Get Real! Out, Out Damn UTI!

Heather Corinna

Urinary tract infections (UTIs) probably are not influenced by how you clean your body after sex, but there are a host of preventative measures you can take if you're not taking them already.

amberbug asks:

Could not cleaning myself a certain way after sex be causing my frequent urinary tract infections? What is the proper way to clean myself after sex (we use condoms and KY)?

Heather Corinna replies:

I feel your pain. Big time.

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I have had times in my life where UTIs were something I could count on more than the sun coming up every day, owing the IRS money while people who made 100 times more than I do in year didn’t, and never getting a seat on the subway during rush hour. I know too well how crazymaking getting them all the time can be, and because of both what I do in my work here and all too many doctors visits for UTIs of my own, I have an encyclopedia of UTI prevention forever etched in my brain I’m glad to share with you.

Your UTIs probably probably are not influenced by how you clean your body after sex, but there are a host of preventative measures you can take if you’re not taking them already. Let’s start by first filling you and everyone else in on the basics of UTIs.

UTI stands for urinary tract infection. Sometimes you’ll hear UTIs referred to as cystitis or bladder infections. A UTI is an infection caused by bacteria (most commonly E. coli or staph saphrophyticus) that occurs and multiplies anywhere along the urinary tract: the urethra, the ureters, the bladder and/or the kidneys.

Some typical symptoms of UTIs are feeling like you have to urinate often, and then sometimes only being able to squeeze out a few drops; burning and/or strong odor with urination; blood in the urine; soreness or a feeling of fullness in your bladder, stomach, lower back or sides. When UTIs spread or get serious, people can also feel nauseated, start vomiting, or get a fever or chills. Should you ever get the more serious symptoms, you’ll want to head to an urgent care or emergency room, rather than scheduling an appointment with a doctor or clinic.

UTIs can be anything from mild to severe. Very mild UTIs will often go away without treatment, but if UTI symptoms stick around for more than a day, or aren’t mild, you likely need treatment. UTIs are usually treated with a round of antibiotics. If left untreated, UTIs can become kidney infections, which can become very serious, even life-threatening, so it’s always important to do what you can to be seen by a healthcare provider when you know or suspect you have a UTI.

When being diagnosed for a UTI, you’ll ideally want to get a full pelvic exam that also looks for other infections, since sometimes what we think is a UTI is actually something else. If you’ve been sexually active, STI screenings should be part of that exam, especially if you or any partners aren’t up to date with them (and yes, even if you’re using condoms — they reduce the risks of STIs, but don’t mean there have been no risks). Be sure to fill a healthcare provider in on your sexual history and ask for those STI screenings: some providers won’t do them unless you ask. There are DIY at-home tests for UTIs, but if access to a healthcare provider isn’t a big issue for you, I’d strongly suggest being diagnosed by a professional instead, especially if UTIs are chronic.

Some people will never get them, some will get them only occasionally, and some people will get them often or chronically. They’re far more common in people with a vagina than in people with a penis, because for those with a vagina, the urethra is much shorter and is also closer to the anus, which holds bacteria. Diabetics and pregnant people also tend to get UTIs more often than other folks.

UTIs aren’t technically STIs, though they can, and often do, develop due to sexual activity, because that’s a common way for bacteria to be pushed into the urinary tract. All that rubbing of the vulva from some sexual activities that can feel so nice to you unfortunately is also something bacteria greatly enjoy: they get massaged into the urethra that way. Vaginal intercourse, specifically, is the sexual activity most often associated with UTIs, as is having frequent sexual activity (which is why they’re sometimes called “honeymoon cystitis”) or a new sexual partner. Some sexual positions are also more associated with UTIs, namely positions where vaginal entry occurs from behind.

So, you know what UTIs are, and know you’d move heaven and earth to try and avoid them. What can help keep those darn UTIs the hell away from your body?

