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Cystitis in women

What is cystitis?

Cystitis is inflammation of the bladder, which is a very common problem; it is suffered by many women at some stage in their lives. The most vulnerable times are starting sexual activity (hence the term 'honeymoon cystitis'), during pregnancy and after menopause.

What causes cystitis?

It is almost always caused by bacteria travelling upwards along the rather short passage (the urethra) from the outside into the sterile bladder. This is often caused by intercourse, which pushes this short passage and bacteria upwards. These bacteria, which are present in the bowel, are normally found around the openings of the anus, vagina and urethra. The bladder soon learns to cope with these germs by a type of local immunity, but some women are prone to recurrent infections.

What are the symptoms?

burning or stinging when passing urine

an urge to pass urine often

passing only small amounts of urine

discoloured and smelly urine

fever; pain the back or low abdomen (may be present)

feeling generally unwell

What are the risks?

Cystitis is very uncomfortable and irritating, but is not a serious problem. An untreated infection can spread up to the kidneys, and this is serious.

What is the treatment?

Self-help

Keep yourself rested and warm.

Drink a lot of fluids: try 2 cups of water at first, and then 1 cup every 30 minutes.

Try to empty your bladder completely each time.

Gently wash or wipe your bottom from the front to the back with soft, moist tissues after going to the toilet.

Take analgesics such as paracetamol for pain.

Make the urine alkaline by using Ural or Citravescent as directed.

You should visit your doctor if the attack lasts more than 24 hours and bring a fresh specimen of urine, which you should collect after washing your vulva with clean cottonwool and water.

Medical help

You will be prescribed a course of antibiotics, which should all be taken. A follow-up urine test will be necessary. If the antibiotics do not work or if you have more attacks, some special tests (including X-rays) may be necessary to check your urinary tract.

How can you prevent further attacks?

Get into the habit of drinking plenty of fluids, especially on hot days.

Pass urine often and when you feel like it-do not let it build up.

Make sure you empty your bladder each time.

Wash your bottom gently after each bowel motion, using mild soap and soft tissues.

Empty your bladder immediately after intercourse.

If your vagina is dry, use lubrication for intercourse (KY jelly for young women and oestrogen cream after the menopause).

Wear cotton underwear; avoid tight jeans and vaginal deodorants.

Copyright 1995: John Murtagh, Professor of General Practice
Monash University, Melbourne, Australia