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‘The Stigma Between UTIs and Sex Should Not Even Exist’

Denicia Dwarica, left, wears a gray blouse and has long, dark hair. Elizabeth Malm-Buatsi, right, wears a black turtleneck covered in gold flowers.
Veronica Mohesky
/
KBIA

Denicia Dwarica is a urogynecologist and Elizabeth Malm-Buatsi is a pediatric urologist at the University of Missouri’s Women’s and Children’s hospital.

They spoke about some of the common myths and misconceptions about urinary tract infections, or UTIs, during November – which happens to be Bladder Health Month.

Missouri Health Talks gathers Missourians’ stories of access to healthcare in their own words. You can view more conversations at missourihealthtalks.org

Dr. Denicia Dwarica: The only risk factor related to UTIs and intercourse - one is the use of spermicide, that increases your risk of UTIs, and frequency of intercourse, which could be high frequency or even a low frequency, as well.

So, with respect, we would not recommend use of spermicide. There's more effective birth control that should be used, then spermicide and it increases your risk of irritation and UTI. So, that's the one thing that is well studied. 

But overall, we have multiple non-sexually active women who have UTIs. You have your infant population, and I have my elderly population. And lots of these women are widowed or divorced or have partners are unable to have intercourse and they have UTIs.

So, I think the stigma between UTIs and sex should not even exist in the first place.

Just think about your anatomy, and we, as women, have an anatomy that allows us to bring children into this world. So, that's why our anatomy is the way it is. Unfortunately, some parts are closer to the urethra and bladder than others - so, it increases our risk of UTI.

Dr. Malm-Buatsi: I think it’s one of those things that magically you think is working and so you're going to tell them void before sex and void after sex, but I really think it's a water problem. Like if the urine is concentrated, it is going to burn whether you have sex or not.

Right, so increasing water, and most of these people, they don't drink enough water. If you just change your water, I mean, it's it gets concentrated, you don't want to pee, it burns. So, you definitely don't drink. You cuddle and say, “Oh, I'm hurting. I have a UTI.”

They check it. Of course, you have a UTI. You have this bacteria everywhere. Then you get antibiotics, then you of course you feel better. You're going to drink more with the medication. It's just flushing the system.

Dr. Dwarica: With women I see, I usually see the extremes. I see the women who are well hydrated who have their - and they tell me, “I have my 34-ounce bottle and I fill it three times a day.” They're very good at that.

But then you have the other extremes who will drink coffee and tea all day. So, coffee and tea, yes there's fluid in it but we really don't count that it as your water intake. We want you to just to have simple water, like avoid juice and sweeteners and things with different colors.

Dr. Malm-Buatsi: You have to make two to three liters of urine a day. Older kids. Adults. Okay?  so that's a lot of water intake to make that happen.

And unfortunately, there’s so much push for milk consumption that there’s really no water. Maybe a little bit of the whole bottle that they sent to school. And we don't really think about it that way, but that's the major problem because it's connected to the bowel habits, it’s connected to the bladder habits and it is all related.

And what we can do as schools - for all the school districts - with the children that every one and a half to two hours, please allow them to go pee. Actually, encourage them to pee and drink – Not a sip. A big gulp of water and go back to play or have a glass – and I really think every kid needs to do that.

This piece was reported and produced by Veronica Mohesky.

Rebecca Smith is an award-winning reporter and producer for the KBIA Health & Wealth Desk. Born and raised outside of Rolla, Missouri, she has a passion for diving into often overlooked issues that affect the rural populations of her state – especially stories that broaden people’s perception of “rural” life.
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