THE RELATIONSHIP BETWEEN BLADDER FLARES AND YOUR SEX LIFE
WHAT TO DO IF YOU’VE BEEN ASKING, “WILL I EVER ENJOY SEX AGAIN IF I HAVE INTERSTITIAL CYSTITIS?”
Living with bladder pain can take a real toll on your sex life, you can still have plenty of, “yes, I AM sexy” days, but dread doing anything with that sexiness because you end up being in pain for days after a good roll in the hay with your beau, or belle. And as for meeting someone new, how on earth do you explain the after-course to them? You’re probably panicking that your beloved will get bored or feel spurned because you don’t seem to be chomping at the bit to take a tumble. And then the mindset spiral begins:
“I’ll never have sex or masturbate again... How will I ever have kids... No way am I going to that smear test, thank you very much... Oh, they clearly want to have sex... And now I’m in agony for the next week, great...”
You started with the wisdom of showering and peeing after sex - and drinking more water. You’ve been on antibiotics in case it’s a UTI issue. You’ve likely tried abstinence. But that’s not really a long term solution, is it? You’ve tried the old, “switching positions” one. And switching to anal sex didn’t work either, you still had pain. Maybe you’ve been given oestrogen creams, “just in case it’s vaginal dryness.” Then there was the amitriptyline for pain relief, but you were left feeling really sleepy and groggy, and unable to wake up in the mornings. Oh and the pain was still there. Then someone mentioned talking therapy, because they read somewhere that painful sex can be linked to trauma. It can but it’s also not the only possibility.
You’re down the late night search engine rabbit hole, asking:
Why do I get bladder pain after sex?
Can sex cause interstitial cystitis?
How long does IC flare last after sex?
How do you stop an IC flare after sex?
Can UTI from sex be cured?
This needs to stop. You absolutely can - and deserve to - enjoy sex again, even if you’ve been told you have IC. This blog is going to show you that it’s not all in your head, what might be causing your bladder pain, and what you can do to prevent and relieve bladder pain, so you can reclaim your sex life.
THE IMPACT OF BLADDER PAIN ON YOUR SEX LIFE
When you suffer with an IC flare or bladder pain after sex, it can seem like you’ll never enjoy sex or masturbation again, because every time you have sex, you’re in pain for 3-7 days afterwards. You have to rearrange your schedule so you can WFH those days, because you’re too uncomfortable to sit all day at your desk. You can’t wear your favourite jeans, because sitting in them makes the pain ten times worse. You end up skipping the gym as you’re in pain. You cancel plans with friends and constantly seem to be rescheduling, because you need to be home with those anti-inflammatories.
This is miserable and not what sex is supposed to mean. You find yourself filled with regret and wishing you hadn’t bothered having sex; it wasn’t worth it. Everyone else gets to enjoy sex and get on with their lives afterwards. It’s so unfair. It wrecks your entire week. You might even be worried you’ve picked up a UTI, because sometimes it’s hard to know if the pain you’re experiencing is an infection, or if your bladder is sore and bruised from sex.
You really want to have sex and feel normal, but fear the painful consequences. And it’s frustrating the life out of you, because you still feel sexy and want that connection with your partner, but you dread the aftermath and think it’s probably not worth it. And how on earth do you explain all of this to your beloved, without them (or you) feeling rejected?
WHAT CAUSES BLADDER PAIN AFTER SEX?
Firstly, let’s talk about the myths around bladder pain after sex, and dismiss those straightaway. If you’ve ever been told any of these things, you can take it with a huge pinch of salt, and come and speak to someone who has really been there:
You’re too young to have problems with your bladder or have IC. So only older people get bladder pain after sex?
You’ll grow out of it. But what about theory number 1?
“Just relax, don’t be so uptight. Have a glass of wine”. Probably from the same person who will tell you to just flush it out with water and cranberry juice.
What is actually most likely to be the cause, if you’ve managed to successfully rule out a chronic UTI (see this blog for more on the difference between a UTI and IC), is pelvic floor dysfunction (PFD). Yes, I’m sure that’s surprised you. You see, what is often the case is that the pelvic floor muscles have gone into spasm, creating pain. It could also be that you have undiagnosed pudendal neuralgia and that is driving clitoral, coccyx and pubic bone pain.
HOW TO ENJOY SEX AGAIN, WITHOUT BLADDER PAIN
It’s so important that you get support with your painful peeing after sex. To ditch the shame and the stigma and reclaim what is rightfully yours - a life lived to the fullest. There are two key ways to tackle this.
1. Pelvic floor physio
When you’re dealing with bladder pain, it’s likely you have pelvic floor dysfunction, or a hypertonic (overly tight) pelvic floor. The muscles spasm and tighten around the sore inflamed bladder, due to the inflammation and the chronic pain which gets you unconsciously tightening the muscles. Most women won’t be aware they are even doing this. A specialised trained physio will be able to assess and diagnose pelvic floor function.
