Q&A: Is cystitis common after intercourse during menopause?

Read the full video transcript below

Today's topic

Hello and welcome to my weekly video blog. And today, on "A.Vogel Talks Menopause," I'm going to be doing a question and answer.

Now, here at A.Vogel, we get 200, sometimes more than 200 emails a week from women all around the world asking questions about their menopause and how they can help themselves. And what we've noticed is that many of the questions are similar, so women are asking the same sorts of things.

So what I'm going to do, occasionally, is instead of talking about a particular menopause condition, I'm going to do a question and answer on one of the questions that's come in during the week.

Q&A: Is cystitis common after intercourse during menopause ?

Now today, I'm going to talk about cystitis after intercourse. Now, this is a really horrible situation. A lot of women end up suffering from this. It can have a huge impact on their intimate relationship with their partner. It's very uncomfortable. And I'm sure most of us, at some point in our lives, have had a bout of cystitis, and it's not anything that we really want to put up with.

Why does this happen?

So why does this happen particularly in the perimenopause and in the menopause? Well, when your oestrogen starts to fall, that can have quite an effect on the vagina itself. It can thin the vagina walls. It can make the vagina a lot more brittle and less stretchy. That's one of the reasons why sex can be a lot more painful in the menopause, too.

But the other thing that can happen is that falling oestrogen can affect the mucus production in the vagina, and the mucus production in the vagina helps to maintain a level of healthy bacteria.

Now, we all know that we have friendly bacteria in our digestive system, but we also have a range of friendly bacteria in our vagina. And they're very different to the ones that you get in your digestive tract, and these bacteria do a number of things.

How does the friendly bacteria help?

They help to keep the vagina healthy. They help to stop unwanted bacteria and fungi from growing and causing infections in the vagina, but they also help in other ways.

Now, the entrance to the vagina and the urethra, which is the tube all the way up to the bladder in women, they're very, very close together. And our friendly bacteria help to police the opening of the urethra, as well, in order to stop bacteria from traveling up to the bladder causing infections such as cystitis.

So if we're in the position where the level of friendly bacteria have dropped, then all sorts of situations can then arise to bladder infections.

What are the triggers?

And, unfortunately, intercourse can be one of those triggers. It can be for a variety of reasons. If you're still using condoms, you can end up having a slight allergic reaction to the condoms.

And the other thing that can happen is that as we go through the menopause, we can experience what's called a prolapse. And what can happen here is that the internal organs in the pelvic area, your bladder, or your bowel, or your womb, can slightly slip position, and that can cause a lot of problems during intercourse.

If there's an awful lot of friction or there's an awful lot of movement going on, that can irritate the bladder even further.

What can you do?

So what can you do to try and sort this? All I would say, first of all, that if, on intercourse, you're getting a lot of pain, you're getting a lot of discomfort, if you're getting a sort of dragging feeling, or you have discomfort that lasts a long time afterwards, then that could be an indication of a prolapse and, in which case, really important to get this sorted by your doctor and get checked out.

Self-treatment

For sort of self-treatment, there's a number of things that you can do.

Water, water, water

Lots of water all the time. You know how much I go on about water. Water is the best thing for keeping the bladder nice and healthy at all times.

Vaginal probiotic

But what you can do, as well... If you start to get cystitis, the problem here is that, very often, we go to the doctor, we end up getting a course of antibiotics which, unfortunately, kill off more of the friendly bacteria in the vagina, and that can then lead to repeat infections.

So the really important thing here, if you're getting infections after intercourse, is to start using a vaginal probiotic. Now, in the UK, there's a lovely company called OptiBac that do probiotic, especially for the vagina. So it's certainly worth trying to see if that can get the friendly bacteria back again.

Spontaneity can be important but don't forget cleanliness

The other thing, which I know can spoil spontaneity... And I know in the menopause, sometimes, our sex drive is not quite as good as what it used to be. So spontaneity, sometimes, something that's very important.

But cleanliness is really important here because if there's a lower level of friendly bacteria, then there's more chances of infections actually creeping in. So this is quite an important one, but I do understand it's not always possible if the moment sort of strikes you.

Preventative measures

The other thing that you can do is you can look at a preventative just to help to keep the bladder working well. We do a lovely product called Cranberry Complex. You can also drink cranberry juice, but make sure that it's a non-sugar one because sugar helps to feed the unfriendly bacteria, so it's not a particularly good thing if you get bladder infections as well.

Water (again)

And the other really important thing here is as soon as you can, afterwards, is to have a really big glass of warm water just to help flush the bladder out.

So I hope this has given you a little bit of insight, and for those of you who've asked this question, that it's given you a little bit more information to help you deal with this particular problem.

If any of you have any other tips, I would love to hear about them, or if you've managed to solve this particular problem in another way, that would be absolutely great.

So I'll see you next week on another edition of "A.Vogel Talks Menopause".