Every woman in your life has likely had a urinary tract infection, or UTI, whether she’s told you or not. That’s because once women are sexually active, urinary tract infections are so common that some 40 to 60 percent of women have had at least one dance with the pee demon in their lives, with another 25 percent experiencing repeat hauntings.
The experience is hellacious: a burning sensation in the pee hole accompanied by the intense, constant need to take a leak. It’s like diarrhea, only with pee, except after you sprint to the nearest bathroom and drop trou, instead of a torrent of liquid pouring out of you in sweet release, nothing more than a drop or two emerges. It’s one of nature’s sickest, weirdest (literal) burns, topped only by its complementary symptoms of fevers, chills and fatigue that usually mean things have gotten real — like, straight-into-your-kidneys real.
But increasingly it’s clear that UTIs aren’t only a lady’s curse. Men get them too, and they feel just as bad, and just as bad about them. Take Mets pitcher Matt Harvey, who in 2016 woke up on his 27th birthday to find discolored urine during his morning pee. The incident forced him to miss his spring start, which led to massive speculation about his health.
That discoloration turned out to be Harvey passing a blood clot from his bladder due to a urinary tract infection, which, though scary, was easily treated. Still, once it got out that only a little pee problem caused the setback, he got little sympathy and mostly mockery. He got stuck with the nickname MV-Pee, and told the New York Post that people said “nasty things” about him on social media.
The Post also interviewed a 32-year-old man named Matthew who said he’d had recurring UTIs and numerous doctor visits, but is still ashamed about it.
“It’s tied to your confidence and masculinity,” he told them. “The tests that need to be done can be really embarrassing and emasculating.” (The tests involve a genital exam and a urine test.) In between courses of treatment, including a surgery to treat the inflammation of his bladder, he would even put a hot compress in his underwear to relieve the urge to go, sometimes microwaving it at work if need be to keep the heat on.
Elsewhere, men or their girlfriends take to forums to figure out what’s happening downstairs when they experience the burn. One woman asked the Reddit sex forum if her boyfriend’s sore penis after having anal was a UTI. Another 21-year-old man queried the “Ask a Doctor” subreddit what to do given that his UTI-like situation wasn’t clearing up after a week of symptoms and antibiotics. Yet another 32-year-old male asked the same forum if he could use the products aimed at women at drug stores since “they don’t have it for men.” Most of these are about how to solve the problem without having to visit a doctor, without needing antibiotics, or just expressing disbelief that could have a UTI at all.
UTIs are typically (but not always) caused by fecal flora, or E. coli bacteria from stool attaching to the bladder and ending up in the urethra. Women are more likely to get them because the female urethra is anatomically shorter, so the urine has less distance to pass through and less time to do it, giving the female body a distinct disadvantage at fighting or destroy any bacteria before it completes the journey. Add to this that the distance between the urethra and anus — where E. coli begins a-brewin’ — is shorter for women, too, and they are more perfect candidates for a UTI to take hold.
This is why UTIs are related to becoming sexually active for women between the ages of 15 and 25, because vigorous doin’-it creates excellent conditions for the bacteria to easily travel. “Presumably, bacteria gets pushed in during thrusting,” urologist Alex Shteynshlyuger of New York Urology Specialists told us by email.
With men, it’s more complicated.
Okay, How Do Men Get UTIs and How Can I Avoid Them Altogether?
“Prostatitis, urethritis and STI are special types of UTIs,” he explains. “Prostatitis is an infection of the prostate, which is part of the urinary tract; thus prostatitis is a type of UTI. Similarly, urethritis is a type of UTI. The most common type of urethritis, called NGU (non-gonoccocal urethritis) is an STI/STD. Many sexually transmitted diseases such as chlamydia, gonorrhea, ureaplasma infect the urinary tract and are types of UTI.”
