Urinary Tract Infections and Cystitis 'Cystitis' is a common condition in women of all ages. Although it is commonest in the late teens to early 30's. It often presents as a frequency of needing to pass urine, although only small volumes are passed each time. This is often extremely painful, especially towards the end of urinating - like passing something very sharp. Occasionally, blood is also passed in the urine. Causes - The female urethra, vagina and anus are very close together, and since the urethra is very short it is easy for germs to pass from the anus and travel up towards the bladder. - Sexual intercourse can 'agitate' the urethra and push germs into the urethra. Also, poor lubrication can cause friction which may trigger an attack. - Cystitis may be due to sensitivity to soaps, bubble bath, oils or talc. Or any agent in contact with the urethral area. - It may be triggered by strong tea or coffee, alcohol or highly spiced foods. Or it may be caused by a reduced fluid intake (water, cordials etc.) which keep the kidneys and bladder 'flushed' through and prevent germs from collecting. - It may be the result of 'holding on' too long before going to the toilet. - Wearing tightly fitting trousers or underwear creates a warm, moist environment in which germs multiply. - Stress, anxiety or depression can also cause cystitis. Treating an attack At first signs of symptoms, drink lots of clear fluids to flush the germs out. (This will not lead to a worsening of the pain and frequency as it will dilute the infection and markedly reduce the discomfort) Go to the toilet as often as you need - don't 'hold on'. Don't scrub or over wash the vaginal/urethral area as this may agitate further. A hot water bottle may help. Symptoms will usually resolve within 24 - 48 hours of this. Antibiotics are rarely indicated. The symptoms will usually resolve before antibiotics have chance to start acting. Preventing Future Attacks 1. Always remember to wipe your bottom from front to back, to avoid spreading of germs 2. Clean the vaginal area with plain water or a mild soap. It is better not to use a flannel or sponge. Avoid long soaking sessions in hot frothy baths! Avoid perfumed soaps, antiseptics or talc. 3. It cystitis tends to flare up after sex, try washing the vaginal area after sex or going to the toilet straight after intercourse. 4. Avoid tight trousers or underwear. Cotton is preferable to nylon underwear, and stockings are preferable to tights. If symptoms fail to settle after 24 hours a urine specimen should be taken to the doctor to check for infection. Recurrent or frequent attacks should also be investigated by a urine sample.