Doctors may have mentioned the term “honeymoon cystitis” to you and by that they mean inflammation or infection of the bladder caused by more frequent or vigorous sexual intercourse with a new partner or with a partner you see irregularly. It is not always caused by vaginal penetration. Oral sex can pass streptococcus from your partner’s mouth to the vagina or conversely to the man’s penis. Fortunately for men, the male urethra is not as susceptible to the same extent as it is considerably longer and further from the bladder. Sometimes, “honeymoon cystitis” is bacterial (bacteria is pushed up the urethra and into the bladder, and at other times embedded bacteria are moved to the surface of the bladder during coitus). Sometimes, it is inflammation only.
The condition of post-coital bladder infections (UTIs), however, can happen at any other time beyond the traditional ‘honeymoon’ from the onset of sexual activity into old age and some women suffer infections throughout their lives with intercourse and even without. To some extent, historically, the pattern has been in the past linked to cleanliness, socioeconomic analysis and pejorative judgements. More recent studies are clear: cleanliness matters but it really is only part of the story and a quick admonition to wipe from front to back and drink more is a slightly patronising mantra that does not disseminate current knowledge or address the situation intelligently.
Contemporary molecular research has discovered, for example, ways in which the bladder reacts to bacterial infection.
If we take E-coli as an example, we now know that E-coli attaches to the bladder lining with finger-like adhesive, protein tipped, type 1 pili. The protein tips lock into receptors in the cells much like Velcro.
After this adhesion has occurred, the bladder employs defensive strategies to deal with an infection. Cells lining the bladder slough off, carrying attached bacteria with them. Within a few hours, about 90 percent of the bacteria are removed and underlying bladder cells exposed.
According to Matthew A. Mulvey, this could be seen as “altruistic suicide” by the cells in response to infection in that the bladder cells activate protein-destroying enzymes and cut up their DNA before they slough off. “It’s a fantastic first line of defence to have a group of cells purposefully killing themselves in order to protect the rest of the tissue.”
However, despite all these efforts, research shows that some invading bacteria can remain 48hrs later and probably do so by burrowing into deeper tissue layers, creating biofilms that protect them against antibiotic attack. Once burrowed into the bladder lining, they lie dormant and survive until conditions are right for a new colonisation to begin.
There is every chance that increased sexual activity is a factor in reactivating these dormant bacteria and bringing them to the surface along with a rise in urine pH (acidic urine provides perfect conditions for most bacteria that invade the bladder) but knowing that dormant bacteria may be present and not just “introduced” from the perineum gives us information that can help prevent post-coital attacks of cystitis.
Take a teaspoon of D-Mannose in a small glass of fruit juice or tea one hour before sex, and immediately afterwards. If you forget to take it before sex, you may wake up to find that you have an infection that causes you considerable discomfort until you can flush it away. You may need to take a few more drinks of D Mannose over the next 48hrs.
Sweet Cures ’ Anna talks about her battle with cystitis. Read More