What is cystitis
When the inner lining of your bladder becomes inflamed for various reasons, you have cystitis. It can occur on its own, or it can be the most unpleasant symptom of other urinary tract infections (UTIs) or sexually transmitted diseases. It is mostly caused by bacteria infections. But hygiene products, certain medications, and even your perfectly healthy partner can cause this itchy, burning problem.
Perhaps you have heard advice like “don’t sit in the cold”, “don’t wear minis” from your mother or grandmother, which you did not pay attention to, but they are right. Hypothermia can really cause bladder inflammation. But step by step.
Depending on the factors that cause inflammation, there are different types of cystitis.
Causes of cystitis
The female urethra – the channel for urine to leave the bladder, is short. Plus, it is located quite close to the anus. Therefore, it is easier for bacteria that cause inflammation to get to it. These anatomical features are the main reason why women suffer from cystitis more often than men – a ratio of 4 to 1.
It is not the real cause of cystitis. So, types and causes:
Acute bacterial cystitis
Bacteria get inside the urinary tract and begin to multiply. The most common is Escherichia coli – more than 95%, but streptococcus, staphylococcus, trichomonas, chlamydia – and sexually transmitted infections (STIs) in general – also cause cystitis.
In addition, these risk factors contribute to the development of urinary tract infection:
- Postcoital cystitis. It appears 24-48 hours after sex. It doesn’t matter whether it was solo sex or sex with a partner. Bacteria causing inflammation enter the urinary tract for various reasons. Among them are hormonal imbalance, microtrauma of the urethra due to vaginal dryness during intercourse or painful intercourse, physiological features of the female genitalia, like urethra close to the vagina, etc. Basically, sex “helps” bacteria to get into the urethra and bladder, causing inflammation. Additionally, you can’t immediately switch to vaginal sex after anal one. Anal sex with no condom increases the risk of urinary tract infection (UTI) for your partner.
- Improper hygiene. You wash yourself moving from the anus to the vagina, so intestinal bacteria get into the urethra. Or you don’t care enough about hygiene – you don’t wash after every defecation.
“You need to wash your butt with soap and water after pooping” – this phrase parents should say to their child from 1.5 years old
- Uncomfortable underwear. Thongs were invented by the enemies of women: firstly, it is literally a bridge for intestinal bacteria from the anus to the urethra. Secondly, this underwear can injure your intimate area.
- Hypothermia. Yes, do not sit on the cold. The mechanism is simple: local immunity decreases, bacteria multiply, cystitis begins.
- Low immunity. The same story as in the paragraph above.
- Diabetes mellitus. Although the connection between this pathology and cystitis is not yet fully understood, epidemiological studies show an increase in the relative risk of UTI in diabetics by 1.2-2.2 times compared to non-diabetics.
- Hormonal disorders, including those induced by age-related changes, such as menopause, pregnancy and lactation. Moreover, the actual thickness of the bladder lining is also hormone-dependent. With a large imbalance of hormones, its protective function is reduced, which means that bacteria can more easily multiply and cause inflammation.
- Imbalance of microflora. Lactobacillus, which normally maintain the right pH of your microflora and inhibit bacterial growth. In a healthy vagina, it is 4.0-4.5. If the acidity rises above 5, the risk of getting cystitis (and vaginitis too) increases.
- Imbalance of intestinal microflora and the resulting irritable bowel syndrome, constipation or diarrhea. Such conditions contribute to the fact that Enterobacter can penetrate directly into the bladder from the intestines due to the violation of the barrier.
- Certain contraception, in particular spermicides and diaphragms that change the microflora of the urethra.
- Obesity, sugar abuse. In general, an unhealthy diet adversely affects many factors: hormonal levels, microflora balance, and even pH.
- Urinary incontinence. Constant humidity in the intimate area harms the microflora and increases the chances of infection and cystitis.
Chronic bacterial and recurrent cystitis
When cystitis returns periodically, at least 6 times a year, we talk about recurrent cystitis. If you constantly experience its symptoms with varying intensity, it’s chronic cystitis. Recurrence of cystitis occurs in 20-30% of women after experiencing acute cystitis. Actually, it is the main risk factor for the development of cystitis in the future.
Other risk factors include: postmenopausal age, new sexual partner, spermicide use, and family history. If your mother or grandmother had chronic cystitis, you are also at risk.
Non-bacterial cystitis
The inner lining of the bladder can become inflamed for reasons other than bacteria. Risk factors:
- Fungal infections
- Parasites
- Endocrine changes
- Radiation exposure to the lower abdomen
- Damage to blood vessels
- Allergy to local products – hygiene products, lubricant or latex
- Permanent presence of a physical irritant in the urethra, such as a catheter
Interstitial cystitis (IC)
Also called painful bladder syndrome. The causes of this type have not yet been fully established. But this chronic cystitis can really ruin your life, forcing you to go to the bathroom 40-60 times a day and keep you awake at night. 90% of IC diagnoses are made to women, mostly over the age of 40. There is no cure for it yet, only improvement of symptoms. In the United States, there is even an Interstitial Cystitis Association dedicated to developing a cure for this disorder.
