Your mother may have taught you to wipe front to back after peeing.  It sounds logical. It used to be spouted as gospel by health care professionals too.  Yet a well-done review article found no difference in the rate of bladder infections correlated with how a woman wipes after using the toilet. It can’t hurt to be too clean down there or can it?

Bladder infections, the most common type of urinary tract infection (UTI), doesn’t mean you are dirty. UTIs happen when naturally occurring bacteria get into the bladder and fail to be disposed of by our immune system. Sex efficiently moves bacteria into the bladder because of the proximity of the urethra to the vagina and is strongly associated with UTI risk. Fortunately, just because bacteria are in the bladder doesn’t mean they attack, so most women do not develop symptoms. Dr. Betsy Foxman goes on to write that they found no association between the direction women wiped following urination, wearing tight jeans (or pantyhose) or taking bubble baths—so please don’t overzealously scrub down there. Urinating regularly, especially after any type of sex, and keeping hydrated is more likely to prevent UTIs.

In menopausal women, the lack of estrogen commonly makes the vagina feel dry during sex and it makes the urethra susceptible to more pathogenic bacteria resulting in higher rates of UTI.  Using topical vaginal estrogen not only makes sex comfortable, and consequently enjoyable again, it also lessens UTIs.

Cranberry taken daily (recommend capsules since less sugar than cranberry juice) often helps those women who frequently get UTIs. Should all these preventative measures fail to help women with recurrent bladder infections then doctors will often prescribe a single dose of an antibiotic to take either before or after sex.

If you experience burning while urinating, and perhaps also peeing more often, feeling like you’re not empty at the conclusion of voiding, or blood-tinged urine; then you may have a UTI and should be evaluated ASAP.  An over‑the‑counter remedy, Phenazopyridine (also branded as Azo, Uristat), may give you relief in the meantime until you can get to your doctor’s office for testing and treatment.  Please don’t ignore these symptoms as a bladder infection which isn’t dangerous may ascend to your kidneys and become a life-threatening infection that can also get into the blood stream causing sepsis or long-term kidney damage.

Wishing you good health!

Scott Kramer MD, FACOG

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