Audrey asks:

I am 22, I have been on the contraceptive pill since I first became sexually active at age 15. I have REALLY regular UTIs (I always pee and drink water after sex etc) and have been on antibiotics for that quite alot. I also experience a hightened sex-drive if I go off the pill even for a few weeks. I feel like, even though my GP doesn't even consider it, that my UTIs might be due the contraceptive pill.

Jenna replies:

Audrey's question continued:

So I'm looking into alternatives. I followed the links on this site about contraception but it looks like my only options are barriers or hormones and that seems like such a drag for me as I'm in a long-term relationship. Please help? WHEN will there be a male contraceptive? WHEN??

UTIs (urinary tract infections) can be such a drag! I am sorry to hear about your recurring UTIs and contraception conundrum.

UTIs are caused by bacteria that enter the urethra (where you pee from) and can spread to the bladder. Unfortunately, people with vaginas are far more prone to UTIs than people with penises, due to our shorter urethras and more potential for bacteria to enter and cause an infection.

It sounds like you are familiar with your body and do your best to prevent UTIs, so I am going to talk a little bit about the relationship between UTIs and birth control, other UTI suggestions, and other birth control options.

Birth Control & UTIs

Some studies have shown that there is a correlation between oral contraceptives and urinary tract infections. Others say that women using birth control are more likely to have sex, and sex is directly related to UTIs, thus being on birth control indirectly leads to more infections. However, a study (as well as a doctor's opinion) doesn't affect your own personal experience. You know your body better than anyone else, and if you believe that your birth control pills might be causing your UTI, then it might be a good idea to change up your birth control method and see if something else may work better for your unique body. Additionally, it might be worth seeing different GP that will consider your concerns and work with you to find a birth control method that works best for your body.

Additionally, being on hormonal birth control can certainly decrease your sex drive: that's very well-documented at this point, even though it doesn't have that effect on everyone, and some users even find they experience an increased desire for sex while using the pill.

Some people feel that a change in libido is not worth being on hormonal birth control, but many others either do not experience any change in their sex drive or find that the benefit of being on a highly effective form of birth control is worth it. For more details on the possibler side effects of the combined hormonal pill, check out Birth Control Bingo: The Combination Pill.

UTI Prevention Methods

While UTIs are pretty awful, fortunately there are certain steps that you can take (or things you can avoid) to reduce the likelihood of developing an infection. You're already aware that drinking more water can help prevent UTIs, which is great. Instead of focusing on drinking water right after sex, however, being well-hydrated all the time can be even more helpful. Additionally, making it a habit to urinate after sex or masturbation as you have been doing is definitely effective in flushing out your urethra of bacteria that can cause UTIs. There are several other tips and tricks that you can use to decrease the chance of getting a UTI.

• Cranberry Juice: Studies show that that regularly drinking cranberry juice works to prevent urinary tract infections, especially in women that get UTIs often. Certain compounds in cranberries prevent bacteria from hanging out in the urethra and causing an infection. However, cranberry juice or supplements are not advised once someone already has a UTI: their value is as preventative medicine.
• Lubricant: If you ever use lube, it might be worth checking out the ingredients list on your preferred bottle. Some lubricants have certain ingredients that aren't very friendly to those that have sensitive skin or are prone to infections. Some ingredients to keep your eyes peeled for: glycerin, and anything ending in the word paraben. If you don't use lubricant at all, or as often as you need it, that can also create potential issues when it comes to being more susceptible to UTIs.
• Anal Sex: You may have heard the phrase "always end on anal". For people with vaginas that enjoy anal play of any kind, it is really important to make sure that bacteria from around your anus doesn't make it's way to your vagina or urethra... That's an infection waiting to happen! If you have anal sex or any type of anal play with a partner, make sure that either the anal play is the last thing you do, or your partner puts on a new condom or washes his or her hands before getting near your vagina or urethra.
• Get Tested: Getting tested for sexually transmitted infections (STIs) is recommended for all sexually active women under the age of 26 every year, so it's a very important part of maintaining your sexual health. Additionally, what might seem or feel like a UTI might actually be caused by or be the symptom of a different infection, so getting tested for the most common bacterial STIs (chlamydia, trichomoniasis and gonorrhea) with your partner might be a good idea.
• Medication: Some people who have chronic urinary tract or bladder infections have success with using a low-dose antibiotic either daily or before engaging in sex. That's another option you could discuss with a healthcare provider.
• Other Prevention Methods: There are actually quite a few other lifestyle changes that you can make to address the frequency with which you get UTIs! For a comprehensive list, plus other UTI facts, check out Out, Out Damn UTI!.