Chances are, if you’re in the UK or Ireland, your GP won’t be aware that this is a treatment option and you will need to request it. I recommend searching this UK and Ireland register to find a suitable trained physio in your area. It’s easy to self refer if you have health insurance in the UK/Ireland.
You may well have been offered botox injections and/or nerve blocks on your journey. But I bet you’ve never had your pelvic floor mentioned, let alone assessed. Pelvic floor assessment would be far less invasive, with less side effects than botox or nerve blocks.
Although there’s not enough conversation about it, pelvic floor dysfunction (PFD) is a big part of painful bladder recovery - and working with a pelvic floor physio will help reduce your pain. In the US, it’s a first course of action to recommend pelvic floor physio for bladder pain treatment.
Now, you may well have heard someone say, “You’ve not had any kids so why would you need a female health physio. That’s just for new mums or post-natal women.” Another comment on a similar vein that I hear frequently is, “I had a c-section so I won’t need a female health physio”. Not true. You don’t need to have given birth to have hypertonic pelvic floor and bladder pain. And after a c-section you’ll have scar tissue which can cause pelvic floor problems. Plus, even if you had a c-section you carried a foetus the size of a basketball around in your pelvis for nine months, so of course your pelvic floor muscles will need rehab. It’s not just for those who have gone through pushing out a baby.
If you suffer with bladder pain after sex, it’s important for you to consult a female health physio and attend fortnightly or monthly sessions for at least six months. Pick a physio with additional training in chronic bladder pain disorders. If you’ve been referred on the NHS or HSE (Ireland) double check the referral as you need a physio with the additional expertise, not a (well intentioned) nurse telling you to do your Kegels and lay off drinking cups of tea and it will go away.
Yes, it does happen, and actually you should probably hear my experience...
As well as being sent to a urologist who told me to have sex on top and I’ll be fine. Yawn. My GP referred me to an incontinence nurse, instead of a specialist pelvic floor therapist. I waited months to see what I believed (because that’s what I was told) would be a female health physio, and I ended up at an incontinence clinic. There was no internal exam and I was simply told to do more kegels (exactly what not to do when you have IC) and given a bit of paper printed out with advice on cutting out caffeine in tea and coffee. A complete waste of time and clear sign that GPs lack awareness and understanding of female health physio.
Thankfully, when I moved to Sydney my nutritionist referred me to a specialist female health physio. At first I thought she was crazy, I couldn’t understand why she wanted me to see a physio about my IC / bladder pain. But I’m so glad I followed her advice and saw one of the most experienced physios on pelvic floor dysfunction. My treatment included trigger point therapy, where I was taught to manually release trigger points in my vagina which were driving my bladder pain, biofeedback with electrical stimulation to help retrain my bladder muscles, stretches like hip openers to help release tension in my pelvis. I was then referred to physio led pilates classes to start strengthening the muscles that needed rehabilitating.
Honestly, the first few physio sessions I went to, I literally jumped off the bed, it was so painful and unexpected. This improved in time. Clients sometimes tell me they went to one physio appointment but it made their bladder flare. In my experience, my bladder symptoms were always slightly worse for a few days afterwards and then gradually improved. Consistency is key. Going for one session and deciding it made things worse is not the answer. Get a different physio or go back and tell them they need to proceed more gently. It should be a two way dialogue. It’s essential to have an open dialogue with your physio so the treatment is tailored to you.
Ideally you want a physio who can teach you how to do internal trigger point release at home between sessions. I always ask my clients what homework they are given and if I feel anything is missing or has been missed I give them a list of questions to go back and ask their physio. If you feel apprehensive about it, I can help explain what to expect. And if you are unable to access physio I can share resources and books I found helpful.
2. Nutritional therapy and bladder healing support
You’re going to find the link to the key programme I offer specifically to help women like you to heal your bladder below. You need to take a holistic approach. You need to support your immune system, nurture your urinary microbiome, pack your own nutritional power toolkit. And you need dedicated support from someone who has really been there. I’ve been where you are. I have first hand experience and I’ve built my entire practice around the things I wish had existed when I was struggling like you are right now. Because I believe you deserve to enjoy sex again, whether you’ve been told you have interstitial cystitis or a chronic UTI.
There are a lot of myths and nonsense advice for people who experience bladder pain after sex. And there’s not enough attention on how miserable and isolating the fear of this pain can be for you. In particular, there’s not enough conversation about the things that genuinely work when it comes to painful peeing after sex.
Pelvic floor physio and nutritional therapy can make a huge difference. These two combined will help reduce your pain scores and bladder flares. It will help you find sex way more comfortable. This is about getting to the heart of the pain - rather than popping a pill that is simply masking over a symptom - we’re here to heal your bladder. And that’s why you’ll want to take a look at the Heal Your Bladder programme.
