free or not when working out is a personal preference. If you’re wearing shorts that have moisture-wicking underwear built into it, you can forgo the underwear.
Wearing something between you and the fabric may be more comfortable and an even healthier way to catch the sweat. Typically, this would be a high-tech polyester that’s light and slick.
If you do choose to wear a pair, Kelly-Jones notes, “The most important thing is to make sure it fits well and doesn’t cause chafing.”
Once you find your ideal size, you can pick from the tons of great workout-specific underwear options like Lululemon’s Mula Bandhawear Bikini ($18) or Patagonia Women’s Active Briefs ($12).
5. Thongs really aren’t bad for your vaginal health
It’s always been assumed that thongs can’t be good for the health of your nether regions.
However, studies haven’t found evidence that thongs cause yeast vaginitis (YV), bacterial vaginosis (BV), or urinary tract infections (UTIs) — three of the main issues women experience:
- A2005 study looked directly at string underwear and found that the microenvironment of the vulvar skin didn’t change at all due to the style of underwear. The underwear had no effect on the pH, skin microclimate, or aerobic microflora.
- A recent study looked at the association of thongs with UTIs, BVs, and YVs and, again, found no evidence supporting the assumption that thongs can cause these issues.
Instead, they concluded that sexual behavior and hygiene choices had caused these conditions.
Avoid douching. A2011 study specifically associated douching with increased BV. Daily bathing slightly increased the chance of BV. BV was not associated with underwear material, pads, or tampons.
So don’t be afraid to wear a thong when the occasion calls for it.
6. Wash your underwear in hypoallergenic soap
All types of underwear should be handled more gently then the rest of your wardrobe, not just your special lacy, stringy thongs. This isn’t because they’re your “delicates.”
It’s mostly because they sit up against your more sensitive skin area for long periods of time. Kelly-Jones recommends using gentle, hypoallergenic soap to wash them because “anything soapy or chemical next to the vulva can lead to irritation, itching, allergic reactions.”
The cleanest way to wash your underwear
- After washing, tumble dry on low-heat for 30 minutes.
- Sick roommate or family? Don’t mix your underwear in the same load.
- Don’t mix contaminated underwear with clean underwear or with pants if you have BV.
- Wash underwear separately from clothes that have been contaminated with other bodily fluids.
Pro tip: Concerned about the washing machine? Do a hot water and bleach-cleanse (about 1/2 cup of bleach to a full wash-spin-drain setting) to sanitize the machine before putting your laundry in.
7. Consider replacing your underwear every year
Sounds a bit excessive, especially for something that gets washed so regularly. But according to the Good Housekeeping Institute, even clean underwear can contain up to 10,000 living bacteria.
This is because there’s bacteria in washing machine water — about one million bacteria in just 2 tablespoons of used water! Further, about 83 percent of “clean” underwear contains up to 10,000 bacteria.
Beyond bacteria, there’s a chance your underwear could contain feces. According to Dr. Gerba, who told ABC News in 2010, “There’s about a tenth of a gram of poop in the average pair of underwear.”
Throwing out your underwear every year isn’t the eco-friendliest option, and if you don’t have bacterial problems down there, you may not have to clean out your drawers annually.
But if you do experience BV or other symptoms frequently, experts say you may want to replace your underwear every year.
The best way to wash your underwear
Here are some washing recommendations:
- After washing, tumble dry on low heat for 30 minutes: One doctor told the New York Times that tumble drying for 30 minutes or ironing after washing can help minimize new bacteria that’s been picked up during the wash. “The heat from a low dry cycle or an iron was sufficient to get the clothes free of the studied bacteria,” she told the publication.
- Sick roommate or family? Don’t mix your underwear in the same load: With bacteria already swimming around in your washing machine, there’s no need to risk more.
- Don’t mix contaminated underwear with other pairs or pants if you have BV: This is especially important for people who do laundry less frequently. Do a separate wash to keep the bacteria levels lower and avoid cross contamination.
- Wash underwear separately from clothes with other bodily fluids: In hospital settings, wash clothes that have been cross-contaminated (with vomit, blood, urine, etc.) separately. Do the same with your underwear, especially if you have family members who work in a hospital. If there are other fluids, focus on getting the blood or vomit out of the clothes and keeping them away from garments that you wear up against your private parts.
8. The style of underwear can affect your mood
Even though it goes unseen (for the most part), underwear can actually play a major part in how you feel.
In a U.S. nationwide poll from by ShopSmart, 25 percent of self-identified women revealed that their moods were affected by “unattractive” or ill-fitting underwear.
They also discovered that almost half the women polled (47 percent) felt sexier or more confident when wearing a special pair of underwear.
Don’t underestimate the power of your most intimate garment or think that just because nobody sees it, it doesn’t have to look awesome.
If you’re ever feeling a little down, turn to your sexiest pair of panties. Like a power pose, it could give a nice confidence boost.
Emily Rekstis is a New York City-based beauty and lifestyle writer who writes for many publications, including Greatist, Racked, and Self. If she’s not writing at her computer, you can probably find her watching a mob movie, eating a burger, or reading an NYC history book. See more of her work on her website or follow her on Twitter.