The first time you get cystitis it's easy to freak out. It can come on suddenly and be more painful than having teeth pulled, but keep calm and follow these vital steps.

What is cystitis?

Cystitis is an inflammation of the bladder that commonly occurs among women when bacteria that shouldn't be there get inside. Almost every female will have a urinary tract infection (UTI) at some point, thanks to their short urethras (the tube that carries urine from the bladder to the pee hole), which make it easy for bacteria to enter. This opening is also close to the anus, where the wrong kind of bacteria likes to hang out. Design-wise, men's long penises win top prize in keeping away infections.

Symptoms

• Stinging or pain when you pee
• Urge to visit the toilet more than usual, but unable to 'go'
• Cloudy and sour-smelling urine
• Sometimes blood in your wee
• Pain in the lower abdomen or back (your kidneys complaining)
• Tiredness and feeling unwell.

How do you get it?

• Sex makes it very easy for bacteria to get in where it shouldn't. Frequent or vigorous sex can cause what's known as 'honeymoon cystitis'.
• Nylon underwear or tights can create bacteria-breeding conditions - stick to cotton and loose clothing.
• Scented soap and hygiene sprays can aggravate your skin and destroy the bacteria that helps fight infections.
• If you don't or unable to empty your bladder completely, urine will grow stale and become infected. In particular, pregnancy puts pressure on the pelvic area, making it hard to fully empty your bladder fully. 

Ouch - I think I have it

• Go to the doctor. Dr Graham Archard, fellow of the Royal College of General Practitioners, says: "It's important to visit the doctor the first time you have an infection, or if it hasn't cleared up within two or three days.You may need antibiotics, but women should be aware that antibiotics can stop your contraceptive pill working, so talk this through with your GP."
• Drink plenty of water and avoid tea, coffee and alcohol.
• Try sachets of cystitis relief from the chemist or drink a pint of water with one heaped teaspoon of sodium bicarbonate (baking soda) to neutralise your wee.
• Even if you are not always able to 'go' or completely empty your bladder when you visit the toilet, do continue to go to the toilet when nature calls, regardless of whether you like service-station toilets or festival loos.
• Don't have sex. Apart from the fact it'll be painful, if you have a bacterial infection, sex could make it worse by exposing you to more bacteria.
• Take paracetamol or ibuprofen to ease the pain.

What will happen at the doctors?

You should see a doctor if you have blood in your urine, a high temperature or are in severe pain.

Most surgeries will see you without an appointment because it's important to treat cystitis quickly and you may be seen by a nurse.

The doctor will ask you for a urine sample so they can test for blood and protein, which can indicate an infection. "A further specimen may be needed to send to the laboratory for confirmation and identify the bacterium causing the infection," says Dr Archard.

You should receive antibiotics, which, thankfully, usually work immediately. However, if you have recurring cystitis (more than three attacks in a year) you need to see a doctor to discuss possible long-term treatment.

Don't ignore cystitis symptoms

Miriam was 24 when she ended up in hospital because she ignored cystitis symptoms. "I thought if I just kept drinking fluids it would go away," she recollects. "But I ended up in hospital for a week. The infection spread to my kidneys, which is quite dangerous. If I'd gone to the doctor's earlier I would have been fine." In other words, if you don't go to the doctor, you're taking a big risk.

What can I do to prevent it?

• Always pee after sex to flush out any bacteria. Tearing yourself away from a post-coital embrace isn't fun, but neither is a painful infection. Try to pee before you have sex too.
• Wipe from front to back.
• Take cranberry supplements. Cranberries contain a substance that lines the bladder and urethra and helps stop bacteria settling in. Juices are ok, but tend to have high sugar content that can increase bacterial production.
• Again, drink plenty of water and avoid tea, coffee and alcohol.

Common myths

Men can't get it - They can, but it's much less common and more serious. Sexually active, gay men are more at risk.

You get it if a man takes you from behind - Sex increases the risk of bacteria entering the urethra, but it doesn't matter what position you're in.

It's an STI - It's not. You can't pass the bacteria onto your partner through intercourse.

If you have it, you should drink gallons of cranberry juice - So once believed, but tests have shown it doesn't help once you have an infection. Cranberry juice can be used preventatively (see above), but avoid the vodka mixer.

By Gabriella Jozwiak

Updated: 18/02/2011