- What is postcoital cystitis in women?
- Characteristic features
- Can there be men
Cystitis after intimacy: symptoms and treatment
Cystitis after intimacy: symptoms and treatment
Cystitis is a common disease of the urogenital system, especially among women. At the same time an inflammatory process develops in the bladder. There are several of the most frequent causes of its occurrence, among which is dominated by cystitis after intimate intimacy.
Other factors leading to the development of this ailment are hypothermia, both local and general, a decrease in the body’s immune defense, or all together. Particularly noteworthy is cystitis after intimacy, which has its own unique causes of development. This problem is widespread among women – about 40 percent regularly face this disease. And in some patients, an acute lesion becomes chronic with relapses.
The content of the article
- What is postcoital cystitis in women?
- Synonyms of the term
- Causes and mechanisms of development
- Structural features
What is postcoital cystitis in women?
Inflammation of the bladder after sexual intercourse often develops in women who have changed partners or have a first partner. Coitus – means in Latin "sexual contact", respectively, postcoital – is developing after sexual contact. Symptoms of cystitis do not develop immediately after sex, but after one or two days.
Synonyms of the term
The definition of cystitis after sexual intercourse has a long history and many synonymous expressions. In the countries of the East, women after the first wedding night spent some time on a particularly benign regimen due to possible indisposition, they were warmed up by a hot hamam and in every possible way watched the change in their well-being. Such a special attitude led to the formation of the concept of “cystitis of the first night”.
More modern traditions and trends associated with the long-awaited event – the wedding and recreation of young people after it, formed its synonym – “honeymoon cystitis”. All these expressions reflect the relationship of the occurrence of the disease with sexual intercourse.
Causes and mechanisms of development
The bladder is a very vulnerable organ in women. There is an anatomical rationale for this: it passes into the urethra, which in women, unlike men, is straight, short and quite wide. These features lead to the fact that microbes are easier to get into the urinary tract, and from there – and into the bladder. Thus, inflammation develops, which in 80 percent of cases is called ascending infectious — pathogenic microorganisms as if “rise” upward to the urine reservoir.
But for the development of the disease is not enough just the presence of an infectious agent, it is also necessary to reduce the body’s defenses. This concerns the effects of stress, lack of sleep, eating disorders.
The urinary system has its own characteristics. Here plays the role of impaired blood circulation in the pelvis, which leads to the fact that the organs receive less blood saturated with all necessary. And, on the contrary, venous blood stagnation occurs.
This is facilitated by:
- sedentary lifestyle;
- increased pressure in the abdominal cavity (wearing tight belts and pants, flatulence);
- vascular pathology.
Also connects the hormonal system. Estrogens in women are an important component of protection against infections of the urogenital system. In certain phases of the cycle, their content decreases, which will also contribute to the development of cystitis.
All of these factors together lead to the fact that women in general are more susceptible to the development of inflammation in the bladder, especially after proximity. At the same time, various pathogenic microorganisms can penetrate the female genital tract from the partner’s genitals, and from there they migrate to the excretory opening.
A special role here is given to the structure of the female urinary tract oxydrolone. If there are no developmental abnormalities such as the displacement of the urethral opening in the vagina or the excessive mobility of this opening, then aggressive sexual experience in which the dissemination by microorganisms will be extensive, including the excretory pathways, plays a leading role.
An important role is played by the violation of personal hygiene – both men and women.
If there are developmental abnormalities, this leads to the fact that microorganisms from the vagina enter the opening of the urethra, which is displaced during reciprocating movements of the penis.
Normally, the genital tract is inhabited by a variety of microorganisms, including opportunistic pathogens. These are microbial species that do not cause discomfort in a healthy person, but if there are any problems in the body that reduce immunity (chronic diseases, metabolic disorders), then conditional pathogens begin to multiply and colonize the surrounding tissues.
Particularly important in the development of cystitis will be the presence of Escherichia coli. Its entry into the urinary canal more often than other causes leads to the development of cystitis, since the epithelium of the bladder channel is a favorable habitat for this microbe.
Other causes of development
The risk of cystitis also depends on the hygienic habits of the woman. Frequent use of panty liners, tampons, aggressive intimate hygiene products will lead to a violation of the protective barrier of the mucous membrane. And even with minimal soft contact, this will facilitate the dispersal of unwanted microflora. After all, the partner’s genitals have their own microbial environment on the surface, which is a new and unrecognized enemy for the female body.
