Chronic Urethra Pain

I am a very healthy 25 year old woman in an active and successful career. For years I have been plagued with something that has always seemed very similar to 'cystitis' but tests at the doctors always came back negative. I was investigated in hospital when I was sixteen and later discharged being told it was probably stress related.

As I have got older I have begun to understand my body better. I have a long term sexual partner. I suffer from this pain only very occasionally roughly once every six weeks after sexual intercourse, but the majority of the time I can enjoy sex normally. The pain that I experience is soley in my URETHRA. It comes on approximately 12hrs after sex and usually when the sex has lasted for quite a long time. It is incapacitating. I cannot leave the bathroom it is so agonising and I am unable to go into work. It will last for about eight hours all of which find me in the bathroom with a hot water bottle crying with pain. I always shower before and after sex and pass urine straight away.

I have been tested for urinary tract infections which come back negative, sexually transmitted infections also negative, had a scan on my kidneys, changed my diet, drank only water for two years, altered my contraception, not used condoms, not used spermicide, not used soaps or perfumes, completely stopped taking contraception (different types of the pill), taken antibiotics, been perscribed Nitrofurion to take as and when my pain comes, been perscribed amitriptyline to intercept my pain censors, had a well woman physical examination (Which did show that I was inflammed and Sore - Told it was thrush - Came up Negative for thrush in swabs)

I have considered the fact that it is possibly linked to trauma of my urethra which is why it only happens on occasion after sex and the rest of the time I enjoy a normal sex life. Do you know anything that can help me?

[Stephen Liroff, MD]

Without having the advantage of examining you in the midst of your pain (which is undoubtedly the time when you should be examined), I obviously trauma or something sexually related is the issue. Things to think about (and you have obviously thought about this a lot) are lubrication (adequate?, choice of, if using one), sexual position, sex toys, frequency of sexual intercourse just before these episodes, partner’s use of cologne or other chemicals. Does your partner have any penile piercings that might be traumatizing ? Are you having anal intercourse without a condom and then vaginal penetration with feces on his penis?
Certainly, the most obvious answer, however, is to not have “prolonged” sex
Good luck!
S.A.Liroff, M.D.