Steroids and UTIs - The Link Between Anabolic Steroids and Urinary Tract Infections in Men

The Connection Between Steroids and UTIs

Urinary tract infections (UTIs) are common bacterial infections that can affect the urethra, bladder, ureters, and kidneys. While women are more prone to developing UTIs, men are also at risk under certain conditions. One potential risk factor for men is the use of steroids, either for bodybuilding, athletic performance enhancement, or medical treatment.

Anabolic steroids in particular have been associated with urinary tract issues in men. Let's take an in-depth look at the connection between steroid use and UTIs, the proposed mechanisms, as well as prevention and treatment options.

How Common Are UTIs in Men Using Steroids?

Testosterone and anabolic steroids are used by men for bodybuilding, sports performance, and medical treatment of testosterone deficiency (hypogonadism). Research indicates UTIs may be more prevalent among male steroid users than the general population.

A 2010 study of men with infertility found 35% of anabolic steroid users had a past UTI, compared to just 5% of non-users. Another study of 155 bodybuilders found 44% reported a history of UTI symptoms while using steroids.

Evidence clearly indicates anabolic steroid use significantly raises UTI risk in men. But why does this connection exist?

Proposed Mechanisms for Steroid-Induced UTIs

Researchers have proposed several biological mechanisms that could promote UTIs in male anabolic steroid users:

Atrophy of the Prostate Gland

The prostate gland produces fluid that contains substances that fight bacteria and prevent UTIs. Studies show anabolic steroids can cause prostate gland shrinkage and atrophy.

This prostate atrophy limits the production of protective prostatic fluid, reducing the body's defenses against bacteria entering and colonizing the urinary tract.

Urinary Retention

Some research indicates high-dose anabolic steroid use can cause partial urinary retention, where the bladder does not fully empty. Urine left stagnant in the bladder encourages bacterial overgrowth.

Immune System Changes

Anabolic steroids suppress the immune system, which may reduce the body's ability to fight off bacteria before they can establish an infection. This immune suppression involves complex changes to white blood cells, antibodies, and inflammatory cytokines.

Kidney Damage

Several case studies cite bodybuilders developing kidney damage and dysfunction after long-term anabolic steroid abuse. Damaged kidneys are more vulnerable to bacterial colonization.

However, research overall does not clearly indicate high rates of kidney dysfunction in steroid users. More studies are needed on this proposed mechanism.

Risk Factors for Steroid-Related UTIs in Men

While merely using anabolic steroids appears to increase UTI risk, certain factors can further compound the chances of developing a urinary tract infection:

High Doses

Evidence suggests high doses of anabolic steroids raise UTI risk more than lower doses. Heavy abuse for bodybuilding or athletic performance goals is especially concerning.

Longer Cycle Length

The longer the duration of anabolic steroid use, the more it may negatively impact the prostate gland, bladder emptying, immunity, and kidneys. Cycles longer than 8-12 weeks could heighten UTI risk.

Oral Steroids

Some research indicates orally ingested steroids like Dianabol may cause more urinary tract issues than injectable versions. The liver must process oral steroids, often causing more side effects.

Previous UTIs

Men who have had a UTI are more susceptible to recurrent infections. Starting steroid use with prior UTI history raises risk further.

Older Age

The natural prostate enlargement that occurs in older men (BPH) already increases UTI risk. Combining age-related BPH with steroid use compounds chances of developing infections.

Not Staying Hydrated

Dehydration from athletic training or bodybuilding workouts may increase UTI risk if steroid use is suppressing other urinary tract defenses. Drinking adequate water is essential.

Signs and Symptoms of a UTI

How can you tell if you may be developing a UTI while using steroids? Here are some common signs and symptoms:

Burning During Urination

Feeling a burning sensation when peeing is the classic UTI symptom. However, some mild UTIs may cause no burning at first.

Frequent Urination

Needing to pee more often than usual, especially small amounts, can indicate a UTI. Bacteria irritate the bladder, creating urgency.

Cloudy, Bloody, or Foul-Smelling Urine

Bacterial overgrowth alters urine color and appearance. Pink, red, or brown urine indicates blood from infection.

Pelvic Pain

Dull pain or pressure around the pelvis and rectum can develop with kidney infections, an advanced UTI complication.

Fever, Chills, and Fatigue

In advanced cases, UTIs may cause symptoms like fever, body aches, and malaise from a spreading systemic infection.