In the future, the local immune system “adapts”, as it were, to a new set of possible pathogens and develops the corresponding protection factors. Therefore, subsequent sexual acts may not bring discomfort. Especially if a woman at the same time strengthens her immune system, and both partners will monitor personal hygiene.
Postcoital cystitis in women who have not had sexual intercourse before that can completely lead to severe inflammation and spread of the lesion down to the upper urinary tract.
This develops for obvious reasons: the integrity of the hymen is disturbed, there is a wound surface, and microbes from both the vagina and the sexual organ of a man can penetrate the urethra with a general decrease in the opposing forces of immunity.
The causes of honeymoon cystitis also include:
- concomitant diseases of the sexual sphere;
- vaginal microflora change: vaginal dysbacteriosis and vaginosis;
- wearing synthetic tight underwear;
- dry sexual organs during sexual contact;
- fungal and pustular lesions of the skin of the perianal region in both partners;
- traumatization of the skin and mucous membranes during sexual intercourse.
An important diagnostic feature of this form of cystitis is a temporary connection with sexual contact. Postcoital is considered cystitis, which developed within 24-48 hours after sex. Sometimes the first symptoms can appear in a few hours. Here plays the role of the severity of microbial aggression, the intensity of intercourse and the state of the woman’s body. It should be noted that early complaints are more likely to occur in virgins.
- Typical will be complaints of urination disorder. Going to the toilet “in a small way” will hurt, moreover, these pains will be sharp, burning and intensify by the end of urination. This is due to irritation of the inflamed surface with urine. Also, the woman will feel frequent urge to urinate, which sometimes will not lead to the release of the normal volume of urine, but the discomfort during the act of urination will persist.
- Discomfort will be disturbed for some time after a woman urinates. There may be a feeling of fullness in the bladder, pain in the lower abdomen.
- The urine itself will also change: it will become more turbid, or blood will appear in the urine. This is due to the fact that in the urinary tract there is exfoliation of the epithelium, damage to the mucosa by the microbes themselves and their metabolic products.
- The general condition will also suffer. This is manifested by weakness, decreased performance, sometimes irritability and sleep disturbance. The temperature may rise, but the numbers on the thermometer will not be high if complications have not developed.
Thus, the clinical picture is composed of local symptoms of urinary tract lesions and common manifestations that are associated with the time of sexual intercourse. The same symptoms may occur during subsequent sexual intercourse, especially with a new sexual partner.
A typical clinical picture does not make you confuse this disease with anything else. But in the diagnosis of cystitis after intercourse it is the very fact of intercourse that matters the day before. This will be the cause and the basis for this diagnosis.
However, for complete certainty, you can do some analysis. For example, urinalysis.
It will show availability:
- leukocyte in urine;
- epithelial cells.
This is due to the action of microorganisms on the surface of both the bladder and the urethra. In some cases, blood can be detected in the form of red blood cells. They penetrate when small vessels are damaged and are the result of the smallest hemorrhages.
The bacteria themselves will also be released, which colonize the excretory tracts and the urinary reservoir in sufficient quantities. For a more accurate determination of the number of these elements, you can conduct a sample of Nechyporenko with counting of leukocytes, erythrocytes and other components in one milliliter of urine.
To verify the presence or absence of anomalies of the structure of the urinary system, conduct:
- examination on the gynecological chair;
- special tests.
- Hirshhorn’s diagnostic test is designed to detect abnormalities in the structure of the urethra. It consists in identifying the displacement of the external opening of the urethra: two fingers are inserted into the vagina to a depth of 3-4 cm, with the result that the opening of the urethra normally stays in place, and during displacement, or ectopia, as well as if there are any connective tissue), which deform the lumen, the hole moves back and gapes. This test can be done by a qualified urologist or a gynecologist.
- Another useful study would be taking a gynecological smear for flora. This will reveal violations of the vaginal microflora, which often occur during the development of post-coital cystitis. In this case, medication will be required to normalize the micro landscape.
- It is also necessary to make a bacteriological urine culture for accurate determination of the pathogen. This may be necessary for the correction of further antibiotic therapy.
If there is a suspicion of the development of complications due to this disease, it is advisable to pass general and biochemical blood tests to assess the function of the kidneys, liver and the severity of inflammatory reactions in the body. They will indicate inflammatory syndrome.
With the development of purulent complications, the blood will acquire the so-called "bacterial" character: the erythrocyte sedimentation rate, the number of leukocytes will increase, specific indicators of the acute process will appear – C-reactive protein, sialic acids.