Some or all of these things won’t work for everyone, but some ways to prevent UTIs, which may also help you avoid other kinds of genital infections, are:

  • Keep well-hydrated, drinking plenty of water each day. Being dehydrated makes UTIs more likely to happen. Having a glass of water before sex may also help.
  • Eat well: poor diet can also predispose people to UTIs. Eliminate or cut back on some things that may be part of your diet, like refined sugars and simple starches, caffeine, aspartame (an artificial sweetener in a lot of diet foods/drinks) and alcohol.
  • If you smoke, cut back or quit (which is best for you, anyway)
  • When toileting, wipe from the front (your vulva) to the back (your nus), not back to front. That helps keep bacteria from the rectum from spreading to your urinary tract.
  • Don’t “hold it” when you need to urinate. When you gotta go, go.
  • Take showers instead of baths, or at least ditch bubble bath if you bathe. You’ll also want to avoid other potential irritants like scented tampons, any kind of “deodorant” for the vulva, douches, scented or harsh soaps or detergents.
  • Ditch thongs or only wear them very infrequently. They can drag bacteria from the anus to the vulva. Avoiding very tight pants or leggings may also help. (And no, people who advise these things aren’t just being killjoys about the way folks want to dress.)
  • If you masturbate with your hands, be sure to wash them first. If you use any sex toys or objects when masturbating, either cover them with a condom or boil them before and after use.
  • Use condoms with genital sexual activity, especially with vaginal and/or anal sex. While bacteria can live on parts of the body not covered by a condom, they can help reduce at least some of the possible bacteria you’ll be exposed to with sex.
  • Urinate both before and after sexual activity: that helps flush bacteria from the urinary tract.
  • For those who use a diaphragm or oral contraceptives (the pill) as contraception, switching to another method may help. These methods have been associated with UTIs. If you use condoms with a spermicide, switch to those without, as spermicides have also been associated with UTIs.
  • When you have and/or are being treated for a UTI, take a pass on sexual activity.
  • If you’re getting UTIs a lot, ask your healthcare provider about medications or supplements you can take preventatively, like a low-dose antibiotic. Even just a daily cranberry supplement (more advised for preventative use than when you already have a UTI) or a Vitamin C supplement may do the trick, because they can help acidify urine, which helps stave off bacteria.
  • If you’re being treated for a UTI, be sure to take your medication properly, including finishing the whole course of treatment, not stopping when symptoms seem to subside. Just because symptoms of an infection get better or go away doesn’t mean an infection is gone.

When it comes to washing, it’s actually more important for partners to wash before sexual intercourse or other activities than after. I know that’s not always convenient or doable, but the rationale is that our bodies tend to carry bacteria as a rule. So, when we rub them together with someone else’s, we spread that bacteria around. If we and/or a partner clean up first, especially genitally, there’s less bacteria to introduce to the urinary tract in the first place. You can certainly also try showering after sexual activity to see if that helps, but you’re more likely to see results with cleaning up before, especially if BOTH you and your partner do so, not just you.

You mentioned you’re using KY as a lubricant. Have you tried changing your lube? Sometimes, a given brand can irritate us, so making a switch just in case is smart. Some lubes are also more hypoallergenic than others, so I’d suggest seeing if you can’t find one of those, like Pink, Emerita, Pjur or other higher-grade brands than KY. You can also ask your OB/GYN for suggestions on lubes that might be less irritating. Too, to avoid genital irritation from sex that can make UTIs more likely, be sure to use lube right from the start, rather than only adding it if and when you’re feeling the burn. You might also try switching your brand or style of condom: if you use male condoms, try female condoms and see if that helps. If you use latex condoms, try a nitrile or polyurethane condom (female condoms are also non-latex).

I don’t know how you get healthcare, but whoever you see about UTIs, if you’re getting them often, make sure they know that. In other words, if you use different clinics or don’t always see the same doctor, be sure to tell them that you have a history of UTIs, how often you have them, and how you have been treated for them in the past. Investigating and treating a lone or occasional UTI is a different story than investigating a treating chronic UTIs/interstitial cystitis, so you want to be sure you’re getting the right care and treatment. With UTIs that keep coming back for more, your doctor should also be testing you after a treatment to be sure it did actually get rid of the UTI: sometimes they keep coming back because they never fully went away in the first place.

If you have been seeing the same provider for your UTIs who just keeps giving you the same treatment and the same tests, it might also be worth your while to see someone else for a second opinion. Not only can UTIs sometimes not be UTIs at all, but sometimes they can be caused by conditions like diabetes or urinary tract abnormalities that need management of their own. Lastly, sometimes a doctor will treat sexual partners for UTIs when another partner keeps getting them, especially if they keep happening in the same relationship despite a person taking many preventative measures to avoid them.

