Ask Dr Miriam

QI’m a woman in my early 60s and I keep getting cystitis. When I see my doctor he gives me the same antibiotics but the cystitis returns. I’m going round in circles. Have you got any suggestions?

AChronic cystitis is common among postmenopausal women because the lack of oestrogen weakens the health of the bladder lining, and also the urethra which carries urine to the outside.

Chronic cystitis has several triggers including not drinking enough liquid to keep the urine flowing, and having the bouts of cystitis treated for too short a period.

Your kind of cystitis has been the subject of many studies and the latest advice for treating it is first a trial of a five-day course of an antibiotic called nitrofurantoin. Another effective treatment is with an antibiotic called trimethoprim for three to seven days. Then for an infection with resistant bacteria there’s another antibiotic called fosfomycin, and a single high dose of this drug is likely to be most effective.

You could try speaking to your doctor about these treatments.