Kidney function will be characterized by:
- creatinine level;
- residual nitrogen;
- glomerular filtration rate.
Therapeutic measures consist of a complex of drug and non-drug elements. First, for the period of the acute process, it is necessary to abandon sex and observe intimate hygiene carefully. This means frequent washing with warm clean water, the use of various gels or other means is undesirable because it can change the pH of the medium on the mucous surface.
It is also necessary to wear free underwear from natural fabrics and avoid hypothermia. Since cystitis has an infectious nature, namely, bacterial, among the drug therapy antibiotics are in the first place.
The estimated range of pathogens includes gram-negative flora.
- Escherichia coli;
The most common pathogen is E.Coli, and the most dangerous and most often causing complications is Enterococcus. These bacteria are best attached to the epithelium of the urogenital tract, that is, possess urotropnost.
Therefore, it is also necessary to take into account the ability of antibiotics to act in the lumen of the urinary tract. In postcoital cystitis, fluoroquinolone antibiotics – Levofloxacin or Ofloxacin – work effectively. Preparations of this group are recommended as antibiotics by the first ractopamine bodybuilding line of the European Association of Urology EAU.
Prescribed antibiotics for 5-7 days with uncomplicated forms of the disease. If an antibiotic change is required, for example, with microflora resistance, the duration of antibiotic therapy is increased.
Reserve groups are:
- third generation cephalosporins;
- inhibitorprotected penicillins;
These antibiotics will be chosen if the previous therapy was ineffective:
- symptoms persist;
- there are a lot of bacteria in urine tests.
These drugs are effectively used in the treatment of inflammation of the bladder, especially in its uncomplicated forms. Uroseptics are characterized by a selective effect on the urinary tract tissue: there they accumulate and are removed with each act of urination, the systemic nature of their action is much lower than that of antibiotics.
According to the structure, uroseptics are divided into:
One of the effective classes are nitrofurans. These drugs disrupt the respiratory process of microorganisms and their reproduction.
These include drugs such as:
They can be used both inside and locally for flushing the bladder and urethra.
The other group is derived from hydroxyquinoline in structure and is called hydroxyquinoline. These include Nitroxoline. This drug is rapidly excreted from the body – within a few hours. Therefore, it is often prescribed with other uroantiseptics.
Herbal medicines include medicines prepared on the basis of herbal fees. One of the most popular representatives of this class is Canephron. It comes in the form of pills for oral administration and is a mixture of various herbs. Canephron also enhances the effect of antibacterial drugs and reduces the severity of pain.
Another effective herbal medicine is Urolesan.
- essential oils;
- extracts of hops and carrot seeds.
It is also indicated for oral administration and comes in the form of drops and tablets.
Also, urologists recommend the use of decoctions and infusions of cranberries.
- possesses a pronounced antiseptic effect on the urinary system;
- strengthens the immune system;
- reduces the clinical manifestations of cystitis.
It is advisable to use herbal preparations at the initial stage of the disease with unexpressed symptoms, because they are inferior in terms of their strength to anti-antiseptics and antibiotics.
Another effective tool that occupies an intermediate position between antibiotics and uroseptics is Monural. Some experts call it an antibiotic because it has bactericidal activity and a wide spectrum of action. Importantly, Monural reduces the attachment of bacteria to the epithelium of the urinary tract, thereby additionally eliminates the bacterial load on the body.
Monural is a derivative of phosphonic acid and has the active ingredient fosfomycin trometamol. In the body, it is fosfomycin that exhibits the antibacterial properties of the drug. Monural take once with acute cystitis. It is also possible to drink this antibiotic as a preventive measure – 24 hours before the perceived risk of infection.
With the development of inflammation, the natural reaction of the smooth muscles of the organs will be a spasm, which in turn causes both painful sensations and a violation of urine outflow. Therefore, when cystitis can take antispasmodics. Effective and proven tool is Drotaverine, or No-shpa.
It also makes sense to drink drugs from the group of nonsteroidal anti-inflammatory drugs, such as Ibuprofen or Diclofenac, to relieve a general reaction to the disease and inflammation. However, you should not get involved in them and take more than 5 days.
To relieve severe pain that cannot be relieved by either antispasmodics or anti-inflammatory, pain medications can be used:
They act on the mechanism of development of pain and interrupt it. As a local remedy, you can use some drugs rectally or vaginally. Anti-inflammatory and some painkillers are produced in these forms.
Traditional medicine for cystitis mainly concerns herbal medicine.
