From baths, to sugary drinks, to exercise and sex. There are lots of everyday trigger that can cause chronic UTI to flare up.
Day-to-day triggers that could cause a flare or irritate the bladder or urethra
This information is based on the research about known bladder and urethral irritants, advice from some specialists and the experiences of chronic UTI sufferers who are aware of their own triggers.
All triggers are very individual and some may have no issues at all. None of this information is prescriptive and if they don’t apply to you, then ignore. If they do, remember things can be reintroduced once the bladder starts to heal. Lives are there to be lived, not excluded.
- Baths – sometimes an unclean bath can harbour bacteria.
- Bubble bath/bath creams and bath bombs can also cause issues.
- Swimming pools – caustic chlorine can irritate the urethra and bladder. If the water looks cloudy, chemicals may only recently have been added
- Public hot tubs/jacuzzis – these can be a breeding ground for bacteria as they are not regularly cleaned and sterilised
- Condoms lubricated with spermicide – these can lead to an increase in UTIs. Find out more about Contraception and UTI.
- Scented toilet paper – chemicals can cause vaginal, vulval and urethral irritation
- Douching – will upset the natural balance of vaginal secretions and can lead to bacterial vaginosis/thrush/vaginal bacterial infections
- Underwear made of synthetic materials. Thongs are also known to cause UTI issues due to the proximity of the string to the anus (back passage) and bacterial transfer between anus and vaginal and urethral openings
- Tight jeans – can cut blood supply to urogenital tissues and rub along the urethral entrance
- Scented washing powders and fabric softeners – chemicals can cause vaginal, vulval and urethral irritation
- Coffee and tea – a diuretic due to caffeine. Find out more about diet and drink
- Cranberry juice/fruit juices – these are acidic and can cause irritation
- Carbonated drinks – carbonic acid can be a bladder irritant and fizzy or sparkling water contains dissolved carbon dioxide which results in an acidic solution and may increase urinary urgency. These also contain caffeine which may make any symptoms of urgency or frequency worse.
- Chocolate – In general, chocolate with high cocoa content such as dark or bitter chocolate may lead to reactions due to the biogenic amine content. White chocolate usually is better tolerated. To produce white chocolate, the cocoa mass is deprived its cocoa powder. Only the cocoa butter is used. Milk constituents and sugar is then usually added. White chocolate contains less biogenic amines, as only the cocoa butter is used.
- Alcohol – due to the fermentation process and in some cases high tannin levels which can cause histamine problems. It can also increase the acidity level of your urine and irritate the bladder lining
What else can you try?
Although we are all know wiping ‘front to back’ when passing a bowel movement is important as bacteria can be transferred from the anus to the vaginal/urethral entrance via the perineum causing UTIs, it is worth ensuring that children and the older generation carry out this simple practice to prevent infections
Pelvic floor cushions
For those with a tight pelvic floor and/or who experience a lot of pain when sitting for long periods of time, a pelvic floor cushion with a cut out specifically for the urogenital area has provided some with lots of relief. It’s also useful for travelling as well.
Chronic UTI and work
A chronic UTI can affect the ability to work. Sufferers struggle on in silence worried about having more time away from the office on sickness absence which increases the stress already felt.
Once a diagnosis of chronic UTI has been established, consider discussing this with your HR department or line manager and contact your specialist to ask them to write a letter of diagnosis/explanation of treatment. The nature of these infections may mean that more frequent bathroom trips are needed, sitting for long periods of time can cause pain and there may be days where you feel generally very unwell. All this needs to be taken into account.
We’ve produced a guide to chronic UTI for employers. It is designed to help employers understand more about chronic UTI and how they can assist you, their employee.
For those unable to work due to long term sickness, each country may provide social security benefits.
- In the UK, the Citizens Advice Bureau can provide information about benefits available. See also the webpage for the Department for Work and Pensions.
- In the US, the IC Network provides information about claiming sickness disability payments.
- In Australia, the Department for Human Services provides more information.
There are also personal, private insurance schemes that can be taken out to cover sickness absence. These would need to be researched further as there are often clauses excluding long-term health issues which are known as pre-existing conditions.
Sex and a chronic urinary tract infection
Unfortunately sex may lead to an increase in your symptoms. The act of penetration can increase pain purely because the vagina is so close to the inflamed urethra and bladder and penetration irritates these areas.
Try to give the bladder time to heal with the treatment regime you are following before attempting sex and only do so when you are feeling comfortable and well enough. Do not feel pressured into this. Be honest with your partner and ask for respect and time whilst you heal. Be open and if needs be seek counselling to help maintain and strengthen your relationship.
There is also a theory that having sex breaks up the biofilm/embedded bladder wall infection by agitating the bladder wall cells, therefore releasing bacteria into the urine and increasing pain due to a flare of symptoms. This is also applies to orgasm whether through penetrative sex, outercourse or masturbation.
If symptoms deteriorate following sex, always seek medical advice.
Ways to minimise post sex flares
- Wash your vulval area both before and after sex
- Ask any partner to thoroughly clean themselves and scrub fingers before sex
- Use plenty of a non-irritating water-based lubricant such as Yes or Sylk
- Drink a pint of water before sex and then urinate immediately afterwards and drink plenty of water.
Keep up any antibiotic or antibacterial treatment even if things have completely settled. Even some who are well are still reporting flares after sex and have found they have had to take antibiotics afterwards for a few days.
Exercise is a very individual issue and what works for one may cause another to have a bad flare.
In the early days of treatment, aerobic exercise including body pump classes and running, cycling and horse riding, Bikram and Ashtanga yoga are reported to have caused an upsurge of symptoms for some.
Swimming pools can irritate as chlorine is a known urethral and bladder irritant. Be cautious if the water looks cloudy due to the recent addition of more chemicals.
But if exercise causes no problems, keep exercising.
Walking and restorative yoga classes are an excellent start for those starting to heal and wanting to gently exercise. After that, listen to the body and add in exercise gradually. Remember if attending a group class make sure to tell the teacher about any pelvic floor issues. A good teacher should always offer alternatives and as with any exercise, if it is causing pain anywhere in the body – stop.