Cystitis

Cystitis is an inflammation of the bladder, usually caused by a bacterial bladder infection.

Almost all women will have Cystitis at least once in their lifetime. Around one in five women who have had Cystitis will get it again. Cystitis can occur at any age, but it is more common in:

  • Pregnant women
  • Sexually active women
  • Women with diabetes
  • Women who have been through the menopause.

What causes it?

If bacteria reach the bladder, they can multiply and irritate the bladder lining, leading to the symptoms of Cystitis.

Bladder infections can be caused by:

  • Not emptying your bladder properly – for example, because of pregnancy or an enlarged prostate
  • Damage or irritation around the urethra (the tube that carries urine from the bladder), which could be caused by sex
  • Bacteria being transferred from the anus to the urethra – for example, during sex, wiping after going to the toilet, or inserting a tampon.

Symptoms

The symptoms of Cystitis can also be caused by other conditions, so it's important to see a sexual health clinician or your GP the first time you have any of these symptoms.

  • A need to urinate urgently and often but only passing a small amount
  • Pain or stinging when you urinate
  • Pain in the bladder
  • Urine that's dark, cloudy or strong smelling
  • Traces of blood in your urine
  • Pain low in your belly (directly above the pubic bone), or in the lower back or abdomen
  • Feeling unwell, weak or feverish.

You can sometimes have Cystitis but have no symptoms. This is particularly common if you’re older.

Long term effects

Although most women will not experience any long term effects, some women will experience recurring Cystitis and it can progress to the kidneys if left untreated and become pyelonephritis (kidney infection). This can be serious but can be treated with antibiotics.

Treatment

Mild Cystitis usually clears up within a few days if you drink plenty of water and avoid having sex until your symptoms have cleared up. You can take paracetamol or ibuprofen for pain relief.

If your symptoms are severe, you may be prescribed a short course of antibiotics.

Telling your partner

Although you can’t pass on Cystitis, you may wish to tell your partner if you are experiencing discomfort that means you don’t want to have sex. If sex is triggering your Cystitis, you may find it helpful to talk to your partner about how you feel and what you can do to reduce the risk of infection. Recurring Cystitis can lead to anxiety about sex and can impact your sexual relationships.

How to avoid or improve Cystitis

There are many ways to reduce the chances of infection:

  • After having sex, empty your bladder as soon as possible to get rid of unwanted bacteria
  • Always wipe from the front of your genital area to the back, not back to front, when you go to the toilet
  • Don't use perfumed bubble bath, soap, or talcum powder around your genitals
  • Have a shower, rather than a bath to lessen exposure to chemicals in your cleaning products
  • Always empty your bladder fully when you go to the toilet
  • Don't wait to go if you need to urinate – delaying it can place extra stress on your bladder and make it more vulnerable to infection
  • Wear underwear made from cotton rather than synthetic material such as nylon
  • Avoid wearing tight jeans and trousers
  • Some women find that drinking water and avoiding alcohol can relieve symptoms.

There is conflicting evidence about whether cranberry juice has any effect on bladder infections.

Where to get tested

Women who have had Cystitis before may be able to recognise the symptoms and seek treatment at a pharmacy.

However, you should seek advice if:

  • You have Cystitis symptoms for the first time
  • There's blood in your urine
  • You have a high temperature (fever) of 38°C
  • You're in a lot of pain
  • You develop pain around your back (flank pain could mean the infection has progressed to the kidneys).
  • You've had Cystitis three times in one year
  • You're pregnant
  • You have a catheter (a tube inserted into the urethra to allow urine to flow into a drainage bag, which is often used after surgery).

Your sexual health clinician should be able to diagnose Cystitis from asking about your symptoms. In some cases, they may ask you to provide a urine sample to identify any bacteria.

Questions?

In women who have had, or are going through, the menopause, the lining of the urethra and the bladder become thinner because of a lack of the hormone oestrogen. The thin lining is more likely to become infected, damaged or irritated.

No, Cystitis does not affect fertility in men or women.

No, a UTI is not sexually transmitted, but it could be a sign that an STI is present. It is always good to have an STI screen to make sure that it is not a sign of an STI.

Sex can sometime cause a UTI.