Dr Sarah Jarvis
My Weekly’s favourite GP from TV and radio writes for you
Do you ever find it intensely painful to pass water, have to rush to the loo every five minutes and suffer low tummy pain?
At least half of women get a urine infection at least once, and for many it’s a much more frequent misery. How can you reduce your risk?
The most common kind of urine infection is cystitis, or inflammation of your bladder and urethra – the tube your urine passes down when you wee. You have “recurrent” urine infections if at least two urine samples in 6 months, or 3 in a year, prove a bacterial infection. A kidney infection is more serious and makes you feel far more unwell.
Conditions causing similar symptoms include overactive bladder. So your doctor won’t make the diagnosis without checking a urine sample for signs of infection. In mild cases drinking lots of fluid and taking paracetamol can relieve symptoms while your body fights the infection. But if symptoms are severe or don’t settle, you’ll need antibiotics.
These days we’re very aware that taking too many antibiotics increases your risk of a resistant infection, which is harder to treat, in the future. Ideally delay treatment for 2-3 days to allow a urine sample to be tested in the lab so your doctor can be sure you get the right antibiotic.
If you suffer repeated infections, your doctor may arrange tests to exclude possible causes such as kidney stones or problems emptying your bladder. If other measures don’t help, your doctor may recommend several months of low-dose antibiotics.
Traditionally, doctors have recommended cranberry juice
IF YOU HAVE URINE INFECTION SYMPTOMS WITH LOIN PAIN, FEVER AND FEELING SHIVERY, SEE YOUR DOCTOR URGENTLY TO EXCLUDE A KIDNEY INFECTION
or increasing fluid intake to reduce your chance of repeated bladder infections. Recent studies suggest neither makes much difference.
You may be at higher risk of bladder infection if you get dehydrated. So it is a good idea to drink enough nonalcoholic fluid to keep your urine pale strawcoloured. Alcohol tends to dehydrate you.
Tips to cut your risk of urine infections: ◆ If you use contraception, avoid using a diaphragm (cap) and/or spermicide gel. The front of a diaphragm presses on the back of the urethra and may make you more prone to cystitis. Condoms can also occasionally lead to cystitis. ◆ For years I’ve recommended emptying your bladder before and after you make love to reduce risk of urine infections. Sex is a common cause of cystitis, as the friction lets germs around the entrance to the urethra get up into the bladder. The theory is that you can flush out germs on their way up. Evidence is limited, but it won’t do any harm. ◆ Washing too much on the other hand can do more harm than good. Soap or vaginal douches can irritate the skin around the entrance of the urethra, making infection more likely. So wash just once a day, don’t scrub too hard and ideally use just water. ◆ After menopause oestrogen levels in your body drop. Along with hot flushes and night sweats, this leads to thinning of the lining of your vagina and vaginal dryness. Even if you don’t have discomfort, this can make you prone to urine infections. Topical oestrogen (as a cream, pessary or flexible vaginal ring) may help. ◆ If you get cystitis after making love, using a lubricant may help, or your doctor may prescribe a single low dose antibiotic tablet (usually trimethoprim 100mg) to take within 2 hours of having sex. Next week: Is your cough dangerous?
BLOOD IN THE URINE CAN BE DUE TO CYSTITIS, BUT OCCASIONALLY IT’S A SIGN OF MORE SERIOUS PROBLEMS. ALWAYS GET IT CHECKED