Cystitis and UTIs — treatment and when to seek help
Reviewed by the My London Pharmacy clinical team, Yvonne Lim, Pharmacist Independent Prescriber
·29 July 2026
·7 min read
Quick answer
Cystitis is inflammation of the bladder, usually caused by a urinary tract infection (UTI). It commonly causes burning when passing urine, needing to go more often, and lower tummy discomfort. Many mild cases settle with self-care, while others need a short course of antibiotics.
What are cystitis and UTIs?
A urinary tract infection is an infection anywhere in the urinary system — the bladder, urethra, or kidneys. Cystitis specifically means inflammation of the bladder, and it is the most common type of UTI. It happens when bacteria, often from the bowel, travel up the urethra and into the bladder.
UTIs are very common in women, largely because the female urethra is shorter, making it easier for bacteria to reach the bladder. Most bladder infections are uncomfortable rather than serious, but they need attention so they do not spread to the kidneys.
UTIs can affect anyone, but they are far more common in women, and many women will have at least one at some point. In men, and in children, a UTI is less common and is more likely to need assessment to check that nothing else is going on. Understanding where an infection sits in the urinary tract helps explain the symptoms: a bladder infection tends to cause discomfort low down, while an infection that reaches the kidneys usually makes a person feel much more unwell.
Who gets cystitis and why
A number of everyday factors can make a bladder infection more likely. Because bacteria from the bowel are the usual cause, anything that helps them reach the urethra can play a part, which is why sex is a common trigger for cystitis in women. Not fully emptying the bladder, holding on for long periods, and being dehydrated can all give bacteria more opportunity to multiply.
Hormonal changes around the menopause can make the tissues of the urinary tract thinner and more prone to infection, and using a diaphragm or spermicide is linked with more frequent UTIs for some people. Pregnancy, diabetes, and conditions that make it harder to empty the bladder fully can also increase the risk. None of these mean an infection is inevitable, but recognising your own risk factors can guide simple, practical steps to reduce how often cystitis occurs.
Symptoms to recognise
Typical symptoms of cystitis include a burning or stinging sensation when passing urine, needing to urinate more often or more urgently, and passing only small amounts. Urine may look cloudy, dark, or strong-smelling, and you may feel a dull ache in your lower tummy or back.
In older adults, and particularly those who are frail, a UTI can show up as confusion or feeling generally unwell rather than the classic urinary symptoms. Blood in the urine, a high temperature, or pain in the side or back can suggest the infection is more significant and needs prompt review.
Symptoms can range from mildly annoying to genuinely distressing, and they do not always appear together. Some people notice mainly the urgency and frequency, while for others the burning is the dominant problem. It is also worth knowing that not every episode of stinging or frequency is due to infection; irritation, dehydration and some skin or hormonal changes can produce similar sensations, which is another reason an assessment can be helpful when symptoms are new or unclear.
Self-care and easing symptoms
Many mild cases of cystitis ease within a few days. Drinking plenty of water to flush the system, taking paracetamol or ibuprofen for discomfort if suitable for you, and resting can all help. Over-the-counter urinary alkalinising sachets may ease stinging for some people, though evidence is limited and they are not suitable for everyone.
It is sensible to avoid holding urine for long periods and to pass urine after sex. If symptoms are mild and you are otherwise well, self-care for a day or two is reasonable — but if things are not improving, treatment may be needed.
There are also a few things worth doing regardless of whether you end up needing antibiotics. Emptying the bladder fully each time, rather than rushing, and keeping up your fluid intake both help. Some people reach for cranberry products or supplements; the evidence for these in treating an active infection is limited, so they are best thought of as a personal preference rather than a treatment. If symptoms are worsening, spreading to the back, or accompanied by fever, self-care alone is not enough and prompt advice is important.
Antibiotic treatment
When antibiotics are needed, a short course usually clears the infection quickly. First-line options in the UK for women include Nitrofurantoin 100mg MR Capsules for Women and Trimethoprim 200mg for Women, typically taken for three days. Fosfomycin is an alternative, given as a single-dose sachet, and may be used where other antibiotics are not suitable.
It is important to finish the course as prescribed, even once you feel better. The choice of antibiotic depends on your symptoms, any allergies, whether you are pregnant, and local resistance patterns, so a clinical assessment helps ensure the right treatment. NHS guidance encourages using antibiotics only when genuinely needed, to help reduce resistance.
Most people start to feel better within a day or two of beginning treatment. If your symptoms have not improved after a couple of days on antibiotics, or they return soon after finishing, it is worth going back for review, as occasionally a different antibiotic is needed or the diagnosis needs revisiting. Taking the medicine with plenty of water and following the instructions on timing helps it work as well as possible.
Preventing recurrent UTIs
Some people experience UTIs repeatedly. Measures that may help include staying well hydrated, passing urine after sex, wiping from front to back, and avoiding perfumed products around the genital area. If you use a diaphragm or spermicide and have frequent UTIs, it is worth discussing alternatives.
For those who have UTIs linked to the menopause, vaginal oestrogen can sometimes help, and for recurrent infections a clinician may consider a longer preventative approach. If you have two or more UTIs in six months, or three or more in a year, it is worth a review.
At that review, a clinician can look for any pattern or contributing factor, check that previous infections were genuinely UTIs, and discuss options ranging from self-care advice to a preventative course of treatment for people who keep getting infections. The right approach is individual, and what suits one person may not suit another, so it is worth having a proper conversation rather than simply repeating the same short course again and again.
What to expect from an assessment
Getting the right treatment starts with a clear picture of your symptoms. A clinician will usually ask what you are experiencing, how long it has been going on, whether you have had UTIs before, and whether there are any features that point to something more than a simple bladder infection, such as fever or back pain. This alone is often enough to decide on suitable treatment for a straightforward case.
Sometimes a urine sample is checked, either with a simple dipstick test or by sending it to a laboratory, which can confirm infection and show which antibiotic is likely to work best. A laboratory test is particularly useful for recurrent infections, in pregnancy, in men and children, or when a first course of treatment has not worked. Being ready to describe your symptoms honestly, and mentioning any allergies or other medicines you take, helps a clinician recommend the safest and most effective option for you.
When to seek urgent help
Seek prompt medical advice if you have a high temperature, shivering, pain in your side or back, vomiting, or blood in your urine, as these can indicate a kidney infection that needs urgent treatment. You should also seek advice if you are pregnant, if symptoms affect a man or child, or if symptoms do not improve within 48 hours of starting antibiotics.
Recurrent or unusual symptoms deserve proper assessment rather than repeated self-treatment. Our clinical team can review your symptoms and, where appropriate, recommend a suitable course of treatment discreetly and quickly.
Frequently asked questions
How long does cystitis last?
Mild cystitis often settles within a few days with self-care. If symptoms persist beyond 48 hours or worsen, a short course of antibiotics may be needed.
Do I always need antibiotics for a UTI?
Not always. Mild cases can settle with fluids and pain relief, but persistent or more severe symptoms usually need antibiotics. A clinician can advise.
Can men get cystitis?
Yes, though UTIs are less common in men and are more likely to need assessment. Men with urinary symptoms should always seek clinical advice.
When is a UTI an emergency?
Seek urgent help if you have a high temperature, back or side pain, vomiting, or blood in your urine, as these can signal a kidney infection.
How can I prevent recurrent UTIs?
Staying hydrated, urinating after sex, and avoiding perfumed products can help. For frequent UTIs, a clinician may suggest further measures or a preventative approach.