Many people with CF experience urinary incontinence, or "leakage" of urine, particularly when they cough or laugh. Some people may experience this during exercise, and while performing lung function tests or chest physiotherapy. Incontinence may be more of a problem during periods of increased cough or when constipated.
Coughing causes incontinence because it increases the pressure on the pelvic floor muscles, which help to hold urine inside the bladder.
Urinary incontinence can be treated with pelvic floor exercises. CF physiotherapists can give advice about how to do these exercises. There are also specialist physiotherapists and nurses who can help with the management of urinary incontinence.
Many people develop genital candidiasis (thrush) when they take antibiotics. It is caused by a yeast (fungus), called Candida albicans that lives in the bowel. When conditions in the bowel are altered, for example, when starting or changing antibiotics, the balance between yeast and bacteria can be disrupted and lead to an overgrowth of Candida.
Thrush is very common in women. It occurs in some men, including men with CF, who often take antibiotics. It may occur with particular antibiotics, after a change of antibiotics, or during a tune up (i.e. when receiving intravenous antibiotics). It can cause itching, redness, pain, irritation and burning on urination.
There are many different treatments available for thrush. It is important to talk to your CF team if you are worried about thrush. It is best if it is treated early and it is important to make sure that the thrush treatments (including complementary medicines) don’t interact with your other medications.
In the past, the onset of puberty in young people with CF was delayed by up to two years. Now, most people with CF start puberty around the same time as those without CF (remembering that the timing of puberty varies in healthy people). Delayed puberty and a later growth spurt are more likely in people who have had trouble gaining weight or who have reduced lung function.
Part of CF care involves assessing growth and pubertal development. Puberty and the production of sex hormones (oestrogen and testosterone) are important for bone development and growth. Some CF centres may arrange for a review by an Endocrinologist (a doctor who specialises in hormones) to further assess pubertal development.
Some people with CF are concerned by their delayed growth and/or pubertal development. It is important to discuss concerns about puberty with your CF team as treatments may be available.
CF does not affect hormonal function. Men and women with CF have normal levels of sex hormones and can expect to have normal sex lives.