You might also want to look at a couple of the resources I double-checked when writing this piece, namely Our Bodies, Ourselves (The Boston Women’s Health Book Collective), the Mayo Clinic’s page on UTIs and some UTI info from the Office on Women’s Health in the Department of Health and Human Services. Your healthacre provider is also someone you can talk to and who should take the time to sit down with you and give you the skinny on all of this: providing you information is just as much a part of their job as giving you medical treatment.

Commentary Media

David Daleiden Is Not an Investigative Reporter, Says New Legal Filing Confirming What We Knew Already

Sharona Coutts

An amicus brief filed in a federal court case provided an opportunity for journalists to state in clear terms why David Daleiden's claims to be an investigative reporter endanger the profession and its goal: to safeguard democracy by holding the powerful to account and keeping the public informed.

Last week, 18 of the nation’s preeminent journalists and journalism scholars put their names to a filing in a federal court case between the National Abortion Federation and the Center for Medical Progress, the sham nonprofit set up by anti-choice activist David Daleiden.

From the minute he released his deceptively edited videos, Daleiden has styled himself as a “citizen” or “investigative journalist.” Indeed, upon releasing the footage, Daleiden changed the stated purpose on the website of the Center for Medical Progress to be about investigative reporting instead of tissue brokering, as he had earlier claimed.

The amicus brief provided an opportunity for journalists to state in clear terms why David Daleiden’s claims to be an investigative reporter endanger the profession and its goal: to safeguard democracy by holding the powerful to account and keeping the public informed.

“By calling himself an ‘investigative journalist,’ Appellant David Daleiden does not make it so,” the journalists and academics wrote. “We believe that accepting Mr. Daleiden’s claim that he merely engaged in ‘standard undercover journalism techniques’ would be both wrong and damaging to the vital role that journalism serves in our society.”

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The signatories included former and current professors and deans from the nation’s top journalism schools, who have collectively trained hundreds, if not thousands, of reporters. They included women and men with storied careers in investigative journalism, whose credentials to speak with authority about what journalism is and how we do it cannot be doubted.

Their message is clear: David Daleiden is not an investigative journalist, and what he did is, in fact, at odds with the fundamentals of our craft.

Daleiden’s motivation for claiming the status of an investigative reporter is clear. In order to avoid financial ruin and potential jail time, he seeks to cloak himself in the protection of the First Amendment, arguing that everything he did was in his capacity as a reporter, and that the Constitution protects him as a member of the free press.

In so doing, Daleiden threatens to inflict yet more damage than his campaigns have already done, this time to the field of journalism. For if the court were to accept Daleiden’s claims, it would be endorsing his message to the public—that journalists routinely lie, break the law, get people drunk in order to elicit information, and distort quotes and video footage so dramatically that people appear to be saying the exact opposite to what they said. What hope would reporters then have of preserving the already tenuous trust that the public places in our word and our work?

This is not the first time some of the nation’s most decorated reporters have carefully reviewed Daleiden’s claims and the techniques he used to gather the footage for his videos, and concluded that he is not a reporter.

Last month, the Columbia Journalism Review published an article titled “Why the undercover Planned Parenthood videos aren’t journalism,” which was based on the results of a collaboration between the Los Angeles Times and the University of California, Berkeley’s graduate program in journalism.

That study was led by Lowell Bergman, a legendary investigative reporter whose career over the past few decades has been symbiotic with the evolution of the field. Bergman’s team and the LA Times concluded that:

Daleiden, head of the Irvine-based Center for Medical Progress, and his associates contend that they were acting as investigative journalists, seeking to expose illegal conduct. That is one of their defenses in lawsuits brought by Planned Parenthood and other groups, accusing them of fraud and invasion of privacy.

But unpublicized footage and court records show that the activists’ methods were geared more toward political provocation than journalism.

The team found what we already knew: Daleiden and his co-conspirators attempted to plant phrases in their targets’ mouths in the hopes of making them sound bad, hoping to drum up “political pressure,” according to a memo obtained by Bergman’s group that Daleiden wrote to his supporters. The activists’ use of fraud was so extensive and enthusiastic, and their deliberate splicing of videos so manipulative and dishonest, that they in no way reflected the methods or goals of real reporters.

