Rebecca B. Singson, M.D, FPOGS, FACS, PSCPC

WHAT IS HONEYMOON CYSTITIS?
This is actually a form of urinary tract infection which is common during the honeymoon or immediately after. Cystitis means inflammation of the bladder and it is usually due to infection. Bacteria are often pushed mechanically up the urethra and into the bladder during sexual contact. This primarily affects the woman and the symptoms are usually that of frequency of urination, burning sensation during urination or waking up more than once while asleep to urinate. Very often, it is caused by the E.coli bacteria from the anus which gets dragged towards the vagina and urethra, and finds its way through the urethra’s tube passageway to get to your bladder, thus causing infection of the bladder. Sometimes, when the infection erodes a blood capillary in the bladder, you may even see bloody urine.

The male urethra, being longer, is not usually affected. The term ‘honeymoon’ was applied because, in the past, this was expected to be the time of first intercourse, which is no longer the norm. Of course, urinary tract infection after sex occurs at many times beyond the traditional ‘honeymoon’ – from the onset of sexual activity into old age.

HOW IS IT TREATED AND HOW CAN IT BE AVOIDED?
It is, however, easily treated with a 3-day antibiotic and the symptoms can resolve within a few days. For prevention, urinate immediately after sexual contact to discourage bacteria from going up to the bladder, wash in a front to back direction to avoid contaminating the vagina and urethra with organisms coming from the anus, and never hold your urine when you feel like voiding so you don’t encourage the bad bacteria to adhere to the bladder walls and multiply.

CAN ORAL OR RECTAL SEX CAUSE URINARY TRACT INFECTION?
Yes. The most common cause of urinary tract infection in 85% of cases is E coli. E. coli can be a normal resident in the mouth.1 In 10% of cases UTI is caused by Klebsiella, Proteus, Pseudomonas and Enterobacter. Pseudomonas may or may not be found in the mouth. In less than 5% of cases, UTI can be caused by Staph aureus, enterococcus, fungi and others. Both Staph aureus and enterococcus are normal residents of the mouth.1 Having oral sex introduces these bacteria to the urethra which can creep up to the bladder and induce infection.

Rectal sex can definitely induce UTI because the rectum is ridden with E. coli. The potential is even heightened if the male, after rectal sex, performs vaginal intercourse without adequate washing.

I KEEP GETTING URINARY TRACT INFECTION EACH TIME AFTER SEXUAL CONTACT, WHAT CAN I DO?
Up to 20 percent of young women with acute cystitis develop recurrent UTIs sexual intercourse has definitely been linked to be a cause. When these episodes recur, the organism causing it should be identified by urine culture and then documented to help differentiate between relapse (infection with the same organism) and recurrence (infection with different organisms). Fortunately, most recurrent UTIs in young women are uncomplicated infections caused by different organisms. It has been found that there may be some value in taking cranberry juice or tablets

Studies show that cranberry juice can reduce bacteria levels and discourage new bacteria from taking hold in the urinary tract. (Drinking cranberry juice won’t cure an existing infection, though, so if you’re having symptoms, you still need to see your doctor immediately to get a prescription for antibiotics.)

Recommended doses range from 90 to 480 milliliters (3 to 16 ounces) of cranberry cocktail twice daily, or 15 to 30 milliliters of unsweetened 100% cranberry juice daily. 300 milliliters per day (10 ounces) of commercially available cranberry cocktail (Ocean Spray®) has been used in well-designed research.

Other forms of cranberry used include capsules, concentrate and tinctures. Between one and six 300 to 400 milligram capsules of hard gelatin concentrated cranberry juice extract, twice daily by mouth, given with water 1 hour before meals or 2 hours after meals has been used.

Honeymoon cystitis can turn a lovely honeymoon into a wretched one. Be aware of it and take measures to prevent it to keep your honeymoon memorable and not miserable.

The following tips will help you prevent UTIs:

1. After a bowel movement, wash and wipe yourself in a front to back direction to prevent bacteria from the stools from contaminating the urethra. Use your forefinger and middlefinger for the vaginal area and the ring and pinky fingers for the anal area to avoid contamination.
2. Wash with lactic acid based vaginal wash (not soap since it is the wrong ph for the vaginal) before intercourse and urinate immediately after intercourse to prevent the organism from ascending through the ureter to the bladder.
3. Avoid douching because it mechanically removes your protective bacteria, thus, making you more prone to infections.
4. Avoid feminine sprays, powders and soaps that can irritate your urethra and genitals and make them a better breeding ground for bacteria.
5. Never ignore your urge to pee. Keep the urine in the bladder encourages bacterial multiplication and increases the chances of the bacteria adhering to the lining of the bladder causing infection.
6. Drink plenty of water, at least eight 8-ounce glasses a day to keep urine dilute.