If you need to race to the loo when nature calls, experience a burning sensation when you pass urine or feel that you haven’t fully emptied your bladder, I’m sorry, it sounds as though you have cystitis. This troublesome bladder irritation is often due to a lower urinary tract infection (UTI), but can also simply be a result of local irritation of the bladder lining and/or the urethra (the tube running between the outlet of the bladder to the exit near the vagina). This irritation can be caused by perfumed soaps, douching or from sex. Vaginal dryness, particularly related to the menopause, can also leave you more prone to cystitis – as can diabetes.
Almost all women will experience cystitis at least once in their lifetime and around one in five will get it again, according to the sexual health clinic Brook. This is because women have a shorter urethra than men, making it easier for bacteria to find its way into the bladder, causing a UTI. A mild infection will usually clear within a few days and drinking plenty of water helps flush it out.
However, if it happens two or more times in six months, you are said to have recurrent cystitis and often episodes are far more frequent.
Here are a few measures you can take to prevent or treat it early on…
● Drink plenty of fluids – around two litres (or more if it is hot or you are physically active). Remember urine should be pale-coloured.
● Take sodium citrate sachets, which you can buy from the chemist, to settle symptoms. Some say a glass of cranberry juice daily can help but the evidence for this is not strong.
● Reduce caffeinated, alcoholic and fizzy drinks as these can irritate the bladder. Foods can also be a trigger – keeping a diary can help to identify the culprits.
● To reduce the risk of bacterial infection, always wipe from front to back when you go to the loo and make sure to fully empty your bladder.
● Only wash the vaginal area once a day and avoid douching or feminine hygiene products as they remove the natural protective barrier.
● A healthy vaginal microbiome may aid in preventing cystitis. If you have taken antibiotics recently, consider a course of probiotics to restock the ‘good microbes’.
● Make sure to change sanitary pads and tampons frequently.
● Postmenopausal women may benefit from topical oestrogen cream.
● Keep your sugar intake to a minimum as bacteria and yeast thrive in a sugary environment.
● Preliminary research suggests the supplement D-mannose (available without prescription) may prevent some bacteria from growing in the bladder and reduce or even prevent recurrent infections. More and more of my patients are finding this helpful.
● Methenamine hippurate is also used to prevent the growth of bacteria but will not treat an infection. It can be bought at the pharmacy.
● As a last resort, a low-dose of antibiotics can keep recurrent infections at bay. You may be given antibiotics to take as a one-off tablet within two hours of having sex to prevent an infection.
See your GP urgently if…
● Your symptoms are not settling or are getting worse as you may have a more severe UTI which needs antibiotics, particularly if you are unwell and have a fever.
● There is blood in your urine.
● You are getting abdominal or loin pains.
● You are pregnant.
B12 injections: Are they worth a shot?
There have been a lot of Instagram posts about vitamin B12 injections with captions such as ‘health boost’ and ‘wonder woman’. Lots of people believe it will boost energy, help weight loss and improve mood. So should we all winter-proof ourselves with one of these shots?
Vitamin B12 performs vital functions in the body, keeping the brain, nervous system and blood cells healthy. The richest sources of vitamin B12 come from animal products, especially dairy, eggs, meat, salmon and cod, while vegans can get B12 through fortified plant milks, cereals, soy products, yeast extract and supplements.
Injections could help people who have trouble absorbing enough of the vitamin, such as those with pernicious anaemia, Crohn’s disease, on medications such as metformin or PPIs (proton-pump inhibitors used for indigestion) or who’ve had stomach surgery. But for healthy people, there is little evidence of any benefit.