Honeymoon Cystitis

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What is cystitis?

Cystitis is inflammation of the urinary bladder. This affects women much more than men. About 80% of women have suffered from cystitis at some time in their lives.

Why is cystitis more common in women?

Women have a very short (about one inch) urethra (the opening anterior to the vaginal orifice through which urine comes out) and hence bacteria from the anus, vagina or from the contaminated skin in the area can easily enter the urinary bladder. Men have much longer urethra (about 5-6 inches, inside the entire length of the penis) and bacterial access into the bladder is obviously much harder.

Why the name "honeymoon cystitis"?

Cystitis is very common among those on their honeymoon, especially among women on their first sexual experience. Since lovemaking involves physical activities that could lead to some trauma to the genital and the urethral orifice, and bacterial contamination from the fingers or mouth of the either partner, cystitis is highly prevalent among honeymooners, especially among females.

What bacteria is the usual culprit?

The most common bacteria that cause cystitis are called E. coli (Escherichia coli), which normally live in the bowel. In the colon, these bacteria do not cause any harm to the bowels, and may even be useful, but in the urinary bladder or other organs, E. coli causes infection and harm. E. coli thrives in an acidic milieu, and because urine is acidic, these bacteria multiply rapidly in the urethra and in the urinary bladder, causing inflammation (cystitis). If not treated, E. coli can spread upward to the ureters (the two tubes that bring urine from the left and right kidneys down to the bladder in the pelvis) and cause infection of the ureters and, in the neglected cases, the kidneys (pyelitis). If not managed early and properly, the damage to the kidneys can be serious and irreparable.

What are the other causes of cystitis?

An ill-fitted diaphragm, contraceptive foam or jellies, herpes and trichomona infection (sexually transmitted diseases), non-bacterial infection, like thrush, from contraceptive pills, kidney stones or cysts, etc. can all cause cystitis. Some women seem to be more prone than others to acquire cystitis, many of them having the infection 3 to 4 times a year.

Do children get cystitis?

Yes, children, even babies, can develop cystitis. This is also more common among girls than in boys. Most of the time, babies with cystitis come down with a fever, become fretful and may even vomit. In younger girls, they may have the classic pain and urges to urinate often.

What cause cystitis in children?

Not drinking enough fluid can cause the urine to be concentrated and therefore irritating to the urethra, leading to inflammation. Congenital abnormality in the kidney or bladder, which are rare, can cause cystitis also, but the most common cause is contamination with feces. The proper technique of wiping (or even washing) after defecation is from the front to the back, since the urethra and the vaginal orifices are anatomically located in front, and the anus behind. This will prevent the fecal dirt and bacteria in the anus from contaminating the "front" where the vagina and the urethral orifices are. All females, young and old, (and even males) should use this technique habitually for better personal hygiene.

What are the symptoms of cystitis?

The urinary bladder is a muscular bag that holds urine until it is voided. When the bladder is inflamed, the symptoms include frequency of urination and urges to urinate even if the bladder is empty, pain on urination, and sometimes blood in the urine (making it appear as dark as tea or cola drink, instead of light yellow). Among women, the first sign could be that of pricking pain, burning and scalding sensation during urination. This then develops into a sharp pain in the lower abdomen.

Can dry sex in women cause cystitis?

Cystitis invariably results if the vagina is not moist and well-lubricated during sex. The bruising and irritation to the vaginal and urethral orifice due to the dryness make women prone to this infection. Also a source of infection are bacteria under the foreskin of the penis among uncircumcised men.

Can cystitis be due to hormonal imbalance?

Yes, changes in the female hormonal cycle predispose women to suffer cystitis. The attack can occur shortly after the onset of menstrual cycle, during pregnancy, after delivery, during menopause or after a hysterectomy. Stress or depression can disrupt the hormonal cycle. Hormonal changes affect the acidity or alkalinity of urine and the level of moisture in the vagina.

How can one prevent cystitis?

Some of the causes of cystitis mentioned above should be avoided. Drink enough water (6 to 8 glasses daily) and cranberry juice (it destroys E.coli bacteria), urinate whenever you feel the urge to avoid urine retention, use proper wiping/washing technique (from front to back), take a shower (wash genitals and hands well) before and after sex, avoid using perfumed soap, talcum powder, or antiseptics on the genitals, do not use bubble bath or bath oils in the bath, use vaginal lubricant during sex if needed, avoid tights and tight jeans and nylons (cotton pants are better when afflicted with cystitis), and avoid spicy foods, coffee, and especially alcohol.

When does one see a physician?

When the first symptoms of cystitis occurs, drink a pint of bland liquid (cranberry juice is best) right away, and half a pint every hour for 8 hours. Sodium Bicarbonate (Alka Seltzer or Bromo Seltzer, etc.) helps make the urine more alkaline (less acidic) and discourages bacterial growth. However, if the symptoms persist for than 24 hours, medical consultation is recommended. Children with cystitis should be seen by a physician sooner.

©2003Raoul R. Diez, M.A.O.D.