What Is Cystitis? Causes, Symptoms and Treatment for Women UK
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Cystitis is inflammation of the bladder, and in most women it is caused by a bacterial urinary tract infection (UTI). It affects millions of women in the UK every year. The usual signs are a burning feeling when you wee, a constant urge to go, and cloudy urine. Mild cases can settle on their own; bacterial cystitis usually needs a short course of prescription antibiotics — most often nitrofurantoin (NICE first-line) or trimethoprim. Both are available through a GPhC-registered online consultation at Access Doctor.
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Treat cystitis online →What Is Cystitis?
Cystitis is inflammation of the bladder. Most of the time it is caused by bacteria in the bladder — a urinary tract infection (UTI) — and it is one of the most common problems women of any age bring to a GP or pharmacist in the UK. It is painful and disruptive, and it is worth treating properly: a bladder infection left alone can travel up to the kidneys and become something more serious.
Not every case starts with bacteria, though. Bladder inflammation can also follow chemotherapy (cyclophosphamide and ifosfamide are the classic culprits), radiotherapy to the pelvic area, or contact with perfumed soaps, bubble bath, spermicidal jellies and lubricants. Working out which type you have matters, because only the bacterial kind responds to antibiotics.
For the full picture on treatment, see How to Treat Cystitis: Home Remedies, Antibiotics and Prevention, and for the medicines themselves, Cystitis Medicines UK: Nitrofurantoin and Trimethoprim Explained.
Is Cystitis a UTI?
People use the two words interchangeably, and for good reason — but they are not quite the same thing. Cystitis means inflammation of the bladder, and that inflammation is not always bacterial. A UTI means bacteria have infected part of the urinary tract. In otherwise healthy women, almost all cystitis turns out to be a bacterial UTI, so the distinction rarely changes what happens next.
Can Men Get Cystitis?
Men can get cystitis, but it is far less common. When a man has UTI symptoms, it can point to something else going on — an enlarged prostate, a kidney stone, or a narrowed urethra — so it needs a face-to-face GP assessment rather than an online consultation.
Men with UTI symptoms should always see a GP in person. Access Doctor’s online cystitis service is for adult women with uncomplicated acute cystitis only.
Symptoms of Cystitis
Symptoms vary from woman to woman, but most people get some combination of the following:
- Needing to wee more often than usual
- Still feeling the urge to go straight after emptying your bladder
- A burning or stinging sensation when you wee (dysuria)
- Urine that smells strong or looks cloudy
- Blood in your urine (haematuria)
- Cramping low down in your abdomen or back
- A slightly raised temperature, if the cystitis is infective
Seek urgent care if you also have nausea and vomiting, stabbing pain in your back, side or abdomen, or a fever with chills. These can mean the infection has reached your kidneys (pyelonephritis), which needs urgent in-person treatment.
What Causes Cystitis?
Bacterial UTI
The most common cause — usually E. coli travelling from the bowel to the urethra. Sex, wiping habits and some contraceptives raise the risk.
Certain medicines
Chemotherapy drugs such as cyclophosphamide and ifosfamide commonly inflame the bladder. Other drugs can irritate it as they are excreted.
Radiotherapy
Radiation to the pelvis or lower abdomen irritates the bladder lining — known as radiation cystitis.
Hygiene products
Perfumed sprays, scented gels, lubricants, spermicidal jellies and strong bubble bath can all irritate the urethra in women who are sensitive to them.
Occasionally cystitis is a complication of something else. Kidney stones, long-term spinal injury, diabetes, prostate enlargement and HIV can all play a part.
Can Stress Cause Cystitis?
There is no evidence that stress on its own causes cystitis. Long-term stress does take a toll on the immune system, though, and a weaker immune response makes you more susceptible to infections generally — bacterial UTIs included. Some women also find that stressful periods seem to trigger symptoms or make them worse, even if the exact reason is not clear.
How to Diagnose Cystitis
If you think you have cystitis, speak to your GP or a pharmacist. Diagnosis usually involves:
- A urine sample — the first-line test. It checks for bacteria, blood or pus. If it is positive, a culture may be sent to identify the exact organism.
- Cystoscopy — only if no bacteria are found but symptoms continue, or if the cystitis keeps returning. A thin camera examines the bladder lining, and a biopsy may be taken at the same time.
- Imaging — rarely needed. An ultrasound or X-ray can pick up unusual causes such as tumours or structural problems.
When Should You See a Doctor for Cystitis? Red Flag Symptoms
Get same-day medical advice if any of these apply:
- A temperature above 38°C
- Back or loin pain alongside urinary symptoms — a possible kidney infection (pyelonephritis)
- Shaking, rigors, or feeling extremely unwell
- Nausea and vomiting alongside UTI symptoms
- Blood in your urine that is new or getting worse
- No improvement within 48–72 hours of starting antibiotics
- Pregnancy — a UTI in pregnancy always needs in-person assessment
Do not use an online consultation if you have a fever, back pain, or feel very unwell. Contact your GP, call 111, or go to A&E if your symptoms are severe.
