In her late 20s, Jasmine began getting lots of urinary tract infections (UTIs). This went on for about two years, up until getting pregnant with her first child. Jasmine went to see her GP about the UTIs many times and was given courses of antibiotics. Some of Jasmine’s UTIs were asymptomatic (or had different symptoms to usual) which made her “hesitant” to ask for help as she may “look like a hypochondriac”. She notes that her doctors didn’t ask about her daily behavior or sex life, which she thinks is “crucial” information. She noticed a link between sex and UTI, and began to feel worried about having sex several days in a row. Jasmine read online about the importance of having a wee soon after sex, which “helped me a lot”. She thinks there may have been other causes too, including hormones and doing a lot of cycling, but isn’t sure exactly why her UTIs went away. Jasmine had heard about treating UTIs by drinking cranberry juice, but found it was “lots of sugar” and “not useful”.
After the birth of her child, Jasmine was doing her pelvic floor exercises. It was more difficult to be consistent about this once she went back to work though. She currently has mild urinary incontinence, but considers it “not that bad” in her daily life. She hasn’t found it to impact her sex life much, as she doesn’t leak enough for it to be an issue. Jasmine has considered seeing her GP about her urinary incontinence, but thinks there isn’t much that they would do for her except recommend more pelvic floor exercises. She enjoyed attending post-natal Pilates classes and thinks that these were helpful for keeping up with her pelvic floor exercises. She stopped the classes during Covid-19 lockdowns and now doesn’t feel that she can’t go back because the classes aren’t really set up for mothers with active toddlers.
Jasmine feels frustrated that she may need to do pelvic exercises “all my life”, and wishes more research and funding was focused on treatments: “it’s like why would women need to live with this?” Talking to other women she knows, she gets the sense that many of them think that some degree of urinary incontinence is “part of the life of being a mother”. When possible, Jasmine prefers to talk to other women rather than using the internet to get advice. She thinks that her urinary incontinence issues have “slightly” affected her choice to have more children, and has been told before that “it’s over for you” after the second baby.
Jasmine has sometimes found it difficult to talk about her health concerns and has felt “shy just to come out with” topics related to gynaecology. Moving to the UK, she expected healthcare professionals to be more open to talking about sex, but has found this to not be the case. Jasmine thinks that being Arabic may have impacted her care and medical interactions at some points. She has noticed that doctors tend not to ask her about her sex life, and she wonders if this is because of their assumptions about her. She has also had issues as a non-native English speaker, such as being misunderstood with pronouncing letters over the phone. Jasmine would like to know more from a doctor about how a second child could impact her body and sex life, but doesn’t feel confident about how to start that conversation. At times, Jasmine has felt “uncomfortable” talking to a male GP, and would prefer to talk to a female health professional who has had similar issues like urinary incontinence.
Looking back on her care, Jasmine thinks there have been times when she could have been more “pushy” about getting help. She previously lived in a country where patients could directly contact specialists, rather than rely on referrals from a GP. She thinks there is a “trade off” with different types of healthcare systems, and that seeking help through the NHS tends to be slower and there is less concern with finding the underlying causes for conditions like recurrent UTIs.
Jasmine feels fortunate to be able to “participate in my own treatment” because of her background knowledge in medicine, but she notes that people like her parents risk being “lost in the system”. She encourages other women to be open and ask questions about their sex lives. To healthcare professionals seeing patients with recurrent UTIs, she advises them to consider the activities and physiological factors that could be contributing. She would also like for midwives to check on women’s sex lives and ensure that they know how to do pelvic floor exercises properly.
Jasmine noticed when she began having sex with her husband, she started getting urinary tract infections.
Jasmine noticed when she began having sex with her husband, she started getting urinary tract infections.
