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I think I have a UTI: what should I do?

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ab asks:

I am a teenager and think I may have UI and that could be from a UTI but what should I do to treat it/make it go away as it is affecting daily routine? I have not visited any doctor as I am embarrassed to tell my parents about this possible problem. Do I need to see a doctor, if so how should I tell about this condition to my parents as I can't go on my own? What is the typical process during a doctor's visit for UI or UTI? Will it include a full body exam, because I feel nervous and sensitive to that, especially with someone else in the room with me (e.g. parents). What should I do about this? Can this be cured without need of going to a doctor?

Heather Corinna replies:

Let me first talk lay out the basics of UTIs.

A urinary tract infection (also called cystitis or bladder infections) is essentially something that happens when external bacteria enter your body through the urethra -- your urinary opening -- and get into your urinary tract and your bladder. That bacteria can get there any number of ways, from your hands and/or during toileting, via your undergarments (thongs in particular may provide a more direct route for bacteria from around the anus to get to the urethra), from fluids moving bacteria from your rectum to your vulva, and/or via masturbation or partnered sex. Spermicides have also been a suggested factor in urinary tract infections, if you use those or use condoms with spermicide.

It's far more common for women to get urinary tract infections than men, for a few reasons. Our urinary tract is shorter than the male urinary tract, which means bacteria can get into our bladders more easily. As well, because the vaginal opening is so close to the urinary opening, it's easier for bacteria from sexual activities to result in a urinary tract or bladder infection. Because women toilet differently than men (men don't wipe their penises), and our vaginal opening is also close to our anus, bacteria from fecal matter can wind up in the urinary tract that way.

Sometimes, we might have some irritation of the urinary opening, tract or bladder that isn't, or isn't yet, an infection, but could become one. If we're on the fringe like that, we might be able to fend off an infection and dump the irritation just by doing things like drinking extra water, taking a brief break from partnered sex, or using cranberry supplements for a few days.

But once you've got a bonafide infection, it's not likely to go away on its own, even if the symptoms of the infection get better for a while or seem to go away. If it was/is an actual infection, you can be pretty sure it's only going to really go away with treatment, which is usually a round of a specific class of antibiotics that tends to do the job and provide relief very quickly. Your doctor might also provide you an analgesic to take as well to help you feel better before the antibiotic can fully get rid of the infection (sometimes those make urine turn funny colors, by the way, so don't get freaked if you pee orange while taking that). There's really nothing you can do yourself to self-treat at that point, and you don't want to try and self-diagnose that anyway in case it's something else entirely or has spread to other parts of your body. If and when we don't get urinary tract or bladder infections treated, we can risk some real dangers, like a kidney infection. Kidney infections can actually get really serious, to the point where sometimes, people with them will need to be hospitalized.

You can perhaps, then, see why it's so important to get UTIs diagnosed by a healthcare professional and have them treated properly. And as you probably know already, it's also no small thing when it comes to your comfort. Feeling like you have to pee all the time, like your bladder is always full or having pain or burning when you do urinate is not at all pleasant and can really disrupt your life.

All a healthcare provider usually needs to do to test for a urinary tract infection is to have you give them a urine sample: you pee in a cup, they analyze your urine in the lab. They may also want to press around your abdomen, too, and ask you some basic questions about your health, your lifestyle and your symptoms. If you have been sexually active, your provider may suggest a pelvic exam and STI screening (since it's possible an STI could also be the reason for some issues), but if you have been, I'd suggest you start that kind of healthcare anyway. I know it can feel really awkward at first, and seem scary -- just like, say, going to the dentist can be -- but it really is important for your general health, and to a healthcare provider, your vulva really isn't any different from your ears. If a pelvic exam and/or pap smear is suggested, though, know that your doctor is suggesting that based on their best interest in protecting your health. They don't tend to suggest exams just because. For more information on gynecological exams in general, you can have a look here: Your First Gynecologist Visit. Again, even without these symptoms, if you are sexually active, getting those exams regularly (at least every year or two) is something I strongly encourage everyone to do.

I want to add that users in the age group that post here not only don't need to have a parent in the room during doctor visits, it's often not appropriate (just like there comes an age when a parent being with you while you bathe isn't appropriate when it comes to your privacy). A healthcare provider should really be asking them to wait in the waiting room unless you've asked, as the patient, if they can be present. And you are going to need general health exams which will involve some examination of your body: at your age, even routine physicals should include things like breast exams, for instance.

In case you also have concerns about other parts of your right to privacy with healthcare, know that your sexual health information, and any information about your sex life, is also protected. In other words, if you are sexually active, and are inclined to be dishonest with a doctor about that, please know you don't have to be in order to have any of that information remain with you and not be told to your parents. Your doctor cannot legally share that information with your parents unless they have reason to believe your life or health are in serious danger.

For the future, some things that can help to prevent urinary tract infections are:
• To be sure when toileting to wipe from front to back, rather than from back (your bum) to front.
• Not to hold it when you have to urinate. When you gotta go, go.
• To avoid douching (that also helps prevent bacterial vaginosis), or any kind of deodorant-anything when it comes to your vulva or vagina (soap, tampons, sprays, et cetera). If we're trying to make our vulvas smell like anything but vulvas, we can figure we may be putting our vulval or vaginal health at some kind of risk.
• Wearing undergarments made of natural fibers, not man-made fibers like nylon.
• Being sure to urinate both before and after any masturbation or partnered sex.
• Drinking enough water each day: usually, around eight glasses of water each day is what healthcare providers recommend.
• Some women who find they have ongoing trouble with UTIs can find taking a daily cranberry supplement helps.

Urinary incontinence -- loss of bladder control -- can be one symptom of a UTI, but an ongoing issue with incontinence over weeks, months or years probably is not about a run-of-the-mill UTI. Some typical causes of pervasive, ongoing UI are things like drinking too much water or too little, as a side effect of certain medications, sometimes it can be dietary issues (like due to alcohol or caffeine), pregnancy, the aging process (likely not applicable to you yet), urinary or bladder stones, and more.

I am concerned that it sounds like you may possibly have had a UTI for some time now that you have left undiagnosed and untreated. I don't mean to be a broken record, but it really is very important if you think you have any kind of infection in your body for some time that you get in to see your doctor ASAP. If you need your parent's help to do that, please ask for that help, but you also can go into your doctor or clinic on your own for that care, as well. If you have anxiety around doctor's visits in general, that's also something you can talk to your healthcare provider about and that they can help you manage so you're not going without care when you need it.

Lastly, I get that at a certain point, it can start to feel weird to ask parents about health issues pertaining to your genitals or systems of your body linked to your genitals. If it's feeling that way, and that's keeping you from getting care, that's obviously a big problem. So, you might either want to have a chat with one or both of your parents about how to arrange things so you can get care in this arena without talking to them about it, or talk about ways you all can make it more comfortable when you need to ask. You may even find that just voicing you feel awkward or uncomfortable about this to one or both of your parents, all by itself, makes you feel a lot better about it. If you want to know how to ask them about this right now, I'd suggest just telling them about what symptoms you have, and that you're having pain and discomfort. That really should be all you need to say for them to know you need to see a doctor.

Alternately, you also can choose to get that care yourself through a sliding-scale clinic (like Planned Parenthood clinics) so that you don't have to go through your parents for care at all.

Okay? Please do get in and get seen so that you can both be done with your symptoms, and protect your health. I'll leave you with a few extra links here to round all this out and give you some extra information:

written 26 Aug 2009 . updated 13 Dec 2013

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