Sex & Intimacy Tips for Women with Underactive Neurogenic Bladder
Women with underactive neurogenic bladder often struggle with sex and intimacy due to the painful recurrences of UTIs. Unfortunately, urinary retention, long-term catheterization, and sex all increase the risk of UTIs. For women with underactive bladder, the former two are already part of their everyday life, so adding another risk factor—sex—into their lives can feel intimidating.
However, many women may still want to pursue the sense of empowerment and the bodily joy that come with sex. If you’re on the same journey, here are some tips to help you reclaim sex and intimacy.
Brief overview of UTI and CAUTI
Urinary tract infection refers to an infection at any point in the urinary tract system, which includes the kidneys, ureters, bladder, and urethra.
The infection is caused by E. coli 75%-95% of the time. E. coli usually resides in your colon and moves to the anal area during bowel movements. Every time you walk or run, the rubbing between your skin or between the underwear and your skin can move E. coli to the urethral opening, where it enters and infects the urinary tract.
UTI can also be caused by other types of bacteria, or more rarely, by viruses and fungi.
CAUTI refers to catheter-associated UTI, which is caused by the insertion of a urinary catheter contaminated with germs. People who catheterize long-term are especially prone to CAUTI.
Now that we know what caused the infections, here are some tips to avoid them.
1. Clean both you and your partner’s genital and anal area before sex
Sex increases the chance of UTI because it involves motions that can push bacteria from either partner’s genital and anal area into the urethra.
Men don’t usually get UTIs because their urethra is longer and their urethral opening is not located next to the anus. Women, on the other hand, have short urethras and urethral openings located close to the anus. This allows bacteria to travel much easier to the urethra and up to the bladder. This is the main reason why women are more prone to UTIs after sex and in general.
To nip the problem in the bud, both partners need to thoroughly clean their genital and anal area before sex. Soap and water can mechanically remove bacteria from your body. If during sex, other instruments or body parts are going to touch the genitals, make sure to thoroughly clean them as well.
2. Avoid unprotected sex with someone who has not been screened for STIs (sexually transmitted infections)
Although UTIs can not be sexually transmitted, sexually transmitted infections can cause UTIs. Diseases such as chlamydia and gonorrhea that infect the genitals can also infect your urethra. Therefore, if you are not absolutely sure the other person doesn’t have an STI, protection is needed. Keep in mind that condoms are not 100% effective.
3. Avoid sex when you already have a UTI
When you have taken antibiotics for a couple of days and your symptoms are cleared, it can be tempting to resume sex. Although it is rare for you to get a second UTI while on antibiotics, there is still a slim chance. You can, of course, make the decision to take the risk. However, penetration can irritate the urethra and bladder that neighbors the vagina and ureters, making your UTI symptoms worse.
4. Ensure hygiene when during self-catheterization
The following steps are crucial for clean intermittent catheterization:
- Wash your hands with soap and water. To do this correctly, scrub your palms, fingers, wrist, the back of your hands, and under your fingernails with soap for 20 seconds.
- Clean your urethral opening with soap and water or antiseptic wipes.
- If the catheter is taken out of the package and touches anything before insertion—your unclean hands, your clothes, your skin, etc—you should dispose of it and use a new one.
- Use single-use, no-touch catheters to lower the risk of catheter contamination.
Bonus tip: try using these intermittent catheters pre-lubricated with anti-bacterial silicone oil to see if they can help you lower infection rates.
5. Don’t push yourself if you are uncomfortable
If you already suffer from UTI symptoms, or if you start to feel uncomfortable during sex, listen to your body and stop. There will always be another chance to try again.
If you feel a lot of anxiety around sex, it is also good for you to work out that anxiety with your partner and with a therapist. You can also start a conversation with your doctor on what specific things you can do to avoid getting UTIs from sex.
Sex should only be done when it brings you pleasure, satisfaction, and power. If it doesn’t at the moment, there’s no need to push yourself.
If you use intermittent catheters and get frequent infections, see if CompactCath is right for you.
CompactCath catheters are pocket-sized, no-touch, and pre-lubricated with anti-bacterial silicone oil.
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Please note that the above tips are not foolproof ways of eliminating UTIs, nor are they formal medical advice, but hopefully, they can help you.