Wellness

Female bladder infections (UTI) are common and affect about half of women at least once in their lifetime. One of the first signs is pain on passing urine. E.coli is the most common bacteria that causes the infection and naturally occurs in the gut. It does not cause any problems there unless it enters the urinary tract, where it can result in a water infection.

A recurrent female bladder infection is defined as having three or more infections in a year, and most commonly occurs in young, sexually active women and in those over the age of 55. 

If you suffer from recurrent UTI's, then it is important to discuss this with your doctor. Different treatment options are available. Some women find that having a 3-day course of standby antibiotics (such as Trimethoprim or Nitrofurantoin) is useful, so they can be started without delay when necessary. 

If your recurrences are very frequent, then another option is taking a course of low-dose antibiotics every night, often for six months. This acts as a preventative measure, reducing the number of episodes, but may not stop them completely. If you develop an infection while taking these preventative antibiotics, then it is usually caused by a resistant bacteria. A urine test should be arranged by your doctor, and you will usually require an alternative antibiotic.

The term cystitis means inflammation within the bladder, and the most common cause of this is a bacterial urine infection, with bacteria spreading from the bowel. The skin around the back passage will be colonized with this bacteria which can spread to the opening of the urethral tube. From there it can pass up through the urethral tube and into the urine in the bladder. Since women have a shorter urethra than men, the bacteria can pass into the bladder urine more easily. Therefore it is more common in females.

Certain factors can increase a woman’s chances of developing urine infections. This includes:

• being sexually active
• using a spermicide
• pregnancy
• being postmenopausal
• diabetes
• having a suppressed immune system
• having a condition affecting the urinary tract (kidneys, ureters, bladder or urethra)

There are certain things you can do that may help with recurrent bouts of cystitis. Here is a list of 7 lifestyle changes which you may want to consider:-

Aim to drink about 1.5 to 2 litres (approximately 4- 6 glasses a day) of fluid a day as a guide. You may need to drink more or less depending on your lifestyle. If you are very active or in hot weather, your requirements will increase, as your body loses more fluid through sweating. Also, fruit and vegetables contain water which will add to your daily intake. 

If you do not drink enough fluid, then your body becomes dehydrated, your urine will develop an intense colour and becomes more concentrated. This concentrated urine may irritate your bladder and make it more likely for you to develop cystitis.

Your bladder acts as a temporary store for your urine. When it becomes full, you develop the urge to urinate. Pass urine when you feel the need to go and try to empty your bladder completely. This helps to reduce the chances of bacteria multiplying within the bladder.

Try to avoid tight fitting trousers around the groin, and opt for cotton underwear. Synthetic (human-made) fibres in underwear can prevent the air reaching the perineal area and may cause irritation. 

Incorrect wiping of the perineal area (the area around the vagina and anus) can cause faecal bacteria (from the stool) to spread. By wiping your bottom from front to back carefully, it can avoid bacteria such as E.coli from the anus spreading to the urethral opening (the tube through which you pass urine).

Chemical products such as scented soap, washes, deodorants or washing powders may result in irritation of the urethra. Try to avoid using products in this sensitive area.

Try to pass urine before and after sex, as friction from sexual activity can cause bacteria from the perineal skin to enter the urethral tube. If cystitis is usually brought about by sex, then you and your partner should consider washing your genital areas before sexual activity. This may help prevent cystitis in some people. Repeated episodes of cystitis can happen with frequent sexual activity, otherwise known as 'honeymoon cystitis,' but this usually resolves over time.

There is conflicting scientific evidence on the use of cranberry tablets or juice to prevent cystitis. A Cochrane review of studies did not show any evidence to show a reduction.¹ However, natural alternatives are a personal choice and are not often studied adequately to form a definitive conclusion about the benefits. Cranberries contain plant substances called tannins and are thought by some to stop certain bacteria from growing in the bladder. There is no evidence to support this though.

Cranberry juice should be avoided if you have arthritis, IBS, hiatus hernia or heartburn as it may worsen the symptoms in some people.

Recurrent episodes of bladder infections (three or more episodes within a 12 month period) should be discussed with your GP. We can assess and treat female bladder infections quickly and safely through i-GP, as long as you have not suffered from three or more infections in the last 12 months. Please go to our Start a Diagnosis Page for further information.