You have to go, and you have to go now. Come to
think of it, it seems like you've had to go every 15
minutes since you woke up this morning. And each
time, it's been the same story. Not much comes out,
but it burns like crazy. What in the world is going
If you have pain or burning on urination, the
frequent urge to urinate, and/or blood in your urine,
chances are you have a bladder infection (also
called cystitis, urinary tract infection, or UTI).
These symptoms may also be accompanied by
lower abdominal pain, fever and chills, and an allover
Bladder infections are caused by a bacterial
invasion of the bladder and urinary tract. "The urine
in the bladder is normally sterile," explains Amanda
Clark, M.D., assistant professor of obstetrics and
gynecology at Oregon Health Sciences University
in Portland. "However, if it becomes contaminated
with bacteria, a bladder infection can develop."
If you're a woman who suffers from bladder
infections, you're not alone. "Women tend to suffer
more bladder infections than men because the
female urethra, the tube leading from the bladder to
the outside of the body, is only about one-and-ahalf
inches long--a short distance for bacteria to
travel," says Sadja Greenwood, M.D., a women's
health specialist and assistant clinical professor in
the Department of Obstetrics, Gynecology, and
Reproductive Sciences at the University of
California at San Francisco. (A man's urethra is
about eight inches long.) Frequently, the urinary
tract becomes contaminated with Escherichia coli,
bacteria that are normally present in the bowel and
anal area. In 10 to 15 percent of cases, bladder
infections are caused by another organism, such as
Women also suffer more bladder infections
because sexual intercourse can irritate the urethra
and contribute to the transport of bacteria from the
anal area and vagina into the bladder. "We don't
really know exactly why intercourse increases the
risk of bladder infections," says Clark. "We think it
might make the bladder tissues a little more
receptive to having an infection or it may cause
more bacteria to move up the urethra."
Women who use the diaphragm for birth control
have a greater risk of bladder infections, too, says
Clark. The diaphragm presses against the neck of
the bladder, which inhibits normal urination, she
says. As urine flow decreases, pressure within the
bladder increases, and the bladder is unable to
completely empty itself. The pooled urine then acts
as a growth medium for bacteria.
Pregnant women are also more likely to suffer
from bladder infections. The changing hormones of
pregnancy and the pressure exerted by the enlarged
uterus on the bladder and ureters (the two tubes that
carry urine from the kidneys to the bladder) put
pregnant women at greater risk.
Men can also suffer from this malady. In men,
bladder infections are almost always secondary to
an infection of the prostate gland (prostatitis),
according to Theodore Lehman, M.D., a urologist
in private practice and director of The Oregon
Impotence Center in Portland. "Primary infection of
the bladder in men just doesn't happen, because the
bladder is well protected," explains Lehman. "But
the prostate sits right in front of the bladder, and
bacteria can get into it--through sexual intercourse,
trauma like bouncing on a bicycle seat, or some
kind of blockage--and it stirs up an infection in the
prostate. Then the prostate infection can 'move
upstream,' if you will, and infect the bladder."
In men, prostate infection usually feels like
"you're sitting on a brick," says Lehman. When the
infection extends to the bladder, the symptoms of
irritation, urinary frequency, and pain and burning
on urination join the achy-bottom feeling.
Bladder infections can often be treated at home
with the self-care tips that follow. However, if your
symptoms persist for more than 24 hours, if they
don't respond to home remedies, or if you suspect
that your symptoms may be due to a sexually
transmitted disease or other infection, see your
Load up on fluids.
At the first sign of bladder infection, start drinking
water and don't stop. During the first 24 hours,
Greenwood recommends drinking at least one eightounce
glass of water every hour. People who suffer
from recurrent bladder infections usually don't
drink enough liquids. So even when you don't have
an active infection, you should make a habit of
drinking eight tall glasses of water every day.
According to Lehman, drinking lots of fluid not
only dilutes the urine, giving bacteria less to feed
on, it also has a "washout" effect on bacteria. "The
more bacteria you can wash out," says Lehman,
"the less there will be to reproduce."