UTIs were previously sometimes called honeymoon cystitis, because back in the day, brides developed it from all the sex they finally had once they got married. To prevent UTIs, women are often told to pee immediately after intercourse, always wipe front to back, and to never follow anal sex with vaginal sex without a thorough cleanup.
Men can get them from sharing that bacteria with a partner, and from unprotected anal sex, too (though it’s not considered an STI). Some UTIs are associated with spermicide use. Just 3 percent of men pick up a UTI annually, and only 12 percent of them will get even one at all in a lifetime.
When Should I Start Worrying About UTIs?
Most of the men who do get them are over the age of 50, and it’s usually related to an enlarged prostate.
“UTIs in younger men are often related to sexual activity which includes oral, vaginal and anal sex,” Shteynshlyuger explains. “All of these can cause UTI symptoms. UTIs from oral and anal sex tend to be the most challenging to treat as bacteria may be atypical and may not respond to typical antibiotics used for UTIs. UTIs may also occur as a result of infected kidney stones.”
One other possibility in men that causes UTI symptoms is mycoplasma infection, Shteynshlyuger writes. “Some studies estimate that 20 percent of adults are infected but not all patients develop symptoms of UTI. Mycoplasma genitalium typically causes urinary problems but other mycoplasma infections often cause no problems.”
And although UTIs are less common in men, Shteynshlyuger says they’re more difficult to treat. “While in women up to 30 percent of UTIs will resolve on their own without treatment, it is thought to be rare for UTIs to go away on their own in men for the same reasons that it makes it harder for bacteria to get into a man’s bladder,” he says. “Once it’s there, it’s more difficult to get rid of it.
In men over age 50, Shteynshlyuger says that UTIs become more common as a result of incomplete bladder emptying caused by age-related growth of the prostate. The reason? “The prostate acts as a mini-dam that blocks urine flow,” he says.
The UTI symptoms are the same as for women — the pain, the intense urge to pee, the inability to squeeze anything out, discoloration or cloudy urine. But those symptoms can also be associated with chlamydia or gonorrhea. A recent study found that there may be a link between UTIs, Crohn’s disease and tobacco use in men, which can cause flareups of Crohn’s.
Because of all this, if you feel the burn, guys, see a doctor and get it checked out. Though the treatment is likely antibiotics, it won’t necessarily be the same course of treatment your girlfriend would be prescribed.
What If It’s Something Else?
And there’s the chance that it’s something else. “Not everyone who has symptoms of UTI such as burning, frequent urination and urge to pee has a UTI,” Shteynshlyuger told us. “Other problems such as overactive bladder, bladder cancer and incomplete bladder emptying can cause similar symptoms.”
It could also be related to premature ejaculation. “UTIs in particular prostatitis or urethritis are often associated with new-onset premature ejaculation in men who had no problems before,” he says. “Men who develop premature ejaculation and have urinary symptoms such as frequency and urgency should be evaluated and treated for underlying infection if present as it may help resolve premature ejaculation.”
This is why it’s so important for men to be examined rather than cross their fingers and hope for the best. “Typically men with UTIs need to be treated with antibiotics,” Shteynshlyuger told us. “While in women, often even a single dose of antibiotics is sufficient and a three- to five-day course is curative; in men, we typically prescribe a longer course of treatment for seven to 14 days. I would not rely on home remedies for the treatment of UTI in men. UTIs in men that are not treated promptly can develop into a more severe infection including epididymo-orchitis (infection of the testis — very painful), and prostatitis.”
Oh. Oh No.
Well, in Harvey’s case, the cause of the infection was holding his urine in for too long when he had to take a leak, which is another reason men may pick up a UTI well below the age of 50. By not peeing as often as he should, he turned his bladder into a breeding ground for bacteria. You can avoid that (hopefully!).
“Think about a pond versus a stream,” Ash Tewari, urology head of Mt. Sinai in New York, told the Wall Street Journal about Harvey’s incident. “A stream is less likely to have an infection, but a pond is more likely.”