In fact, the U.S. Office on Women’s Health even lists out that advice (and more) on preventing UTIs, calling out the wiping from front to back technique as one of the best tactics. It’s a little shocking, then, to see a urologist say that you actually don’t need to stress about the direction you wipe.
Ashley Winter, MD, chief medical officer at women’s sexual health clinic Odela Health, went viral on Twitter in late February. “It doesn’t matter if you wipe front to back or back to front. Sincerely, Your friendly neighborhood urologist,” she wrote. And people had questions—a lot of questions.
Where did the advice about not wiping from back to front come from?
Again, this advice is listed on a government website. However, it’s worth pointing out, it’s not included in advice from the American Urogynecological Association or American College of Obstetrician and Gynecology (ACOG) for preventing UTIs.
UTIs are caused when bacteria from the bowel, which tend to live on the skin near the anus or in the vagina, spread to the area around the urethra, ACOG explains. If that bacteria moves up the urethra, it can cause infections of the bladder and other areas of the urinary tract.
With that, the advice on wiping front to back came into play in an effort to avoid moving that butt bacteria forward to your urethra. There is one study that came out in 2006 that looked at pregnant women with UTIs and the direction that they wiped. And, while it found that women who wiped from back to front were more likely to get UTIs, it didn’t include any other information about UTI risk factors, like how often the women had sex or even their ages. “It’s a poorly-designed study,” Winter says. “There has been no high-quality evidence that UTIs are caused by the directionality of wiping.”
Winter says you definitely shouldn’t wipe from back to front in some situations, like when you’re changing a baby’s poopy diaper. But for most adult women, wiping from back to front is not an issue because they wipe from the general area of their urethra forward—not their anus forward.
“I’m not talking about wiping from your anus all the way forward,” Winter says. “That is hard to do. No one is talking about that. I don’t know anyone who does that.”
There’s a lot of stigma around how we wipe
“When you have the average adult female who has no urinary or fecal incontinence who has a history of UTIs and a doctor says, ‘Well, how are you wiping?’…that is so problematic,” Winter says. “In an adult female with no urinary incontinence, it’s almost never a hygiene issue.”
Winter says it’s “stigmatizing” and “unhelpful” for a woman who is struggling with a UTI to have an encounter with a doctor where she’s counseled on her hygiene and the way she wipes. “That won’t be focused on actually preventing a urinary tract infection,” Winter says.
“If it was a hygiene issue that could be fixed with wiping, 99 percent of the adult females who come in with recurrent UTIs would have already done it,” Winter continues. “There’s just no data to support this.”
The right way to wipe ultimately depends on your needs
Winter stresses that “there’s not some fictitious line over your vulvar area where bacteria drop to zero,” adding, “it’s not like the anterior is sterile and the back part is not.”
Instead, she says, a major risk factor for developing UTIs is anatomy (women have a shorter urethra than men, which makes it easier for bacteria to get into their bladder and beyond) and being in a low-estrogen state, like during perimenopause or menopause. “In a typical, young female, UTIs may be the nature of the beast,” Winter says. “We don’t always know why they happen.”
Certain people may not be able to wipe from front to back, including those with a shoulder injury or other dexterity issues, Winter says. “Some people have also been wiping from back to front their whole life and it’s hard to deprogram,” she says. “There’s no need to tell those people to change their habit if it’s not causing a problem.”
Ultimately, Winter says, “people should just wipe the way that works for them.”
How to actually prevent UTIs
To avoid that painful trip to the toilet that signals another UTI, it’s a good idea to stay hydrated. “You don’t have to go crazy with drinking water, but adequate hydration is important,” Winter says. You’ll also want to empty your bladder regularly. “Urine in your bladder for long periods of time can contribute [to a UTI],” Winter says. Why? If bacteria has started to work its way up your urethra, peeing regularly can help push it back out.
And, of course, talk to a medical professional if you’re struggling. “If you end up in a situation where you have recurrent UTIs, talk to your doctor,” Winter says. “There are a number of things you can try, both prescription and non-prescription to help break that cycle.”
