Saturday, June 30, 2012

Wedding Health Hazards: Honeymoon cystitis and sore genitals syndrome


EVERY Maria Clara has dreamt of her wedding day. However, in her dreams, a typical Filipina will usually glaze over the wedding night, or if she is honest enough to admit it to herself, look forward to her first night with her new husband with some ambivalence: both excited anticipation and fear of the unknown. Medically, there may be good reason for concern.

Unless the honeymoon has happened before marriage, a common scenario nowadays, the blushing bride may not only lose her virginity but come away with an unwelcome souvenir: honeymoon cystitis.

Ouch! Honeymoons are supposed to be pure bliss—but what happens when the bride starts feeling sick, and the act of love is more pain than pleasure?

Honey, it hurts Part 1: After the romance
Honeymoon cystitis is the term for a urinary tract infection that can occur as a result of irritation and bruising from frequent and prolonged sexual intercourse. Why the name? Cystitis is very common among those on their honeymoon, especially among women having sex for the first time, or who have intense and frequent sex after periods of abstinence. Nearly 80 percent of all urinary tract infections occur within 24 hours of intercourse.

Intercourse involves physical activities that could lead to some trauma to the genital and the urethral orifice, and bacterial contamination may result from the fingers or mouth of the either partner. A sudden increase in the frequency of sexual intercourse poses a significant risk for UTI, particularly if a diaphragm is used. Sexual position can contribute to the risk. Vaginal following anal sex, or an unclean finger, penis or other object can introduce coliform bacteria into the urethra (urinary outflow tract) directly.

Contraception may contribute
Barrier methods of contraception can irritate sensitive vaginal and urinary tissue as well, and creates an environment where bacteria can thrive. Oral contraceptives also predispose women to UTIs. Fortunately, today’s low-dose pill is less likely to do this than the higher-dose pills of the past.

Contraceptives may also contribute to risk in a number of ways:

• The spring-rim of the diaphragm may bruise the area near the bladder neck, making it susceptible to bacteria.

• Unlubricated condoms may injure vaginal tissue and make it vulnerable to infections. (A sterile lubricant, such as KY jelly, may help reduce this risk. Avoid petroleum-based lubricants because they weaken latex condoms.)

• Spermicides are not protective and greatly increase the risk for urinary tract infections. The active ingredient in most spermicidal foams and jellies, nonoxynol 9, kills some of the vagina’s beneficial bacteria, allowing the bacteria that cause cystitis to colonize.

• Some women experience UTI as an allergic reaction to latex in condoms or to oral contraceptives.

It’s a woman thing
Honeymoon cystitis is actually a form of urethritis—the bladder is not involved. It’s a localized inflammation of the urethra—the tube near the front of the vagina, through which urine passes from the bladder to the outside. The most common cause is the introduction of Escherichia coli bacteria (which normally lives in the bowel) into the urethra. These bacteria are not harmful to the bowels but cause infection in the urinary bladder and other organs. Urine being acidic is the perfect environment for E. coli to thrive; these bacteria multiply rapidly in the urethra and in the urinary bladder. Left untreated, E. coli can spread upward to the ureters (two tubes that bring urine from the left and right kidneys down to the bladder) and in neglected cases infect the kidneys (pyelonephritis).

Women are more prone to infection because of their anatomy: they have much shorter (about one inch) urethras than men. The urethra is located along the upper wall of the vagina and can be irritated during intercourse. The irritation occurs because the tighter a woman’s vagina is, the tighter it grips the penis, resulting in more pressure on the urethra. The thrusting penis then irritates the urethral lining. After one or more sessions of intercourse during which this occurs the irritation can become pretty severe. The irritation may allow bacteria from the anus, vagina or from the contaminated perineal skin to easily enter the urinary bladder. It’s a very short trip. The way to avoid this is to prepare the vagina for intercourse so it does not grasp the penis quite so tightly. If the vagina is not moist and well lubricated during sex, bruising and irritation to the vaginal and urethral orifice may result.

Women who wipe from back to front, rather than from vagina to anus, are also at higher risk for this infection.

Men have longer urethras (about 5-6 inches, inside the entire length of the penis) and bacterial access into the bladder is more difficult. The foreskin of an uncircumcised male can also harbor bacteria as a source of infection.

On fire
Symptoms of honeymoon cystitis generally emerge within a day or two after bacteria enter the urethra. A woman becomes aware of this when she urinates and it feels like flames are shooting out from her urethra. Not a very pleasant experience. Other symptoms: the urge to urinate frequently, cloudy urine, blood-tinged urine, and pain above the pubic bone

When the symptoms first occur, drink 500 cc of a bland liquid, then 250 cc (a glass) every 8 hours. However, if the symptoms persist for than 24 hours, consult a physician who can confirm the diagnosis of infection through a simple urine test.

Abstinence helps cure
Once a doctor confirms honeymoon cystitis, or urethritis, as the source of a woman’s discomfort, the physician is likely to prescribe a course of antibiotics to clear up the infection.

A urinary antiseptic and analgesic helps relieve the burning, the urgency of urination, and the irritation in the lower urinary tract. Also, abstain from sex, until the infection clears up.

Soaking in warm, non-soapy water can provide additional relief to the area, and drinking plenty of fluids will help to flush the infection out more quickly.

Prevention better than cure
Not so romantic but simple precautions that can help ensure that honeymoon cystitis does not recur:

• Drink 8 glasses of water a day

• Drink cranberry juice (which kills E. coli)

• Avoid coffee, spicy food and alcohol

• Urinate immediately before and after sexual activity to flush bacteria from the urethra

• Shower or wash genitals and hands well before and after sex

• Avoid tight clothing, jeans and nylons. Cotton underwear is best

• When you’re ready to resume penis-vagina sex, apply a water-based lubricant to ease insertion

• Avoid applying strongly scented soap, powder or antiseptics on the genitals

• Do not use bubble bath or bath oils

• See a gynecologist or urologist for further treatment if the infection returns.

Honey, it hurts Part 2: The death of romance
Juan de la Cruz is not exempt from honeymoon hazards. The sore penis syndrome may result from overuse as well as from an infection similar to that of his female partner.

A burning sensation when ejaculating or urinating, and perhaps unusual discharge from penis, suggests urethritis or prostatitis, an inflammation of the prostate gland. Prostatic secretions contribute to the content of the ejaculate. Pain during intercourse may be from balanitis, especially if the foreskin or head of penis is red, itchy, sore, or blistered.

Balanitis (not painful balls!) often results from friction against damp underwear, or by irritants in condoms and contraceptive creams. Soreness or itchiness around head of penis after intercourse suggests sensitivity to spermicidal creams or vaginal secretions, the problem is easy to fix by using a sheath. If the rubber causes an allergic reaction, switch to a non-allergenic brand. This condition is most common in uncircumcised men. This can also due to an infection with the Herpes virus.

Occasionally, friction against the tip of the penis may result from irritation against trailing threads of his partner’s IUD. Her gynecologist will need to shorten its threads. Erection and intercourse can also be painful if foreskin is too tight. If the man was recently circumcised, intercourse may be painful for several months until glands become less sensitive.

Prevention of sore penis syndrome involves personal hygiene, washing hands and genitals before and after intercourse, and urinating after sex. Observe for any untoward reactions to topical creams or latex rubbers. If you do get sore penis syndrome, the easiest thing is to give it a rest. After all, you and your significant other still have many moons together, and your relationship is about a whole more than just sex.


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