The brief submitted in the NAF lawsuit last week echoes these findings and resoundingly makes the same point: Daleiden is not an investigative reporter. The main arguments in the brief boil down to the following, which can be understood as the pillars of investigative journalism:

  • Reporters do not falsify or distort evidence. Daleiden spliced and manipulated his videos and transcripts to give the false impression that they captured illegal conduct. A reporter’s job is to uncover and convey the truth, not to concoct false claims and peddle them as facts.
  • Reporters must use deception as a last resort, not a first resort, if they use it at all. Any use of deception—even in the service of obtaining the truth—tends to undermine the public’s trust in any of the reporter’s work. For this reason, even investigations that have uncovered serious abuses of power are often criticized, if not condemned, by the profession if they have obtained their information through deceptive means. As the brief noted, in 1978, the Chicago Sun-Times was barred as a finalist from the Pulitzer Prize because the truth it exposed was obtained through elaborate deception—Sun-Times reporters opened a bar called The Mirage for the purposes of documenting very real public graft. No one doubted that the evidence they found was both true and of great public importance. But, led by Ben Bradlee, the journalism establishment rejected the Sun-Times’ use of deception because of the long-term damage it would cause to the profession.
  • Reporters follow the law. Daleiden and his co-conspirators created fake government identification which they used to gain access into private events. No legitimate news organization would permit their reporters to take such steps.
  • Reporters do not deceive subjects into making statements to support a “predetermined theory.” Daleiden used alcohol to try to manipulate subjects into using words and phrases that he believed would sound bad on tape. Real journalists try to report against their own biases, instead of manufacturing evidence to prove their own theories.
  • Reporters seek to highlight or prevent a harm to the public. Daleiden caused great harm but exposed none.

A point that wasn’t mentioned in the legal filings is that Daleiden failed to follow a rule that student journalists learn in their first weeks of school: You must afford the subject of your reporting a full opportunity to respond to the allegations made against them. Daleiden’s videos came as a surprise attack against Planned Parenthood and NAF (but not, apparently, to certain Republican members of Congress). No reputable reporter would conduct herself in such a fashion. That is an ambush, not an article.

To many readers, these arguments may seem academic. But the reality is that real reporters take their obligations more seriously than the public might realize, to the point of risking—and sometimes losing—their lives in the service of this job, which many consider to be a calling.

One of the best investigative reporters of my generation, A.C. Thompson of ProPublica, recently reported on a group of assassins that operated on U.S. soil in the 1980s, who murdered Vietnamese-American journalists for political reasons.

To report that story, Thompson attended events held by members of the groups he believed to be linked to—or were actual parts of—these networks of killers. He did phone interviews with them. He met with them in person. And he did all of that on camera, using his real name.

Make no mistake: Thompson potentially put his life at risk to do this work, but he did it because he believed that these men had been able to murder his fellow reporters with impunity, and with possible—if tacit—support from the U.S. government.

Contrast that to Daleiden’s conduct. As noted in the legal brief:

Daleiden may think Planned Parenthood kills babies, but there was no risk whatsoever that its managers would have killed him, or even slapped him, if he approached them openly.

Daleiden’s arguments are, in some ways, the natural extension to the existential crisis that gripped journalism more than a decade ago, with the rise of blogging. What followed was a years-long debate over who could be labeled a “journalist.” The dawn of smartphones contributed to the confusion, as nearly anyone could snap a photo and publish it via Twitter.

It is therefore a tonic to read these clear defenses of the “what” and “why” of investigative journalism, and to see luminaries of the field explaining that journalism is a discipline with norms and rules. When these norms are articulated clearly, it is easy to show that Daleiden’s work does not fall within journalism’s bounds.

At times like this, the absence of David Carr’s raspy voice makes itself painfully felt. One can only imagine the field day he would have with Daleiden’s pretensions to be committing acts of journalism. Judging by this legendary exchange between Carr and Shane Smith, one of the founders of VICE news, from Page One, the 2011 documentary about the New York Times, Carr would not have minced words.

The exchange came after Smith’s self-aggrandizing assessment of his team’s work covering Liberia—where they uncovered cannibalism and a beach that locals were using as a latrine—and then mocked the New York Times’ coverage of the country.

Here’s Carr:

Just a sec, time out. Before you ever went there, we’ve had reporters there reporting on genocide after genocide. Just because you put on a fucking safari helmet and went and looked at some poop doesn’t give you the right to insult what we do.

To paraphrase: Just because Daleiden got some hidden cameras and editing software, and called himself a reporter, doesn’t mean he was doing journalism.

It’s important that both the public and the courts recognize that reality.

Disclosures: A.C. Thompson is a former colleague of the author. The author also appeared, extremely briefly, in the Page One documentary. 

