Impact of Sexual Activity on Interstitial Cystitis Symptoms and Treatment

The relationship between the treatment of interstitial cystitis and sexual activity?

Hello, doctor.
In August and September, I experienced a bladder bacterial infection, along with two episodes of frequent urination and lower abdominal pain, but my urinalysis was normal.
In early October, I had lower abdominal pain and frequent urination again (with normal urinalysis), and the doctor diagnosed it as interstitial cystitis.
I underwent a cystoscopy and bladder augmentation surgery.
Currently, I have been participating in a clinical study for extracorporeal shockwave therapy and platelet-rich plasma (PRP) injections for 6 weeks (with a total treatment duration of 8 weeks).
By the fifth week, I noticed an improvement in my frequent urination (about 10 times a day), and the lower abdominal pain has also decreased.
However, after having sexual intercourse in the morning, with the woman on top position initially, which puts pressure on the bladder, I switched to doggy style and woman on top.
That evening, I began to feel increased pain in the lower abdomen around the bladder area, which has not subsided since then and has returned to a state worse than the previous improvement.
I would like to ask the following questions:
1.
Can sexual intercourse exacerbate the symptoms of interstitial cystitis due to pressure or vigorous activity, and how long might it take for the symptoms to improve? I am concerned that sexual activity may reverse the improvements I have already experienced from previous treatments.
Alternatively, since I have already had two PRP injections, could the damaged areas of the bladder mucosa have been repaired, and the pain and frequent urination symptoms are only temporarily worsened due to the pressure from sexual activity, potentially returning to the previous state shortly?
2.
Would you recommend that patients with interstitial cystitis avoid sexual intercourse or simply adjust their positions?
3.
Since the shockwave therapy and PRP treatment are nearing completion, if I do not see improvement or healing afterward, what other treatment options would you suggest?
4.
Is it possible for interstitial cystitis to heal completely? Do most patients experience a long duration of symptoms?

Niming, 20~29 year old female. Ask Date: 2020/11/23

Dr. Xu Wencang reply Urology

It should be unrelated; you can return to the outpatient clinic for further evaluation.

Reply Date: 2020/11/23

More Info

Interstitial cystitis (IC), also known as painful bladder syndrome, is a chronic condition characterized by bladder pressure, bladder pain, and sometimes pelvic pain. The symptoms can vary significantly among individuals, and they can be exacerbated by various factors, including sexual activity.
1. Impact of Sexual Activity on Symptoms: Engaging in sexual activity can indeed lead to an exacerbation of IC symptoms. The pressure and movement during intercourse may irritate the bladder and pelvic region, leading to increased pain and discomfort. In your case, it seems that the sexual position you chose may have placed additional pressure on your bladder, resulting in heightened pain. Typically, the symptoms may improve after a period of rest and avoidance of activities that aggravate the condition. It is not uncommon for individuals with IC to experience temporary flare-ups following sexual activity, but with proper management and care, symptoms can often return to their previous state of improvement.

2. Recommendations for Sexual Activity: For individuals with interstitial cystitis, it may be advisable to avoid sexual activity during periods of flare-ups or to modify positions to minimize pressure on the bladder. Communication with your partner about comfort levels and potential adjustments during sexual activity can also be beneficial. Some patients find that certain positions are more comfortable than others, and experimenting with these can help reduce discomfort.

3. Further Treatment Options: If your current treatment regimen involving shockwave therapy and platelet-rich plasma (PRP) injections does not yield satisfactory results, there are several other treatment options available. These may include oral medications such as pentosan polysulfate sodium, antihistamines, or tricyclic antidepressants, which can help alleviate symptoms. Additionally, bladder instillations with medications like dimethyl sulfoxide (DMSO) may provide relief. Some patients also benefit from physical therapy focused on pelvic floor relaxation and strengthening. It is essential to discuss these options with your healthcare provider to tailor a treatment plan that suits your specific needs.

4. Prognosis and Long-term Management: Interstitial cystitis can be a chronic condition, and while some patients experience significant improvement or even remission, others may have persistent symptoms for years. The course of the disease varies widely among individuals. Long-term management often involves a combination of lifestyle modifications, dietary changes, and medical treatments. Many patients find that keeping a symptom diary helps identify triggers and patterns, which can be useful in managing the condition effectively.

In conclusion, while sexual activity can temporarily exacerbate interstitial cystitis symptoms, it does not necessarily negate the progress made through treatment. It is crucial to listen to your body and adjust activities accordingly. If symptoms persist or worsen, further evaluation and alternative treatment strategies should be considered in consultation with your healthcare provider. Remember, managing IC is often a multifaceted approach that requires patience and ongoing communication with your medical team.

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