Cystitis and thrush affect more women than
men due to the unique characteristics of
the female urinary tract and genitalia. Women
have a short urethra; external, open genitalia
and warm, humid conditions within the vagina
and uterus : ideal conditions for these infections
to flourish!. Some medical conditions like
diabetes can increase your risk from urinary
- Pricking or stinging pain around the opening of the urethra
- Burning sensation during urination.
- Frequent urge to go to the toilet but there may be very little
urine to pass.
- Urine may be dark and cloudy
- Urine may have an unpleasant smell
- Pain in the lower back is common
- The sufferer may have a raised temperature.
treatments contain alkali to neutralise
the acidity in the urine, which eases
the stinging, burning sensation.
The active ingredient in OTC medicines is sodium citrate, potassium
citrate, sodium carbonate or sodium bicarbonate.
All form an alkaline solution when dissolved in water to make a drink.
As they contain large amounts of sodium, these products should not
be taken by people with high blood pressure, or impaired kidney function.
In severe cases, when the infection
is more developed, antibiotic treatment
may be required; this is available only
form a GP.
For OTC products, read Cystitis
Sufferers should drink plenty of
fluid throughout the day. However,
it is important that the fluid is not
provided by acidic drinks such as strong
tea, coffee and citrus fruit drinks.
The extra fluid dilutes the urine,
increasing the volume produced and
the increased output can then help
to flush-out the bacteria. Cranberry
juice may be helpful.
After a bowel movement, care should be taken to wipe away from
the urethra to prevent infection. Holding a hot water bottle against
the abdomen can help to relieve the pain.
Alternative remedies containing herbal extracts are also available.
The herbs used include bearberry, buchu leaf, couchgrass, equisetum,
shepherds purse and uva ursi. These have a tradition of use
for symptomatic relief of bladder and urinary tract discomfort.
Some of the herbs have a slight diuretic effect, which helps to
flush-out the infection.
Cystitis is an acute inflammation
of the bladder and urethra. It is usually
caused by bacterial infection. Although
cystitis can affect men, it is usually
much more common among women because
- Warm, humid conditions in the vagina and uterus, which provide
an ideal environment for bacterial growth and multiplication.
- Open, external genitalia, which make infection more likely that
it is in men
- Short urethra, which enables rapid infection of the bladder.
Infection by the bacteria found in or around the anus is the most
common cause of cystitis. The bacteria can be transferred to the
urethra during sexual intercourse, by wiping the bottom from the
anus towards the urethra, or during menstruation.
The pain experienced by people with cystitis is due partly to inflammation
and partly to the irritant effects of the urine, which the bacteria
make more acidic than normal.
NB: Medical advice is needed for:
- Men or children with symptoms of cystitis
- Women with cystitis who are also vomiting, have an unusual vaginal
discharge, have blood in the urine, or are pregnant
- Women with recurrent symptoms, plus increased thirst, weight
loss and thrush
(also known as candida infection)
(also known as candida infection)
- Thick, creamy discharge, or a yellow,
- Discharge is usually odourless
- Vulva and vaginal walls can become red and inflammed, often with
visible white patches
- Intense itching
- Pain in the vagina when having sexual intercourse
- Painful stinging of the vulva area when passing urine
NB: In those who suffer frequently, the symptom pattern may change
and the discharge may be minimal.
OTC treatments include:
- Fluconazole, a single-dose
treatment in capsule form. A single
capsule should be effective. It should
not be used:
- During pregnancy
- By sexually active women of child-bearing
age without adequate contraception
- By women under 16 years old or over
60 years old
- Clotrimazole and Miconazole
for vulval and vaginal treatment.
These are available as creams and
vaginal pessaries that can be used
together. A single overnight treatment
with intravaginal cream or pessary
should be effective.
A lower strength cream can be used
externally to relieve itching and
any inflammation caused by discharge.
NB: sufferers should feel an improvement
within a day or two. If symptoms persist
after 7 days you should see your GP.
For OTC products, read Vaginal
Women with thrush should wear loose,
comfortable clothing and avoid wearing
tights or tight trousers. This is to
avoid creating the warm, moist conditions
that helps thrush develop.
