Cystitis

Friday, January 30, 2004
Cystitis is an inflammation (swelling) of the bladder and urethra. Nearly half of women and some men contract cystitis at some time in their life and symptoms can recur. People with cystitis feel as if they have to urinate very often, but when they do they produce very little urine, and they feel an intense burning sensation during urination. They may also experience lower back pain, chills, fever and nausea, or may notice that there is pus or blood in their urine. Because the symptoms can be painful and disruptive to normal life, some sufferers feel depressed and anxious, which can amplify the problem and actually aggravate it by causing recurrences.

What causes it?
Cystitis can be caused by infections; stress; allergies to certain foods, medications and other substances, particularly some chemicals in soaps and deodorants; pre-menstrual syndrome or illness. Another common cause is bruising of the urethra during intercourse - the penis can rub hard against the urethra, which is adjacent to the interior of the vagina. Cystitis can also be transmitted sexually from partner to partner and there is a risk that it can cause an infection to spread to the kidneys.

Women get cystitis more frequently than men because their urethra is much shorter than a man's - making it easier for germs to travel from the bowel, vagina and urethra to the bladder. After the menopause, the lining of the bladder and urethra are weaker and more susceptible to infections.

During sex, particularly if the woman has not been stimulated enough to produce her natural lubricant or has not used a water-based artificial lubricant, the rubbing of the penis can aggravate and inflame her urethra. When this occurs regularly during intercourse, a woman can feel anxious about having sex at all and, because of tension brought on by anticipation of cystitis, produce little or no natural lubrication before intercourse.

The combination of the stress and dry vagina can bring on yet another recurrence of cystitis. It is important to prevent or reduce the cycle of bouts of cystitis, by eliminating any infection and the pre-conditions (stress, dry vagina and allergies) that can trigger it.

During sex, particularly if the woman has not been stimulated enough to produce her natural lubricant or has not used a water-based artificial lubricant, the rubbing of the penis can aggravate and inflame her urethra. When this occurs regularly during intercourse, a woman can feel anxious about having sex at all and, because of tension brought on by anticipation of cystitis, produce little or no natural lubrication before intercourse.

The combination of the stress and dry vagina can bring on yet another recurrence of cystitis. It is important to prevent or reduce the cycle of bouts of cystitis, by eliminating any infection and the pre-conditions (stress, dry vagina and allergies) that can trigger it.

Treatment

If you are over the age of 15 and not pregnant, try the treatments listed below. Contact a medical practitioner if the symptoms are serious (for example, pus or blood are present in the urine or the pain and/or fever are intense). The symptoms persist after two days or recur regularly. It's a good idea to take a fresh sample of your urine with you when you consult your medical practitioner. During treatment, drink plenty of water - as much as you are able and probably more than usual, particularly when an attack starts. Avoid alcohol, coffee, tea and other drinks containing caffeine.

To reduce the acidity of your urine and the burning sensation when you urinate, take a teaspoon of bicarbonate of soda dissolved in a glass of water. Repeat this a couple of times if necessary. Urinate often if you can - don't hold on to a full bladder. Try to relax and refrain from anything that might cause stress or anxiety. Avoid sexual intercourse until the symptoms have passed. Wear loose fitting garments, preferably made of a soft, natural fiber like cotton. Apply warm packs or hot water bottles to your lower back and stomach for some relief of pain.

Avoid harsh soap, talcum powder, vaginal deodorant, perfumes, body and bath oils. Wash frequently, particularly your vaginal area and the entrance to the urethra, after you've been to the toilet.

If your cystitis is caused by sexual intercourse, make sure you and your partner wash your genitals and hands with luke-warm water before intercourse and then apply a water-based lubricating lotion or gel to your sexual organs. When having sex, avoid putting pressure on the urethra. Take care with extended clitoral stimulation and rear entry intercourse. During intercourse, try sitting astride your partner and avoid too much stimulation or pressure on your anal region. Ask your partner not to 'thrust' too roughly or hard during intercourse. Go to the toilet a little before and very soon after intercourse.

Get advice from your family planning counsellor or medical practitioner about different kinds of contraceptives - some types of the pill, caps, diaphragms and spermicidal creams can trigger cystitis.

Vibrators and other objects inserted into the vagina for sexual stimulation can also sometimes cause or aggravate cystitis.

If the symptoms persist or you suffer from recurring bouts of cystitis you will need to consult a medical practitioner again and perhaps be referred to a specialist urologist for further treatment

Occasionally, some women continue to experience persistent pain when they urinate - without evidence of bacteria in their urine - that is related to bruising by the penis during intercourse, the after-effects of surgery, childbirth or an internal examination, or infection. This is known as urethral syndrome and women who suffer from it must make sure they are well-lubricated (either naturally through arousal or by the use of artificial lubricants) before intercourse. These women should also take extra care about avoiding foods and products (soaps, deodorants, perfumes and lotions) that cause allergic reactions in the genital area, and not wearing tight, irritating or ill-fitting clothes of synthetic fibres.

In addition to this advice, to avoid recurring bouts of cystitis or urethral syndrome, make it a habit to drink two or more liters of water per day, eat properly, get adequate rest and exercise. Take care in the use and fitting of tampons or pads and be scrupulous about keeping your genitals and back passage clean after urination and excretion - but dab, don't rub, your genitals after urinating.

Try also to reduce the stress and anxiety in your life - learn to relax with your partner and to enjoy sex that is not always 'intercourse-centred.'

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