I am one of those women who do not have orgasms while having sex. After masturbating to achieve orgasm, I experience painful bladder spasms -- sometimes even hours later. Is masturbation causing this?

--W.G.

Orgasm, no matter how it is achieved, can lead to bladder spasms in some women. Orgasms produce contractions in many muscles throughout the body -- particularly the uterus, the vagina and the bladder.

Another possibility is that by masturbating, you may also be inadvertently introducing bacteria into your bladder, causing a mild bladder infection. Be sure to wash your hands before you masturbate to decrease this risk. The same process can occur during intercourse, which can "push" vaginal bacteria into the urethral opening.

It's possible, as well, that you may also have a condition called interstitial cystitis, an inflammation of the bladder wall. However, if you have interstitial cystitis, it is unlikely that pain with orgasm would be the only symptom. If you also have pelvic pain, urinary urgency or burning, ask your doctor to evaluate you for this condition.