Post-coital cystitis: what it is and why it is frequent in menopause

Cystitis is a fairly common inflammation at all ages but in menopause it could be even more frequent. Most often, the symptoms come after intimate intercourse. In this article, we explain why and how you can prevent it.

This article was written by our menopausal experts

Post-coital cystitis is a nagging and often painful inflammation of the bladder . In women of all ages, it is quite common because it does not always depend on the same causes.

Finding the reason that makes it easier to develop the irritation that causes cystitis can greatly reduce, or even eliminate, the recurring manifestations.

But let’s go in order.

What is postcoital cystitis

Postcoital cystitis is usually triggered by inflammation of the bladder which – in this case – has a predominantly mechanical origin.

This means that the triggering cause of inflammation is sexual intercourse: the vaginal and vulvar walls are subjected to intense stress in less than ideal conditions and this can subject to a stronger friction that can sometimes generate microtrauma to the intimate mucosa and trigger inflammation.

Of course, the remedy is not to eliminate intimate relationships .

On the other hand, it is important to restore the ideal conditions of pelvic lubrication and relaxation for a satisfying intercourse without unpleasant consequences, such as post-coital cystitis.

Symptoms of postcoital cystitis

Symptoms of postcoital cystitis occur between 24 and 72 hours after intercourse with a specific group of symptoms:

  • Burning in the bladder and urethra
  • Frequent need to urinate
  • Intense pain or burning during and after urination
  • Hematuria, i.e. blood loss in the urine
  • Back pain in the kidneys
  • In severe cases, high fever with intense chills

Causes of postcoital cystitis

Beyond sexual intercourse, there are specific causes that lead postcoital cystitis to be frequent and relapsing and that can be successfully treated.

  • High vaginal pH , i.e. tending to neutral: this factor alters the vaginal ecosystem making it more vulnerable to infections (such as candida) but also more vulnerable to micro-traumas caused by the mechanics of intimate intercourse. A high pH is a physiological condition in menopause , which explains why cystitis can be more frequent.

To know more…

  • Why does vaginal pH change in menopause
  • How the female genital system changes in menopause
  • Vaginal inflammations in menopause: what are they?
  • Intestinal problems such as constipation, which favors infections with Escherichia Coli(endogenous bacterium that causes candida) which lead to inflammation in the upper part of the uro-genital system.
  • Stiffness and excessive contraction of the pelvic muscles during intercourse, usually caused by fear of pain, or by other psycho-physiological factors. This factor restricts the vaginal entry by increasing the effect of mechanical rubbing.
  • Vaginal drynessand poor lubrication that increase the impact of coital friction. Vaginal dryness is one of the most typical manifestations occurring in menopause, often correlated with Vulvo Vaginal Atrophy .


Do you suffer from vaginal dryness ? Are you having difficulty with your partner because of this? Read these articles, they can help you:

  • Vaginal dryness in menopause: symptoms
  • Dryness, when it is appropriate to talk to the gynecologist
  • Embarrassments and psychological implications of intimate dryness

Tests to be done in case of recurrent post-coital cystitis

To detect cystitis, of any type, it is important to do a urinalysis with an antibiogram. This will give the possibility to identify the presence of pathogens and, consequently, to select the most suitable antibiotic therapy .

The antibiotic must necessarily be prescribed by the doctor , as well as any other treatment.

If the cystitis is relapsing, it is important to have a gynecological examination as soon as possible because only the specialist can check:

  • The estrogenic state , or the degree of hormonal deficiency, physiological in menopause and perimenopause
  • The tone of the muscles of the perineum which, as mentioned, can facilitate mechanical trauma to the bladder
  • The consistency and effectiveness of vaginal hydration
  • The presence of a Vulvo Vaginal Atrophy which can directly cause dryness, lesions and coital pain.

Preventing post-coital cystitis: good rules to follow

As we have already said, abstinence is not a solution: it can certainly avoid some inflammation, but it does not eliminate the causes of post-coital cystitis.

There are some good rules you can follow that, after a visit to the gynecologist and a urinalysis, can help eliminate the risk of relapse.

  • Attention to intimate hygiene: in menopause it is necessary to use specific soaps that are not aggressive and that respect the physiological pH in this specific period. At the same time it is important to choose natural detergents that do not contain perfumes or additives that are potentially irritating to the mucous membranes.
  • Do not wash too often: the mucosa has a protective film that is already weaker than normal in menopause. Every time you wash you take it off and this could row against genital health.
  • Use personal and linen towels: avoid exchanging towels with other family members (to avoid passing infections with a ping-pong effect) and use only linen fabrics. To dry yourself do not rub but dab the moisture.
  • Keep an eye on nutrition and correct it to avoid constipation which can be a vector of cystitis and genital infections; bowel regularity is important. Consult your doctor. You can help your body with juices or – better – extracts from cranberries ( cranberry ) and lactic acid bacteria .
  • If the gynecologist has detected an unnatural contraction of the levator muscle you can learn how to do specific pelvic gymnastics that can help you a lot to find the perfect state of relaxation, also helping sexuality and dyspareunia .
  • Don’t get cold in your back because cystitis can get worse with cold.


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