Bumpy Road to the path of romance


Dear Dr G,

I am emailing about an embarrassing problem a newlywed couple, my wife and I, are facing.

My wife and I have been married since April, and the last few months have been a bit of a nightmare when it comes to sex.

We are both in our early thirties and started courting when we were at university.

As we are both devoted Christians, we did not engage in any sexual contact until we were finally married six years after we first met.

The sexual activities were all great until my wife started having pain and bleeding in the urine a few days after intercourse.

The pain was so intense on several occasions she needed to be admitted and treated with

intravenous antibiotics.

The urologist who attended to my wife told us this is a common condition called Honeymoon Cystitis. Apparently, this can persist for several months before it finally resolves by itself.

The problem is we are both so fearful of sex that this often ends up with such infections.

Besides, my wife also started wondering whether this has anything to do with STI (Sexually

Transmitted Infections).

I tried to assure her I had no other sexual partner and never even had sex with anyone.

However, when she started getting such frequent infections, she began to lose trust and patience in our marriage.

Hence, I am putting Dr. G on the spot for some clarifications of Honeymoon Cystitis.

Firstly, can you tell me what exactly is Honeymoon Cystitis and how common it is?

Is Honeymoon Cystitis a type of STI as it is induced by sex?

What bacteria can cause Honeymoon Cystitis?

Can Honeymoon Cystitis be prevented at all, and how long will it take to resolve?

Please help.

Yours truly,

Honeymoon Henry

Honeymoon Cystitis typically describes acute infection of the bladder or urinary tract infection (UTI) and occurs primarily during the sexual debut. Statistics suggest that about 60% of women experience at least one UTI during their lifetime, with a significant increase in incidence occurring during the first year of marriage. Although there is no real data or medical literature on incidences of true Honeymoon Cystitis, it is believed to affect up to 30% of women who are newlywed or who started engaging in sexual intercourse.

Honeymoon Cystitis almost exclusively occur in women, with the pathogenesis of infection intertwined with the close nature of penetrative intercourse. During sexual activity, the short urethra in women can come into contact with bacteria from the genital area. This exchange can introduce unwelcome bacteria into the bladder. The warm, inviting environment of the urinary tract provides these bacteria with a perfect breeding ground, leading to infection and all the unpleasant symptoms that follow.

Generally, the symptoms of Honeymoon Cystitis are mild and self-limiting after adequate

hydration. However, the symptoms of painful urination, frequency, and urgency of urination can affect the quality of life for some women. In some cases, bleeding and constant fever requiring a long treatment duration can also be debilitating for the newlywed.

Up to 78% of bacteria that induce Honey Cystitis are caused by E. Coli. Other common bacteria that induce such infections are Proteus Mirabilis and Klebsiella Pneumoniae. As these pathogens are generally not unrelated to Sexually Transmitted Infections (STI) and spontaneously occur without sex, Honeymoon Cystitis is not considered an STI. Although some couples may start getting frustrated and losing faith in each other, the assurance from healthcare professionals is generally adequate.

The key to avoiding Honeymoon Cystitis is prevention. Staying hydrated by drinking

plenty of water assists in flushing out harmful bacteria from your urinary system,

preventing the bacteria from causing further mischief. Urinating frequently and emptying the bladder regularly can also help to eliminate any bacteria that may have found their way in. Good hygiene practices before and after sexual activity ensure a clean and healthy environment for you and your partner is often the key. Other measures, such as drinking cranberry juice or taking supplements, may help to prevent bacterial adhesion and reduce the risk of UTIs.

The treatment of Honeymoon Cystitis is readily available and effective. Short courses of antibiotics ranging from one, three and five-day treatments are usually sufficient. Seek medical assistance if the symptoms persist or become severe. For some individuals, the infections may be prolonged or recurrent. Under such circumstances, regular consumption or even long-term prophylactic antibiotics may be warranted.

Honeymoon Cystitis can be a pesky little surprise that can put a damper on the honeymoon period. As frustrating as Honeymoon Cystitis may be, don't let it steal the joy of newlywed's bliss. By following good hygiene practices, staying hydrated, and seeking appropriate treatment when needed, partners can overcome this bump in the road with a maximum duration of a year.

Dr. G is often put on the spot for the troubling couples facing the bumpy road to their path of romance. His opinion is this bumpy road of Honeymoon Cystitis is just a small price to pay for the sweetness of intimacy. Other bigger bumps ahead in a sexual journey may just be the bitter-sweet couples need to watch out for.

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Dr George Lee

Dr George Lee

Dr George Lee is a consultant Urologist and Clinical Associate Professor whose professional interest is in men’s health. This column is a forum to help men debunk the myths and taboos on men’s issues that may be too “hard” to mention. You can send him questions at askdrg@thestar.com.my

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