Urinary tract infections (UTIs) occur when bacteria enter the urinary system through the urethra and spread to the bladder. Most UTIs remain in the bladder, but if they reach the kidneys, it can become a more serious health concern. Common symptoms include a burning sensation while urinating (dysuria), cloudy or pink urine, and frequent urges to urinate, regardless of bladder fullness. Over half of all women will experience at least one UTI in their lifetime, and up to 2.8% will develop recurrent UTIs (rUTIs), defined as three or more UTIs in a year or two or more within six months. Roughly 60% of rUTIs are linked to sexual activity, which may introduce bacteria into the urethra, while others result from hormonal changes due to menopause.

Around eight out of ten women with rUTIs report sexual dysfunction, significantly affecting their sex life. In order to assess the symptoms associated with UTIs and their influence on female sexual health, researchers surveyed 300 biological females with rUTIs (average age 42) and 150 controls without UTIs (average age 39). Of those with rUTIs, 31.6% were menopausal, compared to 21.9% of the control group. Participants were evaluated anonymously between 2023 and 2024 using the Acute Cystitis Symptom Score (ACSS), which evaluates typical UTI symptoms, and the Female Sexual Function Index (FSFI), which measures desire, arousal, lubrication, orgasm, satisfaction, and pain.

UTI Symptoms

The ACSS identified frequent urination, urgency, dysuria, and incomplete bladder emptying as common symptoms of UTIs. These symptoms may lead to low mood, fatigue, irritability, and trouble concentrating. Moderate to severe discomfort, interference with work, and interference in social life were reported by 56.9%, 55.5%, and 56% of rUTI patients, compared to 5.6%, 5%, and 5.5% of controls, respectively. Many women also adopt habits such as frequently changing underwear and using only freshly cleaned toilets to try and avoid rUTIs, which may further impact daily life.

Female Sexual Function

The FSFI showed significant differences between the groups, especially between menopausal and non-menopausal women. Low or very low sexual desire was reported by 61.9% of the rUTI group and 48.1% of the control group. Between 12–21% (not all participants answered “no sexual activity” for every relevant question) of the rUTI group reported no sexual activity, with 19–39% of them being menopausal. Only 8–10% of the control group reported no sexual activity. Women with rUTIs may avoid sexual activity to prevent infections, while menopausal women may have decreased libido, further worsened by discomfort from UTIs.

Difficulty reaching orgasm was reported by 29.6% of the rUTI group, compared to 20.7% of controls. Moderate to severe dissatisfaction with orgasm was found in 28.5% of non-menopausal and 22.8% of menopausal rUTI women, and 14.7% of menopausal controls. Pain following at least half of sexual encounters was reported by 43.9% of the rUTI group—half being non-menopausal and a third menopausal—compared to 19.6% of controls.

Finally, moderate to severe dissatisfaction with sex life was reported by 53.6% of the rUTI group, with two-thirds of those coming from menopausal women, versus 15.8% of the control group, with a quarter of those also menopausal. Overall, menopausal women reported much lower sexual function, even more so with the occurrence of rUTIs. This may be due to decreased estrogen, which increases both rUTI risk and sexual dysfunction. Researchers also found that women with rUTIs and only one sexual partner were more likely to report dissatisfaction than those with three or more partners.

Conclusion

Because this data comes from self-report surveys, some undiagnosed conditions like dyspareunia or vulvodynia may affect results. If you are experiencing UTIs at least three times per year, or at least twice per six months, make sure to speak with your healthcare provider, as you may have rUTIs and there are options available to prevent them.

References:

• Medina-Polo, J., Guntiñas-Castillo, A., Arrébola-Pajares, A., Juste-Álvarez, S., de la Calle-Moreno, A., Romero-Otero, J., & Rodríguez-Antolín, A. (2025). Assessing the influence of recurrent urinary tract infections on sexual function: A case–control study. The Journal of Sexual Medicine, 22(3), 454–463. https://doi.org/10.1093/jsxmed/qdae198
• Mayo Foundation for Medical Education and Research. (2022, September 14). Urinary tract infection (UTI). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/urinary-tract-infection/symptoms-causes/syc-20353447