Editorial Human Rights

Pro-Choice and Pregnant? Yeah, It’s Really Real

Jodi Jacobson

In response to a recent profile of NARAL Pro-Choice America President Ilyse Hogue, in which she recounted how anti-choice advocates couldn't handle her growing pregnant belly, we've created a new Tumblr to show off our pro-choice and pregnant, or pro-choice and parenting, selves. Join us!

This week, the Washington Post published a profile of NARAL Pro-Choice America President Ilyse Hogue, which focused on what apparently is to many in the anti-choice movement a mystifying occurrence: Hogue, a leading abortion-rights advocate, is pregnant with twins. As Hogue recounted in the piece, the jaws of anti-choice advocates dropped open when she recently entered one meeting at 36 weeks pregnant. One advocate, referring to her belly, even asked: “Is that real?”

Yes. It’s really real.

The media and others often depict the pro-choice movement as having a political “agenda” equivalent though oppositional to that of the anti-choice movement, which seeks to eliminate access to abortion care, in all circumstances, as well as to contraception and other forms of reproductive health care, irrespective of the consequences for public health or women’s lives.

But what is the pro-choice “agenda?” Is it really just about ideology? And what is so surprising about being pro-choice and pregnant?

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Being pro-choice is fundamentally about parenting, because it means believing, as the international women’s rights movement has long stated, that every child should be a wanted child, and that, by extension, that every parent is a willing parent.

It means focusing on women and girls, first and foremost, as human beings with human rights. It means believing in reproductive justice for all persons, a concept that, while complex and multidimensional, is nonetheless succinctly described by Loretta Ross, a scholar, writer, and co-founder of SisterSong Women of Color Reproductive Justice Collective, as ensuring that every individual has the ability to:

  • Decide if and when to have a child and the conditions under which to give birth;
  • Decide not to have a baby and full access to options for preventing or ending a pregnancy;
  • Parent the children she or he already has with the necessary social supports in safe environments and healthy communities, and without fear of violence from individuals or the government.

Being pro-choice means advocating for the ability of people to parent when they are ready to do so, and the right of every child to receive love, attention, food, housing, health care, education, and other critical social supports, funding for many of which, by the way, legislators affiliated with the anti-choice movement are busy eliminating.

Being pro-choice is also a commitment to using science and evidence in the interest of social progress. Data show unequivocally that in countries or in communities (even in the United States) where people lack access to reproductive and maternal health care (including abortion care), there are higher rates of maternal death and illness, higher rates of infant and child mortality, higher rates of poverty, and lower rates of educational attainment. Access to abortion is therefore an economic, social, and health issue in every sense. If you read and understand medical and public health evidence without bias, you can not help but advocate for what that evidence tells you: access to abortion saves lives. Based on all the undeniable evidence, supporting all people in making decisions about whether and when to be pregnant and whether, when, and with whom to become a parent is the pro-life position in the fullest sense of the term.

It is perhaps because they know this intuitively and from lived experience that the majority of women who seek abortion care are already parenting children, and when they become pregnant make rational and sound choices about their ability to parent another child, not just for as long as it takes to get through the one package of diapers from the crisis pregnancy center, but for years on end. Sixty-one percent of women who have abortions already have at least one child.

I’ve had an abortion. I later had two children, now 16 and 18, when I was able to give them what they needed to grow into healthy and well-adjusted young adults. I am of course still parenting them.

Yet these facts notwithstanding, it seems “pro-choice and pregnant” don’t go together in the minds of those who oppose the right of women to make critical decisions about their lives and those of their families. One anti-choice advocate was overheard by my colleague Zoe Greenberg, who was attending a “pro-life” meeting in California, saying that “abortion terminates motherhood.” To the contrary, abortion confirms motherhood, and is part of the continuum of motherhood, fatherhood, and parenthood.

Still those mouths fall open. So we’ve decided to offer concrete evidence of the extent to which parenthood and abortion rights are tied together at a new Tumblr, called, Pregnant, Parenting, and Pro-Choice. We are pro-choice and pregnant, pro-choice and parents, pro-choice and grandparents, aunts, uncles, adoptive, step-, and foster parents. We are pro human rights for all people, and by default, pro-child, and pro-family. We are the majority, and it’s time for us all to step up and show it.

Share your pro-choice and pregnant and parenting photos and stories for the world to see.

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