Cystitis in women

What is cystitis?

Cystitis is inflammation of the bladder. There are two main types. The only sure way to tell the difference is by a urine test.

Bacterial cystitis is caused by bacteria (germs). These bacteria, mainly Escherichia coli (E. coli for short), normally live in and around the anus (back passage). In men, the urethra goes along the length of the penis and is about 24–30 cm long but, in women, it is only about 6 cm long. So in women, bacteria on the skin can easily get into the bladder by using the short urethra as a ladder. This probably explains why cystitis is much more common in women than in men. Some women find that bacterial cystitis is related to boisterous sex, which can bruise the urethra and may squeeze bacteria up into the bladder. For more information see our section on how to prevent further attacks of cystitis.

Painful bladder syndrome (also called, interstitial cystitis, non-bacterial cystitis, urgency and frequency syndrome) is inflammation of the bladder without any bacteria being present. Most sufferers (90%) are women. It can occur at any age, but is most common in women in their early 40s. It is a bit of a mystery, and no one really knows what causes it.

One theory is that a substance called glycosaminoglycan is deficient in the bladder. This substance is part of the slimy layer that covers and protects the lining of the bladder.
Another theory is that it is a type of allergy, because cells common in allergy (mast cells) are present in the bladder wall in interstitial cystitis.

Symptoms of cystitis

The symptoms of cystitis are:

a burning, stinging or aching pain when you pass urine
a need to pass water very frequently, often only a small amount each time
bloody or cloudy urine (severe cystitis).

Bacterial cystitis. With bacterial cystitis, you usually experience only the burning pain and frequent urination. However, it is possible for the infection to travels upwards to the kidney. Fortunately, this is unusual. Infection in the kidney needs proper medical treatment, so see your doctor straight away if you also have:

blood (or a smoky appearance) in the urine
backache or stomach ache
fever and weakness.

Painful bladder syndrome. With painful bladder syndrome (interstitial cystitis) the symptoms are diverse. You have to pass urine frequently (including at night), and maybe urgently, and passing the urine may be uncomfortable. You may notice discomfort in the lower abdomen when the bladder is filling (pelvic pain), which is relieved by passing small amounts of urine. Sex may be painful. Often, symptoms are worse in the week before a period.

What else could I have?

Not all urine problems are cystitis. For example:

if you have soreness or itching around the opening of the urethra (pee hole) you might have a herpes infection, thrush or a chlamydia infection
if your only problem is having to pass urine frequently, you might have diabetes (especially if you are thirsty all the time), so see your doctor
if your main problem is having to rush to the toilet, you may have a continence problem.

Written by: Dr Margaret Stearn
Edited by: Dr Margaret Stearn
Last updated: Friday, February 1st 2013

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Comments on this article

Posted by Optional on 17/04/2013 at 08:44

water infections all time antibiotics no good

Posted by help:( on 29/03/2013 at 07:03

I have white stuff round my pee hole and it itches and quite sore, it sometimes hurts when i pee, i last had sex 3 weeks ago, im not sure if its thrush or not?

Posted by Optional on 29/03/2013 at 12:23

I have a burning/ stinging pain which is usually onset when needing to urinate and at times during or after ntercourse. This pain can often persist long after urinating/sex. The pain is around the entrance to the vagina. Previously when I did not know how to combat the problem the pain would become so bad and I would start to get very hot and irritable. Previously applying pressure, like sitting on the edge of a chair or the side of the bath helped, although at times i couldnt sit at all. Now I've realised that taking iboprufen helps. I've been given antibiotics, tested for stds and thrush, several times, but still to no avail. This has been going on for many months on and off. I also tried non perfume soaps and no improvement. Can anyone shed any light?

Posted by Anxious and Scared! on 02/03/2013 at 03:53

I used to think that I had some sort of STI but when i went to a clinic they said i just had thrush, so I got a 3 day cure and everything seemed fine from then, apart from going to the bathroom. for the last year or two it has been painful to pass urine majority of the time i go. If I have been drinking lots of water all day it doesn't usually. Just recently my urine hole has been really itchy. Please help I'm terrified and don't want to tell my mum incase it ends up being an STI. Because I have had sex before.

Posted by EBONY on 17/10/2012 at 05:32

OK, I HAVE A PROBLEM; FOR SOME REASON MY PEE HOLE KEEPS HAVING THIS SLIGHT ITCH. ITS NOT A BURNING, SERIOUSLY, ITCHY ITCH BUT ITS VERY ANNOYING AND I DONT KNOW WHATS WRONG. I HAVENT HAD SEX IN 15 MONTHS, I DONT MASTERBATE WITH TOYS, I BATHE EVERY DAY, I WIPE FROM FRONT TO BACK, I DRINK LOTS OF WATER, WEAR COTTON PANTIES, AND EVERYTHING ELSE. NOW I DO WORK OUT BUT OTHER THAN THAT, THATS IT. WHAT COULD POSSIBLY BE THE PROBLEM?

Posted by Amanda on 15/10/2012 at 07:47

after my boyfriend was fingering me the other day i noticed a few spots of blood on my underwear is this cycstitis or does it mean tht he was a little too rough fingering me.also i do have to keep going toilet quite often and i get a burning sensation what does this mean.ive done a water sample for doctor but heard nothing back since.