Who doesn’t love a film with a strong female lead?

While there is still a long way for cinema to go in its quest for gender equality, it’s not all bad news. Compared to times past, an increasing number of movies are passing the Bechdel test*, reflecting the increasing demand for female characters to transcend the traditionally held roles of ‘passive recipient to male characters’ whims’, or ‘damsel in distress’, or both. Female characters are doing lots of things that they would never have done before, and we have even had some female superheroes. Woohoo!

But as a cystitis-prone woman, I can’t help but notice that none of these women — even the ones wearing tight clothes made of inorganic materials, or the ones having lots of sex — ever seem to get a UTI. Statistically, this is very unlikely; 50–60% of women will experience the horror of a UTI in their lifetime, and 2 out of 5 women experience recurrent UTIs throughout their life. The closest movies seem to get to plights of the vagina are period ‘dramas’, and this is usually only mentioned in the context of mood swings, or fertility stuff. So how is it that these female protagonists who are always on the go, or having sex, or in extreme locations with minimal or no access to a clean toilet and a bottle of D-Mannose, staying cystitis-free? What’s their secret??!

…Well, the sad truth is they probably don’t have one, it’s just that we are not getting to see the cystitisy parts of their adventures. What’s up with that, Hollywood?

If I had to hazard a guess, I would say this cystitis radio silence is related to a few things:

1. Cystitis is amongst the least “sexy” of the maladies out there, in that it’s horribly painful but not going to kill you (I promise!), so it doesn’t lend itself to epic, gut wrenching romantic tragedies. The extent of the romantic tragedy will be the protagonist having to cancel a date. Boohoo.
2. Cystitis doesn’t really progress the story in any way- just creates a pointless sort of pause (pretty much how I experience it in my own life, really).
3. It takes sex off the table. And for many films, even if a character isn’t having sex, it’s very important that she could be.
4. To state that a character has cystitis very much puts their vagina centre stage. In films, vaginas are generally only meant to have sex or push babies out, and are never given much prominence in and of themselves. Because let’s face it, no one wants to hear about a sick foof.
5. If a woman is sobbing on the toilet gulping cranberry juice, she can’t really be useful. By which I mean she can’t be sexy, cute, clever or sell a movie franchise.
6. For Bechdel-aware film makers, there might be a need to overcompensate for the past by making women ‘strong’ in the male sense of the word. So, much in the same way as we don’t discuss James Bond’s prostate pain, we also don’t discuss Lara Croft’s burning urethra.

I don’t know about you, but I think that with the exception of non-human female characters who might not have urethras (such as Arwen in LOTR- do elves pee?), there is no excuse to leave this very real, very common problem out of the (talking) picture. I often find myself watching films and thinking, “if that was me, I’d DEFINITELY have got cystitis by now”. Hell, just looking at Anne Hathaway in her Cat Woman suit gives me cystitis! And this got me thinking… what if some of our favourite female protagonists did get cystitis half way through their 90 minutes in the limelight? And what impact would this have on the plot?

With this in mind, here is a selection of some of my favourite UTI-alternative movie endings… SPOILERS AHEAD!

The Hunger Games

More specifically, Hunger Games Catching Fire.

Katniss and co run around the boiling jungle for days, in sexy tight lycra suits with zero ventilation, until they discover that they can get a dribble of water out of a tree. I definitely understand the movie title now- my urethra would definitely be catching fire in that situation. I reckon any cystitis-prone tributes would have topped themselves at the first mention of a lycra suit before the countdown had even started; a very boring death indeed for the game makers! If Katniss had got cystitis in the jungle arena, her sole focus would be on getting a Capitol sponsor to send her a little parachute with D-Mannose or antibiotics. She’d be far too distracted to pay any attention to Beetee’s plan and to realise that she had to shoot an electrified arrow into the arena dome. The revolution would not have happened, and the Mockingjay would have almost certainly been murdered in some dramatic fashion. Although watching 90 minutes of Katniss crouched by a tree screaming in pain before begging some Career tribute to mercifully chop her head (or vagina) off might have been more realistic, it probably would not have made the Hunger Games the box office hit that it was.

Wonder Woman

Okay, so she’s not technically human, but who am I to say whether Goddesses have urethrae? If we assume that Wonder Woman did have a urethra, and that the little superhero pants she wears are not made of cotton, then we can also assume that she might have been prone to the odd bout of cystitis. And if you had cystitis and were given the option of a) staying on an island full of warrior chicks (50% of whom would’ve statistically experienced cystitis as well at some point) or b) getting on a boat with a random guy, what would you pick? Exactly. Wonder Woman with cystitis would have remained Diana, Princess of the Amazons. Still bad ass, but not global super-heroine bad ass. Glass ceilings and all that.

