WOMEN’S BODIES: MORE ABOUT CYSTITIS
Why are women prone to cystitis?
The anatomy of our lower urinary and genital systems makes us more liable to infections and other inflammations of the bladder and urethra.
The urethra is the tube through which urine passes from the bladder to the outside. Women’s urethras open onto an area where there are always plenty of bacteria, including those from the bowel and vagina. Some germs live in the lower end of the urethra all the time. These bacteria generally do no harm, but can cause inflammation if they get into the bladder in circumstances that make it easy for them to grow. And because women’s urethras are only about 4-6 cm long, germs don’t have far to travel to the bladder.
In contrast, men’s urethras are around 20 cm long and the skin of the tip of the penis is unlikely to harbour as many bacteria as the skin around women’s genitals. This is one reason why women are more prone than men to bladder infections. Also, after the menopause the linings of the urethra and bladder are more fragile and prone to infection.
A woman’s urethra and bladder base are very close to the front wall of the vagina where they are liable to trauma from friction during intercourse, especially if the vulva and vagina aren’t sufficiently lubricated by sexual arousal before penetration.
Frictional trauma alone is enough to cause inflammation of the urethra. Some germs probably always get into the urethra and bladder during sex, but normal defences usually overcome these. However, if the tissues are also inflamed from frictional trauma, their defences will be down and infection is more likely to get a hold.
Some women are more prone than others to develop urinary symptoms associated with sex. Sometimes problems only happen when sex is repeated frequently over a short time (for example ‘honeymoon cystitis’).
Some unfortunate women develop bladder symptoms just about every time they have intercourse. They come to fear sex, knowing that it’s likely to bring on another attack. The fear inhibits their sexual arousal so that they’re less well lubricated and more likely to suffer mechanical trauma – the beginning of a vicious cycle of sex and bladder problems. This can play havoc with a relationship.
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