Clark warns, however, that people who suffer
from urinary leakage (incontinence) probably
shouldn't increase their fluids. She says it can make
the bladder infection and the incontinence worse.
Have a cranberry cocktail.
If you've never developed a taste for the sweet
tanginess of cranberry juice, now's the time.
Cranberry juice (without added sugar) may make
urine more acidic and less hospitable for bacterial
growth, says Clark. Drinking cranberry juice is also
a way to increase your fluid intake.
Go, go, go.
Lehman advises both men and women to avoid
what he calls "L.A.-freeway-driver bladder."
"Many people don't urinate when they first get the
urge because it's inconvenient or there isn't the time
or place," he says. "Take a guy who gets off work,
has a couple of cups of coffee or a couple of beers,
and gets on the freeway in rush-hour traffic. He
feels the urge to urinate, but he can't get off the
freeway. When he finally gets home and urinates,
it's difficult and it burns. By the next day, he's
calling his doctor with a prostate infection."
Holding urine allows it to concentrate in the
bladder, creating a perfect medium for bacterial
growth. In older men, holding urine can cause
congestion, inflammation, and obstruction of the
prostate and can eventually lead to a prostate
infection or sometimes a bladder infection. Not
urinating at the first urge also causes the bladder to
distend and stretch. "Essentially, the bladder is a
hollow muscle," says Lehman. "If you repeatedly
stretch it, then it won't void completely and creates
a place for bacteria to grow."
Heat it up.
For lower abdominal pain, use a heating pad or hotwater
bottle or take a hot bath, advises Greenwood.
Lehman says that heat not only relieves the
symptoms, it also brings more blood with white
blood cells and other infection-fighting blood
products to the affected area. (Pregnant women,
however, should not sit in a hot bath or hot tub for
too long, since raising the body temperature above
100 degrees Fahrenheit for long periods may cause
birth defects or miscarriage.)
Take a bath.
If you have a lot of burning, a warm "sitz" bath
(sitting in three to four inches of water) can ease the
Take a break.
Rest in bed, especially if you have a fever. You'll
conserve energy and speed healing.
Wear cotton underwear.
Cotton underwear, cotton-lined panty hose, and
loose clothing will allow the genital area to breathe
and stay dry. For men, boxer-type shorts rather than
jockey-style shorts are better if prostate and bladder
infections are a problem.
Alcohol is a urinary tract irritant for both men and
women and should be avoided during a bladder
What about spicy foods, tea, and coffee? Clark
says, "They really shouldn't hurt a bladder infection.
" However, the caffeine in coffee, tea, and colas
does stimulate the kidneys to produce more urine
and makes the bladder fill up faster during a time
when urination is painful. If caffeine seems to make
your symptoms worse, avoid it until the infection
Take a pain reliever.
Bladder infections can be painful. Acetaminophen,
ibuprofen, or aspirin, especially if taken at bedtime,
can ease the pain.
Wash up, lovers.
Both partners should wash up before intercourse.
Urinate after lovemaking.
If you suffer from recurrent bladder infections,
urinate immediately before and after intercourse,
advises Clark. This can help flush out bacteria that
may have entered the urinary tract.
Switch birth-control methods.
Women who use a diaphragm and suffer from
recurrent infections should try switching to
condoms or a cervical cap. "If you have recurrent
bladder infections, see your doctor to have your
diaphragm's fit rechecked," says Clark. "You may
do better with a smaller diaphragm or a cervical cap"
Keep a bladder-infection diary.
If you suffer from recurrent bladder infections,
keep a diary to discover what patterns precede an
attack. Some people find that their infections are
related to stress, menstruation, lovemaking, or other
factors. Once you discover what precipitates your
infections, you can make changes to alter those
Wipe from front to back.
Most women wipe from back to front, which moves
bacteria from the rectum dangerously close to the