Researchers have identified a number of different factors that can contribute to the development of the disease.
- Bladder trauma (for example, after surgery on the pelvic organs)
- Stretching of the bladder
- Dysfunction of the pelvic floor muscles
- Autoimmune disorders
- Acute bacterial cystitis can also cause IC
- Primary neurogenic inflammation (hypersensitivity or inflammation of the pelvic nerves)
- Spinal cord injury
Symptoms
All types of cystitis have similar symptoms.
- Blood in the urine
- Painful urination
- Cloudy urine with an unpleasant odor
- Frequent urge to urinate, even if there are just a couple of drops
- Pain in the lower back or abdomen
When it comes to interstitial cystitis, in severe cases, the urge to urinate can reach up to 60 times a day. A woman is unable to ignore them, the urges may be accompanied by pain, pressure and cramps. Plus pain in the lower abdomen, urethral or vaginal area, as well as painful sex.
Complications
A timely visit to a doctor is the best way to avoid complications. I remind you once again that even if you have had cystitis before, you should not prescribe medicines yourself, especially antibiotics. You can not only bring yourself to a chronic form, but also develop bacterial resistance to antibacterial drugs. It will become much harder to be treated.
- The most dangerous complication is kidney inflammation – pyelonephritis. The incidence of pyelonephritis is highest among young women, followed by infants and the elderly;
- Transition of acute cystitis into chronic and recurrent form, as well as into IC;
- Urolithiasis;
- Salpingitis – inflammation of the fallopian tubes due to further spread of the infection. This can lead to infertility, and in pregnant women – to miscarriage;
- Vaginismus. In the case of postcoital cystitis, a woman begins to refuse sex – a simple mode of self-preservation. However, it happens that the partner insists, the woman agrees, but there is no pleasure here. Subsequently, the vagina spasms to avoid intimacy with penetration, so vaginismus begins;
- Depression. Chronic cystitis really significantly worsens the quality of life. What kind of mood can we talk about if you constantly run to the toilet, feel pain and discomfort, and do not even want to think about sex?
Treatment and prevention
Cystitis not only needs to be treated quickly, you can take care of yourself in advance and never have to deal with it again. These simple tips will help you.
Prevention
It is crucial to drink 2-3 liters of clean water daily. Tea, coffee, juice, and of course carbonated, or sugary drinks are not included in this volume. However, there is one healing cranberry drink that I recommend to all women, especially those with chronic cystitis.
It is very easy to prepare:
Pour a handful of fresh, dried or frozen cranberries in the boiling water over, infuse and drink it instead of tea.
Cranberries are a recognized natural antibacterial agent that prevents infections from attaching to the bladder mucosa. But it should be a natural berries without sugar and other sweeteners.
Other prevention methods include:
- Drink a glass of water before and after sex, and urinate immediately afterwards;
- Wash the anus in th´direction from the vulva to the anus after you have defecated;
- Wash your external genitals with warm water after sex;
- Wear underwear made of natural materials;
- Avoid douching and harsh detergents, instead use age-specific products for the intimate area;
- Quit smoking and alcohol abuse, these bad habits are triggers of cystitis;
- Do Kegel exercises to train your pelvic floor muscles;
- If you are prone to cystitis, take a shower instead of a bath;
- Try to avoid stress, take care of your psychological state, you will find tips in this article;
- There are certain foods that irritate the bladder, but most of them are just junk or sugary foods. You can simply keep track of what exactly worsens your cystitis symptoms – it can be citrus fruits, spicy food, coffee or tomatoes – and exclude them from your diet.
Treatment
All medications must be prescribed by a doctor! If you have mild symptoms, you can get by with painkillers and plenty of water, but this should be determined by a specialist. You may also be prescribed antibiotics after an analysis to determine the type of bacteria and exclude concomitant infections, including STDs. You should feel better in a few days, but be sure to take the full course.
When it comes to IC, you and your doctor will need to choose a very individual treatment. This may include physiotherapy, bladder stretching, medications or even surgery. But it happens that IC goes away on its own after lifestyle correction, so it is a necessary component of therapy.
Stay healthy!
More about your health and body is in the courses: A girl becomes a woman, All about you. What it’s like to be a Woman, All about you 35+.
I’m eager to file all of these courses in English, just send me a request to dr.silinaeducation@gmail.com
You can always choose your doctor at the Lior Medical Center.