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It’s when I started to would be started to have a relation with my husband now so I think as a sexual relation when it started because I think before I had no sexual relation, it was like not for a long period, interestingly the fact that it was for a long period caused me UTI, and probably later on when I read through like I think probably because after sex we were, I didn’t go to the toilet maybe and then I, and when I went to the doctor after and she said this is one thing important to do after sex. Actually she didn’t, I read about it, they didn’t mentioned this to me. Yeah I think they didn’t ask about my sexual you know, life because I think it’s important because there is this is one thing that I discovered that helped me a lot that peeing after sex is, it’s like, it’s now like a bible for me, so I think yeah yeah.
Jasmine’s GPs managed her UTIs as one-offs and didn’t seem to be interested in the recurrence or underlying causes. She had just moved to the UK, and worried she might be seen as a “hypochondriac”.
Jasmine’s GPs managed her UTIs as one-offs and didn’t seem to be interested in the recurrence or underlying causes. She had just moved to the UK, and worried she might be seen as a “hypochondriac”.
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When I had the recurrent UTI, I think, I was new to this country so I feel if I’m now again having this problem I’ll like ask them to bloody investigate it, I think I’d just say I’d be more like assertive to say “No I have it like now three times, four times, I mean can you check what’s wrong with me or like check maybe, I don’t know my daily life for me I don’t know what I’m doing wrong?”
She was a bit hesitant and I felt like I think it’s always as a patient you don’t want to be looking like I think there is always the fear that you look like a hypochondriac, how you say, hypochondriac. [Laughs] Its’s just like you are too much pushing so I think I’m already into this like worried a bit and then, and I’m I think as a person I’d say yeah I don’t, I’m not like gonna go yeah I want this [laughs] but I was like, I think I was like no can you please just check it for me.
Jasmine learnt a useful approach for talking to receptionists about concerns like thrush and UTIs, by describing them in broad terms as gynaecological or women’s health problems.
Jasmine learnt a useful approach for talking to receptionists about concerns like thrush and UTIs, by describing them in broad terms as gynaecological or women’s health problems.
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I was always struggling like what to tell them like it’s just like because they ask, they always ask “Oh what’s the problem?” and said “Oh I have like problem it’s just like” “Oh so what’s exactly?” because they want to assess it like if it is something urgent but then I was really always, and then there this older British woman she told me just say I have a gynaecologist problem and that’s it, or woman problem and then I think she said especially if a man he should understand that this is like inappropriate question, I think they’re, I think like elderly women here they’re all like, I think they know better how to deal with the with the receptionist of them and he was polite the guy he never, just like yeah I think they dig through like oh what’s wrong with you and sometimes you’re just like a bit uncomfortable to tell I’m like I’m leaking or like I’m peeing on myself or yeah I’m itchy [laughs]. So yeah I think so yeah since then I just say “I have gynaecologist problem” or like “I have a woman problem” kind of talk and I think they respect this I would say, so I think just if you know like they, maybe the word that you can tell, the magic word to tell them and they can stop like interfering in your business, I think it’s fine.
Jasmine feels “shy” talking about topics like urinary incontinence and her sex life. She would prefer that the healthcare professional raised these topics.
Jasmine feels “shy” talking about topics like urinary incontinence and her sex life. She would prefer that the healthcare professional raised these topics.
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Maybe if they ask you about it or if they mention, I don’t know how, when they can mention it or which visit they can ask but I think it will be nice if the doctor asks you because I don’t feel shy answering or like discussing this if I’m asked but I don’t know initiating the question about it I think I’m fine, maybe I should overcome my shyness but it’s just like, I don’t know how to ask it [laughs].
For the midwives or whoever follow women after the birth, I think it’s important to check how they’re doing sex life and how they, because they always say, “Oh how is your relations with your, how is your family relation?” I feel it’s all focussed on like “Oh are you not killing each other” after having a child, you know, it’s just more focussed on the mental health, which is good I think it’s, but then what they’re forgetting as well like I mean having a relation, especially with a child with all of this and just forget about everything and then on top of it if you have a problem then it’s like, I think no-one check about this.
