Question: Dr. Akai, why do I keep getting bladder infections?

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Answer: There are two main types of bladder irritation and inflammation, also called cystitis. One being infective caused by bacteria and the other being mechanical and caused purely by irritation of the urethra, the tube that runs from the bladder to the outside.

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It is important to determine the cause of recurrent bladder irritation because in severe cases repeated bladder infections can get worse and affect and damage the kidneys.

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A bladder infection can only be proven with urine tests sent to a medical lab.

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You may have heard of the expression “honeymoon cystitis” where newlyweds, or women having frequent sexual intercourse for the first time, keep getting bladder infections. This is because intercourse has the mechanical effect of massaging bacteria up the tube that connects the bladder to the outside (the urethra) because it runs up alongside the front wall of the vagina. This problem usually settles, but in some women persists, and they get a bladder infection a couple of days after intercourse every time. If you find this happens with you, then you should always make sure that you empty your bladder very soon after intercourse. This may help to flush the bacteria out.

If there is no infection then the problem may not be cystitis. It could be what used to be called irritable bladder, but is now called detrusor instability (which is the name of the muscle in the bladder wall). This requires investigation to get a proper understanding of the exact nature of the problem and then the appropriate treatment.

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Some menopausal women can get urinary symptoms that mimic cystitis and it is due to the lack of estrogen in the body. Using hormone creams might be helpful.

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Your family doctor can evaluate your bladder problem and sometimes may need to refer you to a urologist for a special test called a cystoscopy to look into the bladder in order to determine why your symptoms are recurring despite medical treatment.