Medical Q&As

Cystitis - not getting better?

I am writing to ask your advice about cystitis associated with sexual intercourse. I am doing all the recommended stuff i.e. lots of water, cranberry juice etc. I have also been treated by my GP, however at 43 years of age this is a reoccurrence from the distant past. Is there anything in particular I am missing? Could it be related to my age?

There are a number of possible explanations for your difficulty. It could be related to lack of lubrication in the vagina during intercourse. The friction of the penis inside a relatively dry vagina can cause these symptoms. Therefore adding a water-based lubricant during intercourse such as KY jelly can deal with the problem. Perhaps you are entering the menopause therefore an oestrogen based vaginal cream or pessary may be appropriate for you. It is also possible that you may have developed a urinary infection because of the introduction of bacteria into the bladder during the act of intercourse. Appropriate hygiene and cleanliness of the genital area may help reduce the chances of introducing bacteria through the urethra. The genitalia should be cleaned and wiped from front to back in order to prevent transporting bacteria from the rectal area to the urethra. It may also be helpful to urinate after intercourse in order to flush out any bacteria that may have been introduced into the urethra. You have already referred in your question to the importance of an adequate fluid intake and the beneficial effects of cranberry juice. Also remember not to add any additives to the bath water when bathing. Bubble baths and various other crystals and liquids can come into contact with the urethra and vagina and may cause a chemical irritation of these sensitive tissues. Always make sure that you wear cotton underpants. It is also worth mentioning that wearing tights can exacerbate the problem of cystitis.