By Katherine Brind’Amour, PhD
Urethritis is inflammation of the tube that carries urine from the bladder to outside the body. It can be caused by infections, trauma or chemical irritants.
Most cases of urethritis require medication to heal and avoid long-term complications. However, you can also try some natural approaches to relieve symptoms at home.
What Is Urethritis?
Urethritis is inflammation of the urethra. The urethra is the tube you pee through — it carries urine out of the body. There are several possible causes of urethritis.
Sexually transmitted infections are the most common cause of urethritis. These cases are usually broken into two main types:
- Gonococcal urethritis — This is caused by the gonorrhea bacteria and makes up about 20 percent of infectious cases.
- Nongonoccocal urethritis — This is caused by bacteria other than gonorrhea but is still infectious. It causes about 80 percent of cases.
Cases caused by something other than bacteria or viruses are noninfectious urethritis. They are rare but can happen after injury or irritation to the urethra. This can be caused by urinary catheters, spermicide, antiseptic or other chemicals.
Urethritis is very common. About 4 million Americans are affected each year, and worldwide more than 150 million cases are reported per year. The problem is believed to be significantly underreported as well. (1)
Urethritis itself is not considered a sexually transmitted disease, but it can be spread by sexual contact if the infection causing it (such as gonorrhea or chlamydia) is spread.
Urethritis Signs & Symptoms
Signs and symptoms of urethritis are different for men and women. The most common symptom for both is pain while peeing and feeling an increased urge to pee. However, some people have no symptoms at all. It is most common in women. This is called asymptomatic urethritis. Still others have symptoms that are actually caused by a different condition, such as a urinary tract infection, urethral diverticulum, urethral prolapse or urethral caruncle.
Urethritis in men may cause symptoms that include: (2)
- Burning or pain while peeing
- Frequent or urgent need to pee
- Blood in the urine or semen
- Itchy, painful or swollen penis
- Discharge from the penis
- Enlarged groin lymph nodes
- Pain during sex or ejaculation
- Fever (rarely)
Urethritis symptoms in women include: (2, 3)
- Burning or pain while peeing
- Frequent or urgent need to pee
- Peeing only small amounts at a time
- Cloudy or foul-smelling pee
- Pain in the lower belly area
- Pelvic pain
- Pain during sex
- Vaginal discharge
- Fever and chills
Causes & Risk Factors
There are several main causes of urethritis. The most common is a bacterial infection. In some cases, the cause is not known. These cases may be considered urethral syndrome instead of urethritis. The general list of possible urethritis causes includes: (2, 4)
- Bacteria such as E. coli and the strains that cause chlamydia and gonorrhea
- Parasites such as those that cause trichomoniasis
- Viruses such as herpes simplex virus, human papillomavirus (HPV) and cytomegalovirus
- Trauma to the urethra, from a catheter or injury
- Irritation from chemicals found in spermicide, contraceptive jelly or foam, soaps or other topical products
It is not unusual for urethritis to be caused by more than one problem (for example, multiple bacteria strains) at once, especially in women. There are also cases of urethritis with unknown cause.
Risk factors for urethritis include: (2)
- Being female
- Being a male age 20 to 35
- Sexual activity that puts you at increased risk of a sexually transmitted infection. These include:
- Having numerous sexual partners
- Having sex without a condom
- A history of sexually transmitted disease
Diagnosis of urethritis involves a physical exam to check for pain, swelling, discharge or tenderness. The health care provider may also order blood or urine tests to check for bacteria, viruses and other problems. You may be tested for HIV and syphilis. In women, a pregnancy test or pelvic ultrasound may also be done. Once the cause of inflammation is known, conventional treatment will be determined. Treatment varies by the cause of the condition and typically includes the following: (2, 4, 5, 6)
- For bacterial urethritis: You can expect a prescription for antibiotics and possibly a pain reliever. This helps ease pain, fight the infection and reduce your risk of passing the infection along to others.
- These antibiotics include azithromycin, doxycycline, levofloxacin, ofloxacin and erythromycin. Most of these are seven-day courses of treatment, but azithromycin is a single dose.
- If you have infectious urethritis, your partner should go in for testing and treatment as well.
- While you are being treated, and for at least one week after, you should avoid sex or use condoms to avoid passing the infection to others.
- Always take the full course of antibiotics, even if you start to feel better after a few days.
- If your infection doesn’t clear up after taking antibiotics, you may be prescribed different antibiotics. Alternatively, the health care provider may search for other causes, such as a virus, trauma or topical problem.
- For viral urethritis: If there is an antiviral medication available to fight the type of virus you have, you may receive it. For example, acyclovir treats herpes simplex. Because test results take some time to come back, you may be prescribed antibiotics to take until the true cause is known.