Recurrent Cystitis: When UTIs Keep Coming Back
Around 20–30% of women who have one UTI will have another. If you are getting three or more UTIs a year, that counts as recurrent UTI and needs a different approach from simply repeating the same prescription.
Investigation usually means a urine culture, a look at lifestyle factors (how much you drink, post-sex hygiene, contraception), and sometimes cystoscopy or imaging. Some women are offered prophylactic antibiotics. If your UTIs keep returning, talk to your GP about long-term management. Access Doctor can treat an acute episode, but recurrence needs an ongoing clinical relationship.
For more on getting treatment, see UTI Antibiotics Online UK for Women and Online UTI Treatment for Women UK.
What to Do When You Have Cystitis
If you think you have cystitis, drink plenty of water and take paracetamol or ibuprofen for the pain. If things have not improved within 24 hours, get medical advice. Access Doctor runs an online consultation reviewed by GPhC-registered pharmacist independent prescribers, with nitrofurantoin or trimethoprim sent out for next-day delivery where it is appropriate.
NICE first-line antibiotic
Nitrofurantoin (Macrobid)
First-line treatment for uncomplicated cystitis and UTIs in women. Prescribed after an online consultation.
Order nitrofurantoin →Alternative antibiotic
Trimethoprim
Used when nitrofurantoin is not suitable — for example if you are allergic to it or have reduced kidney function.
Order trimethoprim →Get cystitis diagnosed and treated online
Our pharmacist independent prescribers review your consultation and prescribe the right antibiotic if you need one. Discreet next-day delivery.
Start your consultation →Frequently Asked Questions
What is cystitis?
Cystitis is inflammation of the bladder. In most women it is caused by a bacterial urinary tract infection (UTI). Typical symptoms are needing to wee more often, a burning or stinging feeling when you go, cloudy or smelly urine, and a dull ache low down in the abdomen. Mild cases can settle on their own within a few days, but if bacteria are involved you will usually need antibiotics.
Is cystitis the same as a UTI?
Not exactly, though people use the two words interchangeably. Cystitis means inflammation of the bladder, and that inflammation is not always bacterial. A UTI means bacteria have infected part of the urinary tract. In practice, almost all cystitis in otherwise healthy women is a bacterial UTI, so the difference rarely changes what happens next.
Can men get cystitis?
Yes, but it is uncommon. When a man gets UTI symptoms it can point to an underlying problem — an enlarged prostate, a kidney stone, or a narrowing of the urethra — so it needs a face-to-face GP assessment rather than an online consultation. Our online cystitis service is for adult women only.
What causes cystitis?
Bacteria are behind the great majority of cases, usually E. coli that has travelled from the bowel to the urethra. Sex, wiping habits and some types of contraception all make that more likely. Less common causes include chemotherapy drugs such as cyclophosphamide, radiotherapy to the pelvis, and irritation from scented soaps, bubble bath, spermicidal jellies or lubricants.
How quickly does cystitis clear up with antibiotics?
Most women feel noticeably better within 24 to 48 hours of starting treatment. Finish the whole course even if you feel fine after a day or two — usually three to seven days depending on the antibiotic. If your symptoms are no better after 48 to 72 hours, go back to whoever prescribed them.
Can I get cystitis antibiotics online without seeing a GP?
Yes. Our pharmacist independent prescribers can assess your symptoms through an online consultation and, if antibiotics are appropriate, prescribe nitrofurantoin or trimethoprim. The medicine is posted out the next day in plain packaging. It is not suitable if you are pregnant, male, or have fever or back pain — see a GP in person for those.
When should I see a doctor urgently for cystitis?
Get same-day help if you have a temperature above 38°C, pain in your back or side, nausea or vomiting, shaking or rigors, or you just feel really unwell. Those signs suggest the infection may have moved up to your kidneys (pyelonephritis), which needs to be assessed in person. Call your GP, ring 111, or go to A&E if you are very unwell.
References
- NICE. Urinary tract infection (lower) — women. Clinical Knowledge Summaries. cks.nice.org.uk
- NHS. Cystitis. nhs.uk/conditions/cystitis
- UKHSA. ESPAUR report 2023. gov.uk
- Electronic Medicines Compendium. Nitrofurantoin 100mg m/r capsules — SmPC. medicines.org.uk/emc
- Electronic Medicines Compendium. Trimethoprim 200mg tablets — SmPC. medicines.org.uk/emc
Medical disclaimer: This article is for general information only and is not medical advice. Always speak to a qualified healthcare professional about diagnosis and treatment. Nitrofurantoin and trimethoprim are prescription-only medicines and a consultation is required before they can be dispensed. If you have a fever, loin or back pain, or you are pregnant, seek urgent in-person care. In an emergency, call 999.