One of the major triggers for flare up of Interstitial Cystitis (IC) symptoms is sexual intercourse. IC can have a disruptive effect on sexuality and relationships. In a recent survey it was found that at least 90% of patients reported that their IC has kept them from sharing intimacy with their partner. Many have pain with intercourse or orgasm, or sexual activity may prompt IC flares later on. Pain can set up a cycle of low desire, tension in the relationship, depression, avoidance, and guilt. From 50-85% of women with IC also have vulvodynia. Men with IC can have genital and perineum pain similar to vulvodynia, pain with intercourse, low desire, and relationship difficulties as well as erectile dysfunction and pain with ejaculation and after ejaculation.
The impact of IC on relationships and psychological well-being is great. In fact, impaired sexual function has been shown to be one of the strongest predictors of poorer quality of life in IC patients. Despite the magnitude of the problem for IC patients, it often is not addressed. Doctors often do not discuss sex with their patients. In addition, it can be difficult to talk to your partner about intimacy.
The condition in India is even worse. In India female sexuality is already a taboo, therefore this issue never gets addressed. Urologists and gynecologists are often clueless about how to resolve this problem and often prescribe pain medication to get rid of the pain. However pain medication alone is not enough to solve this.
A female patient suffering from IC is not frigid. Unlike a frigid woman they enjoy sex however due to their condition they are neither able to satisfy their partners nor themselves making it a major psychological problem. Young IC patients are often eager to conceive yet this condition majorly affects their conception. Pregnancy on the contrary can often put an IC patient into complete remission. Many women with IC experience increased pain, urethral burning, urinary frequency, soreness of the vaginal area after having sexual intercourse. And this condition can last for days or weeks. Therefore many women completely stop having sex even though they feel the desire, making it frustrating for both the patient and her partner.
There are however few tips to improve the sexual life for IC patients:
- The first and foremost is to have an understanding partner who would empathise with you. Talk to your partner. Communicating about sex could be the most important element in having a healthy and fulfilling sexual relationship.
- Avoid sex during flare-up.
- Try to be relaxed during sex.
- Empty the bladder before and after having sex.
- Drink plenty of water before and after sexual intercourse and urinate shortly afterward to clean out the urethra and avoid infection.
- Take any prescribed medication before engaging in sexual intercourse (pain medication, muscle relaxants or any other prescribed medicine) to ensure maximum comfort.
- Lubricate properly.
- Test out any new lubricant or contraceptive product before using to ensure that it does not cause flare. Natural products like coconut oil are safe lubricants. Avoid ribbed or flavoured condoms.
- Ask your partner to penetrate only when you are completely aroused and ask him to do it slowly. Please do not rush as it may cause severe pain. Use proper additional lubricants.
- Find sexual positions that reduce pressure on the bladder and/or friction near the urethra depending on where you experience most of your pain. Side-facing positions are recommended because there is less pressure applied on the urethra and the bladder.
- "Women on top" position can also be tried.
- When penetration is too painful for women use “outer-course” techniques. Often, that means joining either in a “spoon” position or with the partner’s genitals resting on top of the pubic area or between a woman’s thighs, breasts, or buttocks and rubbing bodies in a way to experience high levels of arousal and even orgasm (for one or both partners). Partners can also bring each other to orgasm, if that is comfortable, orally or manually or masturbate mutually.
- Use a cool icepack on the vulva or perineum to reduce the burning sensation that may accompany sexual intercourse. Internal cooling packs (ice packs that may be placed inside the vagina) may also be used as recommended by a physician.
- Take a hot bath and use a heating pad to provide some comfort from pain both before and after sex.
- If your pain is related to tight pelvic floor muscles, consider using a vibrator or series of vaginal dilators, to exercise and relax the muscles. Vibrators may be better because the vibration can encourage a relaxing of the muscles.
- last but not the least, experiment and find your own comfortable position. Sex isn’t all about orgasm. You and your partner may be able to maintain your sexual connection with sex talk, sharing fantasies, cuddling, reading erotica, watching sexy videos, kissing from head to toe, bathing together, or sensuous massage.