- For temporary or mild urethritis caused by spermicide, soap, etc.: No treatment may be needed as symptoms may go away on their own, particularly once you stop using the product. However, if the pain or symptoms continue more than a day or two, or if they are joined by symptoms such as a fever or pain in the belly or back, nausea, or vomiting, seek care immediately.
- You may be advised to stop using spermicides or other topical contraceptives.
- It may be suggested that you avoid or limit vigorous sexual activity.
- You may be told to increase the amount of water you drink.
- If you use scented body products or soaps, you may be advised to switch to gentle, unscented products.
- For urethritis caused by injury or trauma: Depending on the cause of injury, you may require antibiotics to prevent or treat infection. If you have an item lodged in your penis, you may need both medication and professional medical assistance in removing it. In some cases, a health care professional may decide you do not need treatment for infection and may be able to wait for the inflammation to go away on its own.
Your doctor may also recommend prescription medication to ease burning and pain, or an over-the-counter pain reliever or anti-inflammatory. In most cases, urethritis can be cured by treating the underlying condition. However, sometimes symptoms last more than a few weeks or come and go. Urethritis that lasts six weeks or more is called chronic urethritis.
Untreated urethritis can lead to infections in other organs, with serious complications. Once it spreads, infection can be much harder to treat and symptoms may be much more painful or severe. Urethritis can also cause scarring in the urethra (called urethral stricture) or pelvis (causing pelvic inflammatory disease), which can lead to fertility problems. If the infection spreads to the blood and causes sepsis, it can be deadly. If your case is caused by a sexually transmitted infection, you are also at greater risk for urethral cancer.
5 Natural Ways to Help Manage Urethritis Symptoms
In addition to following a health care professional’s advice for your urethritis treatment, you may wish to consider these natural options for symptom management: (7)
Drink lots of water
A publication by American Family Physician recommends that people with urethritis should drink plenty of water during and after treatment. (8) Drinking a generous amount of water each day helps flush bacteria out of the urethra, reduces the concentration of bacteria in the bladder and urine, and can reduce your chances of future infections. This is particularly important for women, who have a shorter urethra than men. (9)
The standard recommendation of about eight glasses of water per day is usually enough. Another option for calculating your minimum need is drinking a quart for every 50 pounds of body weight. You may need to drink more in hot weather or if you exercise. Spread your drinking out during the day, with the goal of urinating about once every 90 minutes. This means you’re regularly emptying your bladder and flushing out the urethra. (10)
Take care with hygiene
Some cases of urethritis are caused by bacteria from the anus, such as E. coli, getting into the urethra. Although most cases of urethritis don’t result from poor hygiene, taking good care of your genitals can help relieve symptoms in some cases and can help prevent future infections. These tips may help: (7, 11)
- Wash your genital area daily with water and mild, fragrance-free soap. Gently pat the area dry.
- In general, avoid scented body wash, soap, lotion and other products you apply on or near your genitals.
- Wipe from front to back to avoid moving stool into the urethra.
- Take showers instead of baths. If you do bathe, don’t add bubble bath, salts, shampoos, soaps or other things into the water.
- Don’t hold back when you feel you have to pee. Keeping urine in the bladder and urethra allows bacteria to accumulate.
- Don’t use genital deodorants, sprays or scented pads or underwear.
- Do not douche.
- Wear loose clothing and cotton underwear.
Adjust your sexual activity
The majority of cases of urethritis result from sexually transmitted infections and can be passed along to other people. Adjusting your sexual habits may help relieve symptoms and can also keep you from spreading the infection. Consider these recommendations: (7)
- Avoid sex while you have symptoms, during treatment and for a full seven days after you finish treatment. If you still have symptoms one week after completing treatment, call a health care professional and continue to avoid sex.
- If you do have sex, use a condom to avoid passing the infection to your partner.
- Use water-soluble lubricant without fragrances or dyes.
- Avoid spermicides, contraceptive jellies or foams, particularly if they have fragrances or chemicals that caused the irritation.
- Avoid trauma to the urethra by reducing or not taking part in vigorous sexual activity.
You can also reduce your chances of getting urethritis again by following these tips for safer sex: (4, 8)
- Get tested frequently for sexually transmitted infections if you have multiple partners.
- Limit your number of partners.
- Do not trade sex for money or drugs.
- Use a condom if you are not in a monogamous relationship with someone who is also infection-free.
- Do not have sex after drinking alcohol or using drugs.
- Go pee after having sex.