Exploring Your Options

In addition to actively preventing UTIs by trying some of the tips above, it sounds like you are also interested in changing up your birth control method. Before that, however, I think it might be helpful to take a step back and assess your attitudes around certain types of birth control with regards to being in a long-term relationship. You mentioned that using hormonal birth control or barriers are a drag because you are in a long-term relationship. Have you given any thought as to why you feel that way? Everyone's body is different, and you might find that the birth control method that works the best for your and your body is a method that you have not given full consideration to, simply because of your relationship status. Many people (myself included) have used barrier methods consistently as a form of birth control while in a long-term relationship, because of the benefits of using that particular method (low cost, accessibility, STI protection, and more). Being in a relationship shouldn't be seen as a barrier to the wealth of birth control options out there, especially if you have open communication and can discuss birth control together. For tips on talking with your partner about sex and birth control, check out Be a Blabbermouth! The Whys, Whats and Hows of Talking About Sex With a Partner.

If you do decide to explore alternative birth control options, there are other methods that are both highly effective forms of birth control, and also might decrease your persistent UTIs. You might find that a different method works better for your body, your lifestyle, and your personal preferences.

• Copper IUD

If you are looking for a form of birth control that does not have hormones and is also not a barrier method, then it is possible that the copper IUD (depending on where you live, it might be the Paragard, Flexi-T, Copper-T, Multiload CU250, or others) is what you are looking for. Everyone is different, so there is no one miracle birth control that will work for everyone. However, copper IUDs are a nice option for someone wanting to avoid hormones but also not rely only on barrier methods. They also work for up to 10-12 years, so if you are interested in a very effective, long-term birth control option, the copper IUD is worth learning more about.

• Other Contraceptive Methods

If you're open to sticking with hormonal birth control, there are other forms that might work well for your body and are a little different than the combined contraceptive pill. These birth control options only contain progestin, and do not have estrogen. Some people find that the side effects are different, as estrogen interacts differently with your body than progestin.
-Implant.
-Depo-Provera (The Shot)
-the Mirena (hormonal) IUD
-Progestin Only Pills

• Condoms for STIs

Additionally, while the above forms of birth control are great options for very effective contraception, they do not protect against STIs. Even if you are in a long-term relationship, condoms act as back-up protection and can also decrease the likelihood that you develop a UTI, as they can reduce the amount of bacteria that you are exposed to.

Male Contraception - WHAT!?

While a vasectomy is a highly effective procedure for people with penises that do not want to get anyone pregnant, there currently aren't a whole lot of short-term or temporary birth control options for men besides condoms. And although deciding on a form of birth control and sharing the cost of contraception can be a joint responsibility, it tends to feel like an imbalanced responsibility, especially because most methods usually involve the female's body. However, today is your lucky day!! Okay, well not quite yet, but reversible male contraception is definitely in the works and will be available in our lifetime. There are a couple of studies that are currently still being evaluated and pending approval before any products or procedure will actually be available to the public.

Unfortunately none of these options are currently available, but the research is encouraging! Hopefully someday birth control will a more equally shared responsibility. For updates and information on male birth control, check out malecontraceptives.org.

More on UTIs and Birth Control

Out, Out Damn UTI!
Mayo Clinic's UTI Fact Sheet
Birth Control Bingo
Hey Boyfriend! Male Reproductive Choices