Cystitis and UTIs: symptoms, prevention, when to get help

Cystitis is one of those problems many women know too well: the burning, the urgency, the worry that it will come back. This guide sets out what the NHS and the CDC say about urinary tract infections, often shortened to UTIs: what they are, the usual symptoms, what raises the risk and the everyday habits that help with UTI prevention. It is general information, not medical advice, and it cannot speak to your own situation. For that, a doctor, a nurse or a pharmacist is the right place to ask.

What a urinary tract infection is

The urinary tract includes the bladder, the urethra and the kidneys. A UTI happens when bacteria, often from the skin or the rectum, enter the urethra, the tube that carries pee out of the body, and infect the urinary tract. The CDC describes UTIs as common infections.

Cystitis

An infection of the bladder, the most common type of UTI according to the CDC

Kidney infection

Less common than a bladder infection, but more serious

Women are more affected for a simple anatomical reason, both sources explain: the urethra is shorter, and closer to the rectum, so bacteria reach the bladder more easily. When infections keep coming back, doctors speak of recurrent UTIs.

The usual symptoms

The NHS and the CDC list similar signs of a bladder infection:

• Pain or a burning feeling when peeing.
• Needing to pee more often, including at night, or more urgently than usual.
• Feeling the need to pee even when the bladder is empty (CDC).
• Cloudy pee, or blood in the pee.
• Pain, pressure or cramping in the lower tummy.
• Feeling tired or weak (NHS).

Dark or strong smelling pee on its own may simply mean you have not been drinking enough water, the NHS notes.

Some signs point to a kidney infection, which the NHS says can be serious if it is not treated: a high temperature, feeling hot or cold and shivery, pain in the back just under the ribs or in the side, and nausea or vomiting (CDC).

Symptoms of a UTI can also look like those of a sexually transmitted infection, the CDC warns, so it is worth asking a health professional whether a test makes sense. The guide to STI testing explains what a test involves.

What raises the risk

The two sources name overlapping risk factors:

Factor	Named by
Recent sex	CDC
Spermicide used with contraception	NHS, CDC
Menopause	NHS, CDC
Pregnancy	NHS, CDC
Wiping from back to front	NHS
Not drinking enough fluids	NHS
A previous UTI	CDC
A weakened immune system, such as poorly controlled diabetes	NHS

Sex can raise the risk, but a UTI is not a sexually transmitted infection, the CDC is clear on that point. The CDC also explains that menopause and spermicides can change the bacteria that live in the vagina. Contraception methods covers the alternatives if spermicide is part of yours.

Everyday habits that help prevention

These are the habits the NHS and the CDC describe for preventing a UTI or stopping it from coming back:

Habits the NHS and the CDC describe

• Peeing as soon as possible after sex (NHS, CDC).
• Drinking plenty of fluids, particularly water, so that you pee regularly during the day (NHS, CDC).
• Wiping from front to back after going to the toilet (NHS).
• Keeping the genital area clean and dry, and washing the skin around the vagina with water before and after sex (NHS).
• Showers rather than baths (CDC).
• Cotton underwear rather than tight underwear (NHS).
• Not holding your pee in, and taking the time to empty the bladder fully (NHS).

And what they suggest leaving aside: scented soap around the genitals (NHS), douching, sprays or powders on the genital area (CDC), lots of alcohol or sugary food and drink (NHS), and condoms, diaphragms or caps with spermicidal lubricant. The NHS suggests a lubricant without spermicide or another type of contraception instead. Safer sex basics covers lubricants and condoms, and vaginal health basics covers gentle washing in more detail.

For infections that keep coming back, the NHS mentions some products sold as supplements, for which it says there is some evidence, and notes they can contain a lot of sugar. It advises speaking to a doctor before taking any of them during pregnancy, and a doctor or a pharmacist is the right person to discuss them with.

Treatment, in general terms

A doctor may test a urine sample, although this is not always needed, and usually treats a UTI with antibiotics, according to both sources. The NHS adds that a doctor may give advice for easing symptoms, or suggest waiting a short while in case symptoms clear up on their own. To ease symptoms, it suggests rest, enough fluids to pass pale urine regularly, and avoiding drinks that can irritate the bladder, such as fruit juice, coffee and alcohol.

Antibiotics are not always the answer. The CDC explains that bacteria can be found in urine without causing any illness, and that most people in that case need no treatment. It adds that antibiotics also affect the helpful germs of the microbiome, which is why they are best used only when needed. The NHS also describes long term UTIs, when symptoms do not go away and tests do not always show the infection; it suggests asking a doctor about a specialist.

When to get help

The CDC advises seeing a health professional for any symptom of a UTI, and for any symptom that is severe or worrying. The NHS asks for an urgent appointment in situations such as:

• A high temperature, a very low temperature, or shivering.
• Pain in the lower tummy, or in the back just under the ribs.
• Blood in the pee.
• Symptoms that get worse quickly, or do not improve after treatment has started.
• Infections that keep coming back.
• Pregnancy, diabetes or a weakened immune system.

Confusion, drowsiness or difficulty speaking call for the local emergency number straight away, the NHS says. A pharmacist can also give advice and point you to other medical help.

Questions about cystitis and UTIs

Is a UTI a sexually transmitted infection?

No. The CDC says sex can increase the risk of a UTI, but a UTI is not a sexually transmitted infection. Its symptoms can look similar, so a health professional can say whether a test makes sense.

Why do women get more UTIs?

Because the urethra is shorter and closer to the rectum, so bacteria reach the bladder more easily, the NHS and the CDC explain.

Does peeing after sex really help?

Both the NHS and the CDC list peeing after sex among the habits that help prevent UTIs.

Can a UTI clear up without antibiotics?

The NHS says a doctor may suggest waiting a short while before antibiotics, in case symptoms go away on their own. The CDC adds that bacteria found in urine without symptoms usually need no treatment. A doctor decides in each case.

Does spermicide cause cystitis?

The NHS and the CDC both list spermicide among the risk factors. The NHS suggests a lubricant without spermicide or another type of contraception.