The worst day of my life went like this: I was at my old job in a small office-share when I started to shake with the type of shivers that make your bones feel like they’re cracking up against one another. I was sweating, my back hurt and I'd been pissing sorely and frequently all day. It wasn't my first time at the painful urination rodeo, so I suspected that I'd been slapped with a common-or-garden variety urinary tract infection. I went to a walk-in centre as soon as work was over, to pick up the meds I'd taken on the countless occasions I'd had a UTI previously.
But this time, as soon as I'd explained my symptoms, a nurse was shoving a drip into my arm so I could be rehydrated and pumped full of antibiotics. An hour later, a doctor explained to me that I'd need to stay overnight to be observed, because I had a severe kidney infection, prefaced by a UTI, the indicators of which had come on in a matter of hours.
It was the culmination of years of low-level illness. From the age of about 20, my UTIs were a bad boyfriend: they came and went, demanding attention and then disappearing as carelessly as they arrived. Every time I stung with the familiar burn, or woke during the night with the searing instinct that if I didn't pee right that moment I would literally die, I trooped dutifully to the doctor's surgery, where I was dispensed antibiotics named like characters from Tekken – Trimethoprim, Nitrofurantoin – which would surely KO the bacteria that had set up camp in my urethra and bladder, until the next lot came along. During one short stretch of time, I got so many infections in my urinary tract that the bacteria there became entirely resistant to a whole strain of antibiotics, and I was unwell, miserable and rarely able to have sex for months.
This isn't unusual: some experts estimate that women and other people with vaginas have as high as a one in two lifetime risk of contracting a urinary tract infection, with many experiencing the illness repeatedly. By contrast, only 20 percent of diagnosed UTIs occur in men and others with penises. That last statistic pretty much explains why, outside of friendship circles and the frankest group-chats, we hear very little about how commonly debilitating UTIs and the kidney infections they sometimes lead to can be. In the same way it's often said that we'd get mandatory sick days for periods if men had them too – and in the same way that people affected by serious menstrual disorders are first exposed to the names of their conditions in the hushed squares of doctors' offices – we'd probably know much more about urinary tract infections and how to prevent them if they weren't viewed as the preserve of the female anatomy.
UTIs happen when bacteria from the anus enters the urethra and travels to the bladder or kidneys. In female bodies, the urethra is much shorter than in male bodies, so it's easier for bacteria to reach your organs and fuck your shit up. At their most minor, UTIs are an inconvenience that can be cleared up fairly promptly. But at their worst, they can represent long, painful health battles.
Anna, 27, told me about her own: "I started to get UTIs regularly after starting immunosuppressants post-liver transplant. Early in 2016 I got a particularly nasty one and ended up on IV antibiotics in hospital. I think it just never really left my system, as I then got one every couple of months for the whole year."
The symptoms Anna describes – "mostly that 'need-to-wee-but-can't' feeling, not wanting to leave the toilet because of feeling like I'd piss myself, and general malaise" – are some of the most frequent. They're the sort of problems that are bearable when you get a UTI now and then, but when you're affected over and over again, as many of those most susceptible are, they start to have a real impact on your day-to-day life and wellbeing.
"The main issues for me were constantly being in fear or expectation of getting those symptoms," Anna explains. "I was worrying every time I went to the toilet, or went away anywhere without scouting hospitals, and struggling to go to the toilet normally without panicking, and having anxiety about doing anything that could contribute, like drinking caffeine or having sex."
One of the most common causes of UTIs is vaginal sex – specifically, not peeing after it. It stands to reason that jiggling all your inside junk about might move things around a bit, and that clearing your pipes might be a good idea, but until I first started getting UTIs nobody told me it was important. My Catholic education conveniently pretended that sex didn't exist (though even if I had learned the STI basics in school, illnesses like UTIs and kidney infections would still have been passed over, because they're not technically sexually transmitted), and my other, usually much more reliable, learning source – books, films and TV – also drew a blank, depicting post-coital moments as a state of transcendent lovers' bliss, rather than a race against time to hop off the dick and into the bog.
Maybe it's that Catholic upbringing talking, but there's also a curious element of shame attached to experiencing recurrent UTIs. Whenever I get one, it feels like my body raising an eyebrow about my actions. While that personal reckoning is difficult on its own, some sufferers have also experienced tacit disapproval from others, and even from the medical professionals they go to for help.
Ellie, 24, told me, "While the physical symptoms were shit enough, there was also a sense that each time I returned to see the nurse it was because I had somehow failed to take care of myself properly. Consultation questions – 'Are you having a lot of sex? Do you pee after sex?' – felt judgmental, and it was as if being unwell was my body's way of making moralistic comments about my sex life."
Anna agrees, noting that she's felt uncomfortable about the implicit associations of UTIs: "I found it embarrassing on occasions when I've had to leave social events, as although I'm a really open person I think there's a stigma whereby people think of UTIs and kidney infections as 'dirty," she says.
These connotations – as with most medical misunderstandings – are largely due to a lack of knowledge. As it stands, the most helpful answers seem to be on the internet. Ellie tells me, "The most useful information I found about UTIs was actually online – nurses told me stuff I knew from previous infections, like always peeing after sex, wiping front to back and drinking lots of water. But it was from the internet that I learned about D-mannose, a supplement made from naturally-occurring sugar. Since taking it daily, I haven't had a UTI or kidney infection."
Various tricks and remedies can help, though for those who repeatedly get infections, the most practical medical answer is preventative antibiotics, prescribed by a doctor and taken regularly. But really, that's not the point: it's more that when I first had UTIs over and over again, I felt as though I was overreacting – as if the problem was too minor to be causing me so much stress and misery, even though it was impacting my life thoroughly – because I didn't know any better. It was lonely, and I felt like my body was against me, despite the fact UTIs are so common – something I also wasn't initially aware of.
With schools ignoring the issue, and essentially no acknowledgment of UTIs in the media, it would be helpful to see more coverage of the illness, if only to eliminate the sad and unnecessary aspect of personal and external shame. Basically, I'm just a girl, standing on a box in the street, yelling about the need for more books, films and TV in which vagina-havers go directly from the shag to the toilet, and more widely-available over-the-counter treatments for a problem that has thousands of people helplessly sitting in doctors' offices every few weeks. That's all.
This article originally appeared on VICE UK.