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The connections between sexuality, hygiene and cystitis

Is cystitis a sexually transmitted infection? What are the best rules of intimate hygiene? Why is sexual intercourse conducive to this type of infection? All too often, the relationships between cystitis, intimate hygiene and sexuality are poorly understood. Doctissimo provides the answers you’ve been looking for.

Hygiene, sex and cystitis
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Cystitis can be caused by various factors. The blame is often laid on sexual intercourse, hormones and intimate hygiene, but to what extent is this true? Dr Jean-Marc Bohbot, of the French Alfred Fournier Institute sets the record straight*.   

Cystitis and sexuality

A large number of women believe that sexual intercourse is directly responsible for episodes of cystitis and assume that their partners must have passed on an aggressive germ.

“The truth is that it is exceedingly rare for non-recurring acute cystitis to be caused by a sexually transmitted micro-organism. However, it is not uncommon for couples to be tested for sexually transmitted infections if they only recently started to engage in intercourse or have been experiencing related gynecological symptoms, such as leakage, burn and pain,” says Dr Bohbot.

The most commonly encountered bacteria are Chlamydia trachomatis and Neisseria gonorrhoeae, also known as gonococcus. Another much rarer cause called herpes simplex virus should also be mentioned as it can in some of its common forms lead to pseudo-cystitis.

There are three ways in which sexual intercourse can play a part in bringing about cystitis:     

  • The mechanical role: the urethra can be stretched and come into contact with germs found at the entrance to the vagina. Intercourse can result in inflammation of the mucous membrane of the urethra, making it more vulnerable to infection;
  • The septic role: aside from the exceptional case of infection by a sexual germ, intercourse may bring out micro-organisms of the normal vaginal ecosystem that can be dangerous for the urethral mucous membrane;     
  • The emotional role: the stress induced by sexual intercourse can, in certain women, lead to the secretion of endorphin, which have a deleterious effect on local immunity.

What role do hormones play in cystitis?

The fact that this kind of infection tends to occur more often during pregnancy and after menopause suggests some sort of hormonal trigger. More specifically, the lack of estrogen (female hormone) might be to blame.  

Hormonal imbalance can weaken vaginal and urethral mucous membranes and simultaneously disrupt the balance of the normally harmless vaginal flora, thereby allowing certain bacteria to spread at the expense of others, such as Escherichia coli, which positively affect urethral mucous membranes.

The golden rules of intimate hygiene

Poor hygiene raises the risks of microbial proliferation. Dr Bohot insists that this is especially striking during menstruation, when “tampons or external protection are kept on too long, as well as insufficient washing of genitals, thereby increasing chances of infection”.

On the other hand, too much of a ‘good thing’ can also be harmful. Excessive hygiene and the use of inappropriate products can induce both mechanical and chemical trauma inside genital mucous membranes. “The vaginal flora is a very fragile ecosystem. Any imbalance caused by excessive washing or unsuitable products results in the proliferation of the most aggressive germs due to impaired natural defenses,” Dr Bohbot adds.

Tight-fitting clothes can also lead to a rise in genital temperature and humidity and therefore heighten risks of infection, so should also be avoided.

* Press conference "Female cystitis" organized by Zambon laboratories.

Posted 16.02.2011

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