Many women know the symptoms of cystitis (a urinary tract infection, or UTI) only too well: frequent trips to the bathroom and a stinging and burning sensation when passing urine. Although these symptoms are often very unpleasant, there are effective treatments. Uncomplicated cystitis usually clears up without any problems.
Unfortunately, there is no sure-fire way to reliably prevent cystitis. And a lot of the common strategies women may use in day-to-day life have not yet been scientifically tested.
This article is about acute cystitis – a bladder infection often also referred to as a urinary tract infection (UTI). It is not about chronic bladder problems such as interstitial cystitis. It also doesn't include information about treating cystitis in pregnant women.
People who have cystitis have to pass urine more often, and this can be associated with a stinging and burning pain. So not only do they have to go to the bathroom more frequently, but doing so can also be very unpleasant.
Many women find that the pain is worse when their bladder is almost or completely empty. The urge to pass urine often comes very suddenly and they quickly need to get to the bathroom – but in most cases only a small amount of urine comes out. Some women have difficulty holding back urine, which can be very distressing. The urine may be cloudy and have an unusual color and smell. It may have visible blood in it too.
The pain sometimes radiates into the entire abdomen or up into the back. Severe cystitis can make you feel generally unwell, sluggish and irritable as well as disrupting your sleep.
Sexual intercourse increases the risk of getting cystitis because that increases the likelihood of bacteria entering the urethra. Sperm-killing agents (spermicides) and contraceptive diaphragms can also increase the risk somewhat.
Pregnant women are more likely to get cystitis. Other risk groups include people who have a urinary catheter or anatomical changes in their urinary tract, as well as people who have diabetes, multiple sclerosis or a urological disease.
Women who have already had cystitis are more likely to get it again. It is also more common after menopause.
Woman are much more likely to get cystitis than men because their urethra is shorter, which makes it easier for bacteria to reach the bladder. More than half of all women have cystitis at least once in their lifetime. Half of all women who have had acute cystitis develop it again within one year.
In uncomplicated cystitis, symptoms are limited to the lower urinary tract (the bladder and the urethra) and there are no risk factors that increase the likelihood of a severe infection or long-term damage. Uncomplicated cystitis is easy to treat and usually goes away without any problems.
It is considered to be a more complicated case of cystitis if, for instance, treatment with the usual antibiotics doesn't help enough. Or if there is an increased risk of the infection spreading to the kidneys. If bacteria travel up the ureters and into the kidneys, they can cause an inflammation of the renal pelvis called pyelonephritis.
The risk groups for complicated cystitis include people with a weakened immune system or a kidney condition. Changes or anatomical abnormalities in the urinary tract also increase the likelihood of complications.
The main signs that an inflammation has spread to the kidneys are:
- Pain in the area of the kidneys (flank pain)
- Sometimes nausea and vomiting too
Pyelonephritis can be dangerous and should be treated quickly to avoid further health problems. But it is very rare.
Doctors can assess whether or not it is uncomplicated cystitis based on your symptoms and medical history. A urine sample can also be tested for bacteria, white and red blood cells, proteins and nitrite (a salt that can serve as an indirect indicator of bacteria). But this test is usually not needed if the symptoms are clear.
Ultrasound can be used to examine your kidneys and bladder. Ultrasounds are generally only needed in complicated cases or if your doctor believes you may have developed pyelonephritis. Cystoscopies or x-rays are also done in very rare cases, such as when a woman has severe cystitis that keeps coming back. A cystoscopy is a procedure that involves inserting a tube with a small camera at the end of it (an endoscope) into the urethra and guiding it through to the bladder. The camera produces images showing any changes in the wall of the bladder.
Sometimes cystitis comes "out of the blue" and it is not clear what has caused it. But many women notice over time that certain factors in their everyday lives increase their odds of getting cystitis. If avoiding those factors isn't enough to make a difference, and they still have recurrent cystitis, medication is an option.
Some medicines can prevent cystitis from recurring – but you need to take them regularly and they can have side effects.
For many women, cystitis is a one-time unpleasant problem. In others, it may keep coming back. Antibiotics have been proven to effectively relieve acute cystitis, and they usually work quickly. There are also some home remedies that may help, like drinking plenty of fluids or applying heat. Herbal products are available too.
American College of Obstetricians and Gynecologists (ACOG). Treatment of urinary tract infections in nonpregnant women. ACOG Practice Bulletin No 91. Obstet Gynecol 2008; 111(3): 785-794.
Albert X, Huertas I, Pereiro II, Sanfélix J, Gosalbes V, Perrotta C. Antibiotics for preventing recurrent urinary tract infection in non-pregnant women. Cochrane Database Syst Rev 2004; (3): CD001209.
Barbosa-Cesnik C, Brown MB, Buxton M, Zhang L, DeBusscher J, Foxman B. Cranberry juice fails to prevent recurrent urinary tract infection: results from a randomized placebo-controlled trial. Clin Infect Dis 2011; 52(1): 23-30.
Falagas ME, Kotsantis IK, Vouloumanou EK, Rafailidis PI. Antibiotics versus placebo in the treatment of women with uncomplicated cystitis: A meta-analysis of randomized controlled trials. J Infect 2009; 58(2): 91-102.
Jepson RG, Mihaljevic L, Craig J. Cranberries for treating urinary tract infections. Cochrane Database Syst Rev 2010; (9): CD001322.
Jepson RG, Williams G, Craig JC. Cranberries for preventing urinary tract infections. Cochrane Database Syst Rev 2012; (10): CD001321.
Malterud K, Baerheim A. Peeing barbed wire. Symptom experiences in women with lower urinary tract infection. Scand J Prim Health Care 1999; 17(1): 49-53.
Milo G, Katchman EA, Paul M, Christiaens T, Baerheim A, Leibovici L. Duration of antibacterial treatment for uncomplicated urinary tract infection in women. Cochrane Database Syst Rev 2005; (2): CD004682.
Perrotta C, Aznar M, Mejia R, Albert X, Ng CW. Oestrogens for preventing recurrent urinary tract infection in postmenopausal women. Cochrane Database Syst Rev 2008; (2): CD005131.
Sen A. Recurrent cystitis in non-pregnant women. BMJ Clin Evid 2008.
Zalmanovici Trestioreanu A, Green H, Paul M, Yaphe J, Leibovici L. Antimicrobial agents for treating uncomplicated urinary tract infection in women. Cochrane Database Syst Rev 2010; (10): CD007182.
IQWiG health information is written with the aim of helping
people understand the advantages and disadvantages of the main treatment options and health
Because IQWiG is a German institute, some of the information provided here is specific to the German health care system. The suitability of any of the described options in an individual case can be determined by talking to a doctor. We do not offer individual consultations.
Our information is based on the results of good-quality studies. It is written by a team of health care professionals, scientists and editors, and reviewed by external experts. You can find a detailed description of how our health information is produced and updated in our methods.