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Choosing method is difficult for women with bladder disorder.


 Women with interstitial cystitis (IC), a bladder condition of unknown origin, have difficulty choosing a contraceptive method because most methods cause averse side effects in these women. IC constitutes a painful, inflamed bladder with pin-point hemorrhages on the bladder wall and recurs regularly. Increased frequency of urination (15-20 times/24 hours); pain in the urethra or vagina characterized as pressure, burning, feeling of electric shocks, spasms, or stabbing pain; and painful intercourse accompany IC. It typically afflicts 30-40 year old women. Yet, young women suffering from allergies, immunosuppression, or neurological impairment also suffer from IC. Even though the data indicate that IC occurs somewhat less often in black women, a female urologist believes that they suffer from IC as often as do white women (particularly black women in inner cities) but do not have the same access to appropriate care as do white women. The hard rim of the diaphragm puts pressure on the neck of the bladder, resulting in swelling and IC symptoms. The nerves IC irritates are in the bladder neck, which also explains pain during intercourse. The cervical cap or contraceptive sponge may be better forms of contraception for women with IC. Spermicides can be pushed into the urethra and irritate it which allows bacteria to cling to the urethra and maybe even the bladder wall. So women using spermicides should insert them high in the vagina. Condoms may be an appropriate method, but women with IC often are allergic to latex, thereby preventing them from using latex condoms. Yet, the new polyurethane male and female condoms may be a good choice for them. Exogenous hormones activate IC or exacerbate IC symptoms in some women, especially between ovulation and menses when progesterone levels are highest, suggesting that progestins may cause this exogenously induced response. Animal studies indicate that estrogen improves the protective bladder lining, perhaps due to estrogen receptors in the bladder.