Seeking prompt medical treatment for these UTI symptoms is important when using steroids. Infections can rapidly worsen and spread to the kidneys if left untreated.

Diagnosing a Steroid-Related UTI

If UTI symptoms develop while using steroids, seek medical assessment to determine if an infection is present. Diagnosis typically involves:

Urine Test

A urinalysis examines urine under a microscope for bacteria and signs of infection, like white blood cells and nitrites. Urine cultures can also identify the specific strain of bacteria.

Blood Work

A complete blood count may reveal elevated white cells from infection. Kidney function tests help assess if the infection has spread to the kidneys.

Imaging

If kidney involvement is suspected, imaging like renal ultrasounds, CT scans, or MRIs can check for structural abnormalities or abscesses.

Prostate Exam

A digital rectal exam helps evaluate prostate size and tenderness that may contribute to infections.

Be fully honest about anabolic steroid use when seeking UTI treatment, as it can impact the diagnosis and choice of medications.

Treating Steroid-Related UTIs

Once properly diagnosed, steroid-associated UTIs require prompt antibiotic treatment and attention to the underlying risk factors:

Antibiotics

Oral antibiotics like Bactrim, ciprofloxacin, and cephalexin are typically prescribed for 7-10 days. More severe kidney infections may require intravenous antibiotics.

Finish Steroid Cycle

Stopping a steroid cycle abruptly can cause hormonal crashes and lost muscle gains. But further use may worsen the infection. A doctor can advise on whether to pause or finish the cycle.

Supportive Medications

Phenazopyridine and anti-inflammatories may help relieve UTI discomfort. Urinary analgesics and antispasmodics can aid bladder spasms and pain while healing.

Address Risk Factors

Make sensible adjustments to steroid dosing, cycle length, or administered forms to minimize future UTI risks once recovered. Stay well hydrated and urinate regularly.

Prostate Exams

Periodic prostate exams can help monitor for atrophy, enlargement, or nodules that may predispose infections.

Cranberry Products

Some research indicates cranberry extract supplements may help prevent recurrent UTIs by limiting bacterial adherence in the urinary tract.

With proper medical treatment and attention to risk factors, steroid users can recover fully from UTIs and take steps to avoid repeat infections.

Preventing Steroid-Related UTIs

Certain precautions during steroid cycles may help minimize UTI risk:

Lower Dose Cycles

Use the lowest effective anabolic steroid doses for your goals. Higher doses appear to disproportionately increase UTI risk but provide limited additional muscle-building benefits.

Shorter Cycle Lengths

Limit cycle length to 8-10 weeks, with at least equal time off between cycles. Extended durations may cause cumulative urinary tract damage.

Avoid Oral Steroids

Injectable steroids may potentially be safer for avoiding UTIs than oral versions, which can be harsher on the liver and whole body.

Stay Hydrated

Drink at least 1-2 liters of fluids daily while on cycle to dilute urine and avoid dehydration and concentration of waste that bacteria feed on.

Urinate Frequently

Empty the bladder regularly and avoid holding urine. This discourages bacterial overgrowth.

Cranberry Extract

Some research shows cranberry supplements may help prevent UTIs by reducing bacterial adherence in the urinary tract.

Support Prostate Health

Saw palmetto extract, pumpkin seed oil, and zinc supplements may help mitigate prostate atrophy and enlargement that can develop during steroid use.

Avoid Irritating Products

Be mindful that lubricants, spermicides, vaginal hygiene products, and condoms with spermicide can irritate the urethra and increase UTI risk.

When to See a Doctor

Consult a physician promptly if the following UTI symptoms develop while using steroids:

• Burning urination
• Increased frequency and urgency
• Cloudy, bloody, or foul urine
• Unrelenting pelvic pain
• Fever over 101 F
• Chills, nausea, vomiting
• Mental confusion

Advanced UTIs can rapidly progress to kidney infection, sepsis, and life-threatening complications. Seek immediate emergency care for high fever, inability to urinate, or other concerning symptoms.

The Bottom Line

Anabolic steroid use significantly increases the risk of developing urinary tract infections in men. Proposed mechanisms include prostate gland atrophy, urinary retention, weakened immunity, and possible kidney damage. Minimizing steroid dosage and cycle length, staying hydrated, urinating frequently, and supporting prostate health may lower UTI risk.

However, UTIs still may occur. Seek prompt medical assessment and treatment if UTI symptoms arise, being fully transparent about anabolic steroid use. With proper care, steroid-related UTIs can be successfully managed in most cases.

Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.