Honeymoon Cystitis

Q:  Lately, I have been experiencing pain during and after sex with my husband. The pain is so severe that we have stopped having intercourse. I’ve also noticed that I have to get up several times during the night to use the bathroom and I’m constantly feeling pressure on my bladder. I’ve had urinary tract questions before, but they didn’t feel like this. Can you tell me what could be causing these symptoms and what can be done to treat them?

A:  I think that I have good news for you and your husband. I believe that you do have a urinary tract infection that is sometimes known as “honeymoon cystitis” that is caused by irritation of the urethra (the passage where urine comes out) during penetration and intercourse. The result is a bladder infection and significant inflammation of the urethra that is the primary source of pain with sex.

A secondary source of pain can be vaginismus, which is failure of the vagina to relax in anticipation of intercourse. Anxiety preceding penetration rooted in the fear of associated pain may yield diminished natural lubrication, which will also make the whole experience that much less pleasant. One can also experience bladder spasms that will add to the painful nature of intercourse.

You need to see your physician and provide a urine specimen to be checked for infection. Assuming that’s the source, a course of antibiotics is the beginning of relief. Your doctor may prescribe pyridium as well which acts as an anesthetic for the urethra and is only given for the first 48 hours. Besides decreasing the pain with urination, this will turn your urine bright orange.

Lastly, a daily sitz bath in warm, non-soapy water for a few days provides additional local relief. It might help to have a water-based lubricant available at the bedside for the first time you have sex after the treatment has taken effect. If the infection returns, you may need to see a urologist or a uro-gynecologist for further evaluation.

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