Harry Potter

Hermione is the real resident bad ass of Hogwarts, and she saves the day. A lot. Let’s face it, if Hermione was glued to a toilet at any point during the story, then Voldemort would have won, for sure. Though, knowing Hermione, she would probably have just “Accio E.coli’d” her urethra and been done with it. Maybe that’s why JK Rowling didn’t bother to include any UTI side stories. Also, Harry Potter and the Goblet of Cranberry Juice just doesn’t have the same ring to it.

Mulan

Life was hard enough for poor Mulan, having to hide her boobs and fanny and periods and weak arms from all the men. But can you imagine having to go to target practice, climbing a big wooden pole, or flirting with your hunky commander (#animatedcrush) with a UTI? If Mulan had had cystitis on the day her dad was drafted to the army, she wouldn’t have even made it there because she’d have been glued to the toilet and missed the opportunity to go in his place. He would have died in battle, and the family would have starved. The end. Disney fairy tale it ain’t.

The Matrix

There is no way that Trinity, queen of black latex, stayed cystitis-free in the Matrix. Can you imagine how hot and sweaty your nether regions would get in that suit?! If Trinity had got cystitis she would not have been able to steer the ship to the Machine City meaning blind Neo wouldn’t have been able to save all of humanity. Though maybe they could’ve popped into The Matrix before the trip and he could’ve scooped out the bacteria in the same way he got her heart beating again in the second film (“you can’t stay on the toilet all day Trinity. I love you too damn much!”)

The question is, if you get cystitis in the Matrix do you get cystitis in the real world…?

Romeo and Juliet

Things go from bad to worse very quickly for poor Juliet. She falls in love with the son of her family’s mortal enemy, marries him the next day (somehow organising a dress in just one night), loses her virginity to him, learns that he has somehow managed to murder her cousin AND be permanently exiled from the city a few hours later, and then finds out that she is being forcibly married off to Paris and that her only hope of seeing Romeo again is to pretend to be dead. Then she wakes up from her nap to find that Romeo has just poisoned himself. It’s all very tragic. But also, there are many cystitis risk factors: high levels of anxiety, and first time sex. Maybe she killed herself because she couldn’t live without Romeo, or maybe, she couldn’t face living in a pre-antibiotic world. Either way, if Juliet had had cystitis she would have skipped the ball and never met Romeo, and no one would have died. Actually, a UTI might have been preferable in this case, Shakespeare.

Sister Act

Firstly, how totally crap would it be to be a nun with cystitis? It’s embarrassing enough when you tell people you have cystitis and they assume it’s from sex, but if you were a nun, that assumption could easily cost you a job. The only bright side of being a nun with cystitis is that you can easily ventilate your coochie with no one being any the wiser. Frolic free, nuns! That version would have to be called ‘Cyst-er Act’. I have no alternative ending to suggest, but this one just tickled me so it stays in. I’m here all night, ladies and gentleman.

Titanic

Another case of first time sex (we assume)! Cystitis Rose would’ve been stuck on the toilet and drowned as the ship sank. I’m sure Jack would’ve easily survived a cold Atlantic night by climbing on that floating door in her place.

So there you have it folks, would love to hear some of your alternative endings so please do share!

*Films which pass the Bechdel test are films which 1) include two women (preferably named), 2) who talk to each other, 3)about something other than a man

Cystitis in Hollywood? Excruciating Plot Twists was originally published in Burning Issues on Medium, where people are continuing the conversation by highlighting and responding to this story.

It was a Saturday morning in the middle of nowhere and I just had run out of D-Mannose. I was very annoyed with myself; when my boyfriend had asked if I had enough capsules left for our Patagonian adventure, I had distractedly given the D-Mannose box a shake and said “yeah”.

So it’s an understatement to say I was feeling pretty sheepish as we zoomed along the dusty roads, in our small rickety rental car, towards the one health store we could find online. Which was closing in 20 minutes.

I ran into the store with 5 minutes to spare and thrust the empty box into the poor sales woman’s hands, trying to explain in my (very) broken Spanish that I needed these to avoid dying a fiery cystitis death in Patagonia. After a few moments, she returned with only my empty box and a “sorry, no”.