For the treatment of inflammation effectively used decoctions of:
- cowberry leaves;
- cornflower flowers;
All these plants have good antiseptic and diuretic properties. It is also customary to drink plenty of liquids – decoctions or tea.
Cranberry was very popular in all its applications inside:
- fresh berries.
Cranberries to this day are effectively used in the treatment of cystitis as herbal medicine.
In order to prepare the infusion, take a handful of dried plants or berries and pour boiling water in a ratio of 1 to 10, let it stand for several hours and take 150 ml 3-4 times a day.
The decoction differs from the infusion in that it is prepared in a water bath. To do this, take a tablespoon of raw materials, 200 ml of boiling water and boil the composition in a water bath for 15 minutes. Then strain and take half a cup 4 times a day. This therapy can be used for up to 14 days in the treatment of cystitis.
The appointment of such procedures must necessarily be carried out by a doctor and carried out under his control. He may suggest the use of weak electric current. At the same time, electrodes are fixed on the lower abdomen and a weak current is applied. This causes spasm muscle relaxation, which improves well-being and restores urine flow. It is desirable to do the procedures every other day with a course of 7-10 times.
Options for appointments:
- Magnetic radiation or ultrasound.
- Electro- or magnetophoresis of therapeutic agents is successfully used to relieve inflammation. These methods improve drug delivery to the bladder wall.
- Hyperthermia can be used to reduce inflammation, in which the affected area is heated, microcirculation is improved, and microbial killing is activated.
- In some clinics, pulsed electroanalgesia is used to relieve pain. In this case, the current is supplied not in a continuous mode, but in pulses with a high frequency. This reduces the spasm of the organ and its edema, due to which the pain is quickly relieved.
It must be remembered that there are contraindications to the use of physiotherapy:
- pathologies of the hematopoietic system;
- neoplasms of any localization;
- decompensation of diseases of the cardiovascular system;
- purulent inflammatory diseases and complications.
Can there be men
Of course, men can suffer from cystitis. But, as a rule, this disease affects them much less frequently than women, especially after sexual intercourse. This is due to a longer urethra with bends, moreover, it has a narrow lumen, which together makes it difficult for microbes to penetrate into the bladder.
However, inflammation may develop if there is a violation of urine outflow in the urogenital system.
The most common causes of this phenomenon in men – especially older ones – are prostatitis and benign prostatic hyperplasia. In this case, the risk of stagnation, and with it – and infection increases, especially during active actions during sexual intercourse.
Men note sharp pains when urinating and in the groin, burning, increased urge to urinate and generally describe a brighter picture, mainly due to the rarity of this phenomenon and the more pronounced effect of urine stagnation on the general condition.
The most frequent complication of acute cystitis is its chronicity, that is, the transition to chronic. This leads to a constant circulation of the pathogen in the genitourinary system. This condition is fraught with the development of pyelonephritis, if the pathogens get further along the urinary tract and reach the chasolous system of the kidney. And this threatens the renal dysfunction in a long-term prognosis.
Interstitial cystitis may also develop, in which inflammation will affect induject-250 all layers of the excretory canal and bladder and lead to the gradual replacement of normal connective tissue – scar. And this will interfere with the normal flow of urine, which also disrupts kidney function.
A particularly terrible complication will be the purulent nature of inflammation, in which the reaction in the organs will proceed rapidly, with the release of a large number of inflammatory mediators and destruction of epithelial tissue.
It is fraught with:
- severe intoxication;
- generalization of infection;
- reduced body size due to wrinkling.
The same is possible with frequent exacerbations of chronic cystitis, when there is no rapid process, but there are frequent lesions of the wall with little intensity.
A rational approach to preventing the development of cystitis is its prevention. To do this, simply follow the simple recommendations.
The measures for the prevention of post-coital cystitis include:
- personal hygiene during sexual intercourse;
- treatment of inflammatory diseases of the urogenital sphere;
- use of barrier contraception;
- regular partner or infrequent change of partner;
- avoid hypothermia, stress, lack of sleep;
- immunity strengthening;
- rejection of tight linen, especially from artificial materials;
- moderate use of daily pads, tampons, gels for intimate hygiene;
- preventive examinations of the urologist and gynecologist, smear on the flora 1 time per year;
- timely visit to the doctor when the first symptoms occur;
- adequate fluid intake and timely emptying of the bladder;
- Rational diet – a balanced, frequent and moderate consumption of food.
In this video, the obstetrician-gynecologist talks in detail about post-coital cystitis.