Women should also avoid using bath salts, vaginal deodorants and
bubble baths that can encourage the development of thrush by removing
Some women find that live yoghurt applied to the vagina can help.
This works by introducing harmless bacteria that compete with the
As thrush also lives in the bowel, women should wipe from front
to back after a bowel movement.
is one of the most common forms of vaginal
infection. Roughly 50% of women aged
between 16 and 60 years will suffer a
thrush infection at some time, and nearly
one third will have at least one episode
NB: When thrush causes chronic symptoms it is important that a womans
sexual partner is also treated. Men can be symptomless carriers,
who infect their partner every time they have sexual intercourse.
Men should be referred to a GP as thrush treatment in men is not
an OTC indication.
Thrush is caused by the yeast candida albicans. It is a normal
inhabitant of the digestive and reproductive tracts and is usually
suppressed by bacteria. Thrush tends to proliferate when bacteria
are reduced in number, for example, when antibiotics are being taken
for another condition.
NB: Topical thrush treatments can reduce the effectiveness of contraceptives
made from rubber.
Most OTC contraceptives use the
barrier method to prevent pregnancy.
These are male condoms, female condoms
The effectiveness of barrier methods
can be increased by using spermicidal
creams or pessaries such as nonoxynol.
For OTC products, read Contraception/Vaginal
Barrier methods of contraception help
prevent pregnancy and also help to
avoid the transmission of sexually
transmitted diseases, such as HIV infection,
Cramping, colicky pains in the
lower abdomen, back and possibly
legs, starting within a day or
two of the start of bleeding and
going on until a day or two after.
- There may be other symptoms, including nausea, vomiting, stomach discomfort,
constipation, headache, backache, fatigue, faintness and dizziness.
All the main OTC pain relievers
-aspirin, ibuprofen and paracetamol
- can be used.
- Aspirin and ibuprofen directly counteract the prostaglandins that cause the
contractions of the uterus and hence the pain, and should in theory be more effective
than paracetamol. However, paracetamol is found to be just as or more effective
by many women. Aspirin should not be used by girls under the age of 16.
- Some women find that taking a product containing codeine as well as ibuprofen
or paracetamol is more effective than either on its own.
For OTC products, read Period
- Taking moderate exercise
may help period pain, as it raises
the levels of endorphins, the
body's own natural 'painkillers'.
- Simple measures, such as a hot water bottle held across the abdomen (but not
in direct contact with the skin), can also help with the pain.
PMS does not usually affect women
under 30. It may worsen with age,
and sometimes becomes continuous
during the menopause, stopping
finally when the menopause is over
- Symptoms start a week or more
before menstruation and subside
once a period has started
- Symptoms fall into three groups:
physical, psychological and neurological
(affecting the body’s nervous
- Physical symptoms include: water
retention causing bloating, swelling
of the abdomen and ankles, a feeling
of heaviness, breast tenderness,
constipation, nausea and vomiting
- Psychological symptoms include:
anxiety, irritability, nervousness,
agitation, anger, insomnia, difficulty
in concentrating, lack of energy,
depression, tiredness, and increased
or decreased appetite
- Neurological symptoms include:
headache, dizziness, fainting,
tingling in the hands and/or feet,
There is little of proven value
available for self-treatment of
- Vitamin B6 is thought to be of
some help for psychological symptoms,
but very high doses for long periods
should not be taken as it can cause
- Vitamin A, magnesium and calcium
may be helpful, but more scientific
evidence is needed
- Evening primrose oil has been
recommended for PMS, especially
breast tenderness, but recent research
has found it not to be very effective
- A herbal preparation made from
Agnus castus (Chaste tree) fruit,
has been traditionally used to
treat PMS, and there is some evidence
that it is effective, although
more proof is needed
Cutting down on salt and fluid
intake for a few days before a
period can help reduce ‘heaviness’ and
- Relaxation and stress relieving
activities, e.g. yoga
- Physical activities – sports,
gym, etc – stimulate production
of endorphins by the body, which
relieve pain and lift mood
- Changes to diet and lifestyle,
including reducing alcohol and
caffeine intake and cutting down
- ‘Complementary’ therapies,
such as hypnosis and acupuncture,
may work for some sufferers
- Diuretics for water retention
- Hormones to correct imbalances
- Antidepressants for psychological
and some physical symptoms
dryness is one of the effects of
the menopause. As the ovaries reach
the end of their functioning life
production of the hormone oestrogen
decreases. Among the many changes
in women’s bodies caused
by lack of oestrogen are thinning
of vaginal skin and drying up of
the secretions that lubricate the
vagina. This can lead to soreness
and irritation and can make sexual
intercourse uncomfortable or even
painful. As vaginal secretions
decrease they also lose the acidity
that helps protect the vagina against
bacterial infections (although
this change actually also reduces
the risk of vaginal thrush).