Tweak your diet
The American Academy of Family Physicians suggests that even though dietary changes aren’t confirmed as impacting urethritis, they may help some people. There is also evidence that diet impacts people with similar conditions affecting the urinary tract, such as interstitial cystitis. You can try adjusting what you eat and drink to see if it eases the pain in your urethra. Options include: (7, 12)
- Avoiding carbonated beverages, tea, fruit juice, alcohol and caffeine
- Limiting high-acid foods and drinks, including cranberry juice, tomato products, lemon juice and other citrus drinks
- Avoiding spicy foods, horseradish, vinegar, chili and peppers
- Eliminate artificial sweeteners and chocolate from your diet
- Limit highly spiced foods, such as Mexican, Thai and Indian cuisine
- Emphasize more water, milk, low-acid fruits (bananas, pears, honeydew, watermelon) and vegetables (cruciferous veggies, mushrooms, peas, squash and potatoes), meat, poultry and seafood, oats and rice, and snacks such as pretzels and popcorn
You can also try tracking your diet and symptoms to note if your urethritis gets worse after eating or drinking certain things. If you have had gut trouble from taking antibiotics in the past or if you are worried about overall bacterial balance, ask your health care provider about adding yogurt or a probiotic to your diet as well.
Consider herbal remedies
Natural remedies have long been used to treat irritation and infection in the urinary tract. Since most cases of urethritis are caused by sexually transmitted infections, you should see a health care provider for evaluation and medication if needed. If you are interested in trying herbal remedies or supplements to see if they help your symptoms, discuss them with your health care provider first. Some herbs and supplements can interact with medications or cause health problems in some people.
The following natural remedies have been used to ease urinary inflammation and infection-related symptoms:
- Cranberry. Although juice is now typically not considered helpful, standardized cranberry capsules have a high concentration of proanthocyanidins (PACs), which may help your body ease infection risk. (4)
- Agathosma betulina leaves (Buchu) or Arctostaphylos uva-ursi leaves (Bearberry). Both of these are reportedly effective for fighting infection in the urinary system. “The Complete Medicinal Herbal: A Practical Guide to the Healing Properties of Herbs” recommends combining Buchu with couchgrass and yarrow for infusions or capsules. It also recommends adding corn silk to the concoction to ease burning. (13)
- Althaea officinalis leaves (marshmallow) has also been recommended for its use with urethritis. It is used in infusions and tinctures and can be combined with yarrow and buchu. (13)
- Whole-root, hot water extract preparations of Uvaria afzalii and Anthocliesta djalonensis were tested in the lab against non-gonococcal urethritis and found to be effective at killing many strains of bacteria known to cause the condition. (14)
- Hydrastis canadensis (goldenseal), Echineceae purpura (echinacea) and Equisetum arvense (horsetail) may also be useful. Some natural medicine research and traditional medical practice has found these and most of the herbs listed above to be at least somewhat effective at reducing inflammation, fighting infection, boosting the immune system or helping the body flush bacteria from the urinary system. (15)
- The vast majority of urethritis cases require antibiotic treatment. Do not attempt to self-treat urethritis unless a trained health care professional has told you it is safe to do so.
- If you are prescribed antibiotics, take the entire course prescribed to you.
- In some cases, symptoms remain after treatment. If you do not feel better within one week of completing treatment, contact your health care provider again for follow-up.
- If you develop a fever, nausea or vomiting, pain in your pelvis or belly, or any serious change in symptoms, seek emergency care immediately. These may indicate the infection has spread to other parts of your body.
- If you suspect you have urethritis, do not delay seeking care. Untreated urethritis can cause fertility problems and/or allow the spread of infection to other people or to other parts of your body, which can be deadly.
- Do not add herbs or supplements to your regimen without first consulting a health care professional. Many herbs and supplements can interact with medications and body processes. This can change how well your prescribed medications work and result in dangerous health side effects.
- If your case of urethritis is caused by a sexually transmitted infection, such as gonorrhea or chlamydia, the diagnosis will be tracked by public health departments and you will be asked to provide the names or contact information for all of your recent sexual partners. Providing this information honestly and accurately is critical to protecting the health of these people.
Urethritis Key Points
- Urethritis is inflammation of the tube that carries pee out of the body (the urethra). It is a very common infection.
- Most cases of urethritis are caused by sexually transmitted infections, such as gonorrhea, chlamydia, herpes and others.
- Conventional treatment for urethritis usually involves a course of antibiotics. If they are ineffective, urethritis treatment without antibiotics may include antivirals, changes to hygiene or sexual practices, or over-the-counter pain and anti-inflammatory medicines.
- If you are interested in a urethritis home remedy, be sure to consult a health care professional first. Left untreated, urethritis can cause complications that can lead to fertility problems or serious infections, which can be deadly.
- With treatment, urethritis symptoms usually disappear in a week or two. However, during treatment and for a full week afterward, you should avoid having unprotected sex. Any recent sexual partners should also be tested if your case is caused by a sexually transmitted infection.
5 Natural Strategies That May Help Relieve Urethritis Symptoms
- Drinking lots of water
- Taking good care with hygiene
- Adjusting your sexual activity
- Tweaking your diet
- Considering specific herbal remedies
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