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Cystitis in women: preventing further attacks

Most women who have a urinary infection do not get another one, but some unlucky women seem to get them constantly. Here are some things you can do to lessen the chance of frequent attacks. They apply mainly to bacterial cystitis, but might also be helpful in painful bladder syndrome (interstitial cystitis).

• Drink cranberry or lingonberry juice (200–750 mL a day) or eat some blueberries every day.
• Wash thoroughly using your hand to soap the anus and vulva (the area between the legs in women). Rinse well. Do not use a flannel or sponge to wash yourself. These harbour bacteria, even if you rinse them well.
• Do not use antiseptic wipes or perfumed soap, and do not put antiseptics or bubble baths in the bath water. Antiseptics, perfumes and other chemicals can irritate the vulva and the opening of the urethra, and make the problem worse.
• After you have passed a bowel motion, wipe your bottom from front to back. There is no need to wash the vulva after each bowel movement.
• Do not wear jeans that are too tight. The knot of seams can bruise the opening of the urethra, which might make infection more likely.
• If you have interstitial cystitis, check your diet. Some people find that caffeine, alcohol, chocolate, artificial sweeteners or acidic foods make it worse. Smoking may also make it worse.
• If you are at or have had the menopause, vaginal dryness can cause soreness and bruising of the urethra during intercourse. Use a lubricant, and ask your doctor about an oestrogen cream to apply to the vulval and vaginal area.
• Ask your doctor about long-term low-dose antibiotics (such as nitrofurantoin or trimethoprim) if bacterial cystitis is making your life a misery. Some women have taken these successfully for 5 years. You will need to try them for 3 months to find out whether they work for you. Alternatively, your doctor could give you a standby supply of antibiotics to keep at home and use when the symptoms start, continuing until 24 hours after the symptoms have gone.

Cystitis related to sex

• Wash your genital area before and after having sex.
• Think about the contraception you are using. Spermicides are used with contraceptive diaphragms to increase their efficiency, and some condoms are manufactured with a spermicidal lubricant. Research at the University of Washington (Journal of Infectious Diseases 2000;181:595-601) showed that urinary tract infections were most likely in women who were most sexually active and who had contact with spermicides.
• Your doctor can prescribe an antibiotic for you to take just one dose after you have sex.
• Ask your partner to wash his hands and penis before sex.
• Pass urine as soon as possible after sex, to flush out any bacteria. Drink a glass of water beforehand so that you have something to pee afterwards.

 

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