- K-Y Jelly (Johnson & Johnson
MSD) is a short-acting lubricant
that can be used just before intercourse
- Replens MD (Anglian Pharma S&M)
is a specially formulated vaginal
lubricant. It attaches itself to
the vaginal wall, and absorbs water
and moisturises it. It also makes
the vaginal wall more acidic, providing
protection against infection. An
application works for up to 72
hours, and it is intended to be
used three times a week continuously.
Hormone replacement therapy (HRT)
counteracts the symptoms of
the menopause, including vaginal
Emergency contraception is available
without prescription at pharmacies
in the form of Levonelle One-Step
(Schering Health Care). It consists
of a single tablet containing levonorgestrel,
a female hormone that is also used
in a smaller dose in the ‘mini-pill’ contraceptive.
Over many years of use levonorgestrel
has been found to be safe and virtually
- To be effective Levonelle must
be taken as soon as possible, and
no more than 72 hours after unprotected
intercourse. If taken within 24
hrs, it is 95% successful; between
25-48 hrs, 85%; and between 49-72
hrs, 58%. If your period is more
than five days late after taking
Levonelle you should have a pregnancy
- Levonelle works in one of three
ways, depending on the stage in
the menstrual cycle that it is
taken. It may prevent ovulation,
i.e. stop an egg being released
from the ovary, it may prevent
sperm from fertilising an egg that
has already been released, or it
may stop a fertilised egg from
attaching itself to the lining
of the womb.
- Levonelle will not abort an established
pregnancy. If you are already pregnant
from a previous intercourse when
you take it, the pregnancy will
- Levonelle is available for women
aged 16 and over. Under 16s would
need either to see their GP or
visit a family planning or NHS
Walk-in Centre for a supply. If
all of these are closed it may
be possible to get Levonelle from
a hospital A&E department.
In some areas of the country there
are schemes that allow girls under
16 to be supplied with Levonelle
- When you go to a pharmacy for
Levonelle you will be asked some
questions by the pharmacist, or
you may be asked to fill in a short
questionnaire, to make sure that
it is safe for you to take it and
that you are not already pregnant.
The pharmacist should talk to you
in a part of the pharmacy where
there is some privacy.
- The most common side-effect of
Levonelle is nausea (feeling sick),
which about one in five women who
take it experience. Vomiting is
very rare, but if you are sick
within three hours of taking the
tablet you should take another
one immediately. Other possible
side-effects are bleeding outside
of normal menstruation, low abdominal
pain, headache, dizziness and breast
tenderness, but they are usually
mild and do not last long.
- Some medicines should not be
taken with Levonelle. The pharmacist
will ask you about any medicines
you are taking, and will consult
your GP or ask you to go to see
him or her if you are taking something
that could cause a problem.
- You should only not take Levonelle
if you have had a reaction to levonorgestrel
in the past, if you suffer from
a bowel disease such as Crohn’s
disease that can prevent proper
absorption of medicines, or if
you have liver disease.
- Levonelle can be used repeatedly,
but should only be used in ‘emergency’ situations
and not as a regular contraceptive.
- If for any reason you cannot
use Levonelle, emergency contraception
can be provided by the fitting
of an interuterine device (IUD)
within five days of unprotected
intercourse. This is nearly 100%
effective and also provides long