I emerged from the shop feeling pretty glum. Okay, so I hadn’t really expected this tiny shop in the countryside to stock D-Mannose after I’d struggled to find it in shops in London, but a small part of me had hoped that maybe I was wrong. And now all hope was gone. Short of stuffing my face with the berries growing around the grounds of our BnB (which wouldn’t have worked anyway as our bodies can’t absorb enough D-Mannose from fruit to actually make a difference to UTIs), I realised I was looking at the reality of a D-Mannose-less existence for the next 3 weeks. I thought I might cry.

I returned to the car, deflated, and hoping that my (up until then) regular supplement taking might carry me through until we flew home. I was just going to have to be extra mindful and extra careful.

The problem, I realised, was that since I’d perfected my urinary care regime with regular supplement taking, I’d become complacent about it; everything was going well, and I just assumed it would continue to go well anywhere I went. But when you’re travelling, routines get turned on their heads and it’s easy to put self-care on the back burner through complacency.

Travelling, with all its unknowns, can be anxiety provoking at the best of times. When you are prone to UTIs, it can become downright scary very quickly. Regardless of the type of trip, travelling changes our environment and disrupts our routine. It can force us to step out of our comfort zones and go with the flow, (particularly if we are travelling with others). We might rest and wash less, but drink (alcohol) and have sex more. In short, travelling has all the ingredients and all the potential to wreak cystitisy hell if we are not careful.

But there’s no reason you shouldn’t have great adventures just like all the other less urethrally challenged people! You just need to be cystitis-aware and cystitis-prepared. And here are my pearls of wisdom on how to do that.

Before you go travelling

1. Count your supplements

Take some time to actually physically count your supplements (no box shaking, please), and do this far enough in advance of your trip so that you can get more supplements if you need them. Also take some extra supplements with you just in case! If you think you can get more supplements wherever you’re travelling to, check this out before (but better to just have everything you need with you from the start, I’d say!)

2. Set a ‘supplements alarm’ on your phone

It’s easy to fall out of routine when you’re travelling, so giving yourself a digital nudge is just plain good sense! Set an alarm on your phone to remind you to take your supplements, and if you take a few a day, set multiple alarms and carry supplements with you (they’re only little!)

3. Make a list of your cystitis ‘triggers’

Sex? Dehydration? Not taking your supplements? Even if you know your triggers, it can be easy to waive them aside when you’re travelling. Try and stay mindful of your behaviour, and to remain cautious (e.g. remembering to pee before and after sex, not getting stupid drunk every single day, keeping to your supplements alarm).

If you get UTIs regularly, make an appointment to see our GP before you travel and ask for emergency antibiotics. This means that if you get an infection somewhere where medical care isn’t easily accessible, you don’t need to panic.

…and once you’re there…

5. Always carry water!

This applies whether you are in the middle of nowhere or in a bustling city (at least until you know what’s what in terms of shop locations, opening times etc). It will also help you feel more in control, so you can act quickly if you do feel that familiar twinge…

6. Take small sips

I know it can be tempting to take massive gulps of water when you think you might have cystitis coming on, but try and resist! Small sips will hydrate you more effectively, and also keep you feeling calm. Win.

7. Drink (water) regularly

Stay ahead of the game! Even if you feel fine, drink water- it helps keep you hydrated, and reduces the chance of an infection developing by continuously flushing out your bladder.

8. Scope out the nearest toilet

Even if you don’t need to go, knowing where the toilets are is always reassuring if you are prone to cystitis. This means that if disaster strikes you know where to head, even in the middle of the night.

9. Pack a hot water bottle

They don’t take up much space and they can be a real lifesaver if you do get cystitis (or period pains). It’s also worth finding out where you can access boiling water as soon as you arrive at your accommodation. Outside of the UK, hotel rooms don’t tend to have kettles in so it’s important to locate one (even if it’s just for an emergency cup of tea). So scope out the kettle and be prepared!

10. Tell your fellow travellers

If you’re travelling with others, consider letting them know that you are prone to UTIs. If they know, they can be more accommodating and supportive. It will also make it easier to say no to stuff if you’re not feeling well, which is a real relief when you have a UTI.

11. Allocate a cystitis ‘section’ in your day bag

Keep reading to find out what to fill it with…

12. Carry toilet paper/tissues

If you’re hiking and you get cystitis, you don’t want to be wiping your delicate parts with leaves. Avoid an ants-in-pants scenario by coming prepared with a small wodge of toilet paper. And remember (for the ladies): always wipe front to back!

13. Carry the correct supplements

Have some D-Mannose on you at all times. Make sure you keep to your travelling supplement alarm schedule.

14. Carry painkillers or temporary pain relief

If you have an infection that needs treatment then painkillers can’t cure the problem, but they can buy you some time if you aren’t able to leave a situation immediately. Ibuprofen or Paracetamol can do the trick to reduce inflammation. Azo can help make peeing more comfortable. If the pain goes away and stays away then maybe your body has fixed itself and that’s great, but if it persists for a few days make sure you get the correct medical attention.

So there you have it, fourteen tips to keep your urethra happy wherever you are in the world! Remember that being prepared is also a state of mind, and that knowing you are prepared can actually contribute towards keeping you empowered, calm and healthy.

Happy travels!

Cystitis on the Road was originally published in Burning Issues on Medium, where people are continuing the conversation by highlighting and responding to this story.

It was 8pm on a Saturday night and I was stuck at home binge watching Friends and feeling sorry for myself. I was supposed to be in Bristol with my boyfriend, visiting some of his uni friends. Unfortunately, my urinary tract had other plans for me this weekend. This sucked.

I’d been struck down by cystitis earlier that day. My boyfriend and I had actually been on our way to Bristol when it happened. I’d felt a niggle that morning but thought I had everything under control after downing a few glasses of water with a couple of Azo tablets. Yes they make your pee look like radioactive Tango, but I’d read that they help ease symptoms temporarily. Except they didn’t. When we stopped for lunch I thought I’d run to the toilet for an emergency pee to try and clear everything out. But barely anything came out. Oh. Crap. No.

You know that moment where you go to the toilet and the cystitsy feeling either eases a bit or gets much, much worse? That day definitely fell into the latter. As I sat there, It felt like a metal claw had latched onto my urethra and pulled. I started to panic.

The screaming in my head sounded something like this:

“WHY DID I GO TO THE TOILET IT’S SO MUCH WORSE NOW! WHY DOES THIS HAPPEN TO ME IT’S SO UNFAIR!!!!! WHY TODAY?? OHMYGOD HOW AM I GOING TO GO TO BRISTOL AND MEET THESE PEOPLE FOR THE FIRST TIME WHEN MY PISS IS ON FIRE? I’M SO FAR FROM HOME AND IT WILL TAKE AGES TO GET BACK! WHAT IF I WET MYSELF IN THE CAR? HOW WILL I SURVIVE THE CAR JOURNEY?? IF I GO HOME WILL MY BOYFRIEND BE UPSET WITH ME? I’M GONNA DIE THIS HURTS SO BAAAAAAAAAAAAAAAD!!!!!”

Meanwhile, the pain was reaching a crescendo and walking hurt. I managed to waddle out of the toilet and caught my boyfriend’s eye, shaking my head ominously. He understood.

In the car we discussed the options, and decided that the best (and only) thing we could do was to drive me home. I instantly relaxed, and although the pain was still intense and my thighs were hurting, it was getting more bearable. At home, my now well trained boyfriend suggested I go up to the flat while he parked the car and brought our stuff back up. Grateful, I shot up the stairs and launched myself headfirst into the bathroom. When I emerged, there was a hot water bottle, blanket, and cup of tea waiting for me.

I curled up on the sofa and instantly felt better. Maybe it was all going to be okay! Maybe I didn’t have another infection, a mere 3 weeks after finishing my last course of antibiotics. Maybe I could go to Bristol after all? Was I even unwell? We spoke about how I was feeling, the awful moment in the toilet that afternoon, and the drive home. The moment the conversation moved back to whether I felt well enough to come to Bristol, I started to panic again.

“What if it comes back while we’re there? It would be so embarrassing!” I wailed.

“They’re really nice, if you were unwell and had to stay in the toilet they’d be cool with it I promise,” he replied encouragingly.

As I thought about it, the pain crept in with my panic. He was looking at me so hopefully, and I really didn’t want to disappoint him and ruin the weekend. But at the same time, I knew that if I went I wouldn’t actually be able to spend all my time in the toilet, and even if I did, what would be the point of even going? More so, if I did spend all my time in their bathroom, what would everyone else do when they needed to go? I was starting to panic just by thinking about it! Much to everyone’s disappointment, I decided to be sensible and stay at home. Almost immediately after making the decision, I felt the pain ebb a bit.

As I lay on the sofa cuddling a hot water bottle and pondering how Monica got her hair so shiny, I realised that the majority of my most excruciating oh-god-just-end-it-all bouts of cystitis had occurred when I was far from home, usually in a car on a long journey, or at work. More specifically, I was usually in a situation where I was unable to access a toilet as regularly as I wanted to. I used to attribute this to Sod’s Law, but now I was starting to wonder whether these situations where I felt trapped and panicky were actually contributing to the development of my symptoms? It would explain why just being near a toilet (or being sped along the motorway in the direction of one) instantly eased my symptoms.

The old Chinese proverb describing the bladder as ‘the mirror to the soul’ suggests that the concept of ‘bladder emotions’ is not a new one (in the East, at least). The term ‘psychosomatic’ describes illnesses which are impacted by the sufferer’s mental state, and has gained increasing credibility within the medical community as a way of explaining symptom ‘flare ups’ (e.g. eczema), and sometimes even symptoms with no clear underlying organic cause (e.g. fibromyalgia).

I have come to learn that my emotional state and ‘self talk’ has a massive bearing on the severity of my cystitis symptoms and the rate at which the pain escalates. Tuning into my inner dialogue has allowed me to slow things down a bit, listen to my self talk, and reappraise the less helpful bits (e.g. “why meeeeeeeee?!”) When I do this, it gives me scope to interrupt the useless panicky self talk and replace it with more useful things. Here are all my top tips for helpful self talk:

Remember what you’ve done to help yourself

I’ve put this first because it’s by far the thing I find most effective. In my case, I remind myself that I have prepared myself by taking daily supplements of D-Mannose and cranberry extract, and that this has served to strengthen my urinary tract over time so that when situations like this arise from time to time I will be able to recover more quickly. This technique is more effective if you a) have more things to draw on (e.g. I took D-Mannose an hour ago, plus I drank two glasses of water today, plus I didn’t drink alcohol last night) and b) have invested long term in your health (e.g. I take D-Mannose supplements daily, and I have massively cut down on my alcohol consumption). Remembering how you’ve helped yourself is great because it moves you from the position of being a passive recipient of pain to a position where you are empowered and active in this fight. Go you! I also try and imagine the D-Mannose sweeping around my urinary tract and grabbing all the nasty, frightened E. coli bugs. Kind of like in those old toilet cleaner adverts. Die evil bacteria, Die!

Challenge the “I’m trapped” self talk

If, like me, you notice that your cystitis is worse when you are in a hard to escape situation, try relaxing yourself by visualising exit strategies. Once I was on a train with friends whilst travelling in South America and I seriously contemplated getting off a few stops early just so I could use the loo. Realising that I physically could choose to do this (even if everyone would think I was crazy) was really helpful because it gave me back my agency.

Misery loves company

When you have terrible cystitis, it’s easy to feel very alone and to imagine that it’s only you who is going through this. But remember that you’re not alone: over 1.5 billion women worldwide have experienced cystitis (and that’s not counting the men!) and around 20% of women who have had a UTI will experience another one. So there is very likely to be another poor soul panicking somewhere in the world at this exact moment (just have a look on Twitter right now!) Reminding yourself of how common cystitis is can help you normalise the experience, which can feel reassuring when you’re feeling rubbish.

“This too shall pass”

You know that this pain has passed before, and it will again. If it’s your first time, try and trust me: it will pass! And when it does pass, make sure to consciously say “thank goodness that’s passed!” And repeat it every time you have a pee that is not painful: it’s good to appreciate your urethra!

On a final note…

Just to clarify, I am not saying that you can talk yourself out of an infection that needs antibiotics, and if your symptoms persist for a number of days you should definitely go to the doctor. What I am saying is that it is worth exploring what you might be doing (however unconsciously) to exacerbate the pain, and to see whether it can be challenged. Because simple empowering actions like taking daily D-Mannose and cranberry supplements, mindfully managing your self talk, and using imagery really can make a huge difference in the moment!

How to Tune Into Your Cystitis Thought Processes was originally published in Burning Issues on Medium, where people are continuing the conversation by highlighting and responding to this story.

“Doc, we can’t keep meeting like this!” I wailed melodramatically at the poor junior GP. It was my third visit to the GP in 6 weeks, and my third prescription for antibiotics.

“W-well, there are some other options. Have you tried urinating after sex?”
“Yes I know all about peeing after sex. What else you got?”
“Do you drink lots of water?”
“Like a fish”
“Okay. Well, for chronic UTI suffers like yourself, we are able to prescribe a continuous low dose course of antibiotics. Usually, people take them just before sex, and it can be very effective for dealing with any infections before they become problematic.”

Hold the phone. An antibiotic every time you have sex? I was gobsmacked. With all that modern medicine has accomplished, was this really the best solution open to the urethrally challenged? And furthermore, had my GP and the wider medical community not heard of the dangers of antimicrobial resistance?? Needless to say, I did not accept.

Because I hated taking antibiotics. Until that point in my life, I had only really taken them for a chest infection and the aforementioned occasional bout of mortal cystitis. Unfortunately, in