Cystitis related to Sexual Intimacy

Cystitis is a major health concern for women in particular and it is estimated that almost all women will have had a urinary tract infection at least once during their lifetime. Many women associate these problems with sexual activity and their intimate lives are overshadowed by a fear of recurrent infection.

Development of Cystitis

Women may develop cystitis within a day or two after having sex. Vigorous movement can agitate bacteria in the peritoneum (the membrane lining the abdominal cavity), bacteria may enter the urethra during prolonged sex, and the vulva may become inflamed or irritated if dry or not well lubricated. This type of cystitis is sometimes referred to as Honeymoon Cystitis because if often strikes during the early stages of a relationship when intimacy usually occurs more frequently.

The most prevalent cause of bladder infections associated with sex is Escherichia coli, causing approximately 90% of infections. Oral sex can also introduce bacteria from the mouth including Streptococcus and Staphylococcus. When cystitis infections become recurrent, they are usually referred to as Complicated Urinary Tract Infections. The dangers of recurrent UTIs range from painful cystitis to serious kidney infectionand life-threatening sepsis. The first line of defence is usually a course of antibiotics. Recurrent infections treated with the same antibiotics often results in the bacteria developing a resistance. Eventually, the antibiotics may become ineffectual in treating the infection.

Recurrent Episodes of Cystitis

It is now generally more accepted amongst the medical community that sex related cystitis is not always caused by an outside source of bacteria, for example, a new partner. Recurrent infections may also be caused by the agitation of dormant bacteria already deeply embedded in the bladder wall, migrating to the bladder lining where they proliferate, causing the same infection to flare up again when conditions become favourable.

Doctors are becoming increasingly reluctant to prescribe antibiotics until the infection has progressed into the kidneys. Antibiotics destroy pathogenic bacteria causing the infection, however they also destroy beneficial bacteria living in the gastrointestinal tract. If enough beneficial bacteria are destroyed, side effects such as an overgrowth of yeast may give rise to Thrush. Many women suffering from recurrent cystitis often report a cycle of infection, course of antibiotics, case of thrush, period of well-being, then reinfection.

So how can we manage sex related cystitis?

• Take prophylactic dose of D-Mannose one hour before sexual activity.
• Immediately after sex, urinate and take another dose of D-Mannose.
• The following morning, take another dose and then another every 4 - 6 hours.
• Maintain a urine pH of 7 or higher, to inhibit bacterial growth.
• Both partners should practise strict hygiene standards.
• Gradually you should be able to return to a normal sex life.

See our article titled How much D-Mannose should you take, for detailed instructions on how to effectively use D-Mannose for Urinary Tract Infections.