WOMEN’S BODIES: THE URETHRAL SYNDROME
This describes urinary frequency and pail on urination, usually related to sex, but with no bacteria in the urine. There’s usually no temperature, no pain in the lower abdomen and often little or no urgency. Attacks are often recurrent and may begin after having a catheter in the bladder, after childbirth or surgery, or after a bacterial infection.
The symptoms are probably the result of mechanical trauma to the urethra by the thrusting of the penis during intercourse. Chronic inflammation around the bladder base, where the urethra starts, may also flare up and cause symptoms after sex. Urethral symptoms occasionally arise from the pressure of the rim of a diaphragm. They are also more likely at certain times such as during a viral infection, emotional upsets, when overtired or under any circumstances that reduce sexual arousal and increase the likelihood of frictional trauma to the urethra during intercourse.
Women who get urethral syndrome aren’t helped by antibiotics unless infection is also present, though often these are prescribed over and over again. The inflamed urethra settles down of its own accord after a couple of days without sex or whatever else is irritating the urethra. The antibiotics usually get the credit. But if further intercourse brings back the symptoms while you’re still finishing your course of antibiotics, you can be pretty sure that infection isn’t the cause.
The best way to conquer the after-sex urethral syndrome is to make sure you’re always properly aroused and lubricated before penetration. This won’t be easy if you’re worried about the outcome or if the problem has put you right off sex. It can help to use a lubricating jelly until you gain confidence in knowing that you can enjoy sex without developing urinary symptoms. Postmenopausal women who are not on hormone replacement will mostly need to use extra lubrication.
Other things can irritate the urethra and lead to symptoms. Your urethra can become inflamed, even if not infected, if you have vaginal and genital inflammations and infections.
Other irritants include soap, bath salts and foams, talcum powder, ‘feminine hygiene’ products (which we can all do without), pressure from a tampon in the wrong position, or synthetic underpants. Some people get urethral irritation a few hours after a spicy meal or other foods and drinks (including vitamin C) that make urine acid. (Always wash your hands thoroughly before going to the toilet after handling chillis. The slightest trace transferred when you’re drying your bottom can leave you stinging for hours! As you’ve guessed, this advice comes from an uncomfortable personal experience!)
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