Silver Fox #2 – The Aftermath
With expert information from Dr Claire Ferraro, London, UK
Later that weekend, Kayleigh was suffering from a frequent urge to use the loo. And each time she went, felt burning and stinging. She put two and two together and realised she’d developed ‘post-coital cystitis’ from the pleasure she’d received from James and his roving fingers.
Post-coital cystitis is inflammation or infection of the bladder and urethra provoked by sex. It’s usually caused by bacteria that travel up into the bladder via the urethra (the tube connecting the bladder to the outside world) and multiply in the urine.
Penetrative sex, either with a penis, toys or fingers, can encourage the bacteria that usually live in the vagina, labia or skin to enter the urethra and get pushed up into the bladder. Women are more likely to get cystitis because our urethras are shorter and nearer the anus, compared to men.
Kayleigh had felt these uncomfortable sensations a few times before, so she spoke to Dr Claire Ferraro, Clinical Fellow in Integrated Sexual Health, for some advice about what she should do to get rid of her symptoms.
Dr Ferraro said: “Mild cystitis symptoms usually clear up within a few days, but sometimes antibiotics are needed. There are a few things you can do to help improve the situation.  Use a hot water bottle on your tummy and/or thighs to help with the discomfort. If that doesn’t work, take over-the-counter painkillers, for example paracetamol or ibuprofen.
“Drink plenty of water to keep your organs hydrated. There’s no hard scientific evidence to suggest that this speeds up recovery time, but it seems like a good idea as it helps to flush the infection out of the bladder.
“Some people find that drinking cranberry juice or something that will reduce the acidity of the urine – for example, a teaspoon of bicarbonate of soda, or potassium citrate added to a glass of water – can help. But having said that, at the moment, there’s a lack of scientific evidence to suggest it’s effective.”
After two days of drinking nothing but water and cranberry juice, things were not getting any better. Now her urine was cloudy and smellier than normal, and she was starting to get some stomach cramps.
Kayleigh spoke to Dr Ferraro again: “It sounds like you need to see your GP, you may need some antibiotics.”
Kayleigh booked an appointment and they took a urine sample. It showed signs of cystitis, so she was prescribed an antibiotic called Nitrofurantoin. She took one tablet four times a day for three days. 
“In some cases, the GP will prescribe you antibiotics, usually for a few days – it is really important that you take all the antibiotics that you are prescribed. If you don’t complete the course, a few resistant bacteria can survive and then re-grow,” Dr Ferraro continued.
“Cystitis after sex sessions is really common, but there are some things you can do to avoid it becoming a problem every time.
“It’s about good hygiene really. Make sure your partner has washed their hands before any digital penetration. If there’s any anal play involved, wash hands and/or toys and/or penis thoroughly before re-entering the vagina, or better still, leave the anal play until last. This avoids any of the bacteria from there inadvertently getting to the urethra.
“Pass urine after sex, as soon as appropriate. This will help to flush out any bacteria that may have entered the urethra, before they make their way up to the bladder. And try to empty your bladder of all the urine every time you go to avoid any residual urine harbouring any bacteria.”
Kayleigh was having drinks with some girlfriends a few weeks later. She mentioned her experience and was surprised to hear that several them had also suffered from this. One had even had it so often that she now had a prescription from her GP for ‘standby’ antibiotics, so that she could start a course as soon as possible if she noticed symptoms. 
Thanks to Dr Ferraro’s advice, Kayleigh didn’t have this issue with Silver Fox #2 again.
 NICE Guidelines: Lower Urinary Tract Infections in Women
 Harris N, Teo R, Mayne C, Tincello D. Recurrent urinary tract infection in gynaecological practice. The Obstetrician & Gynaecologist 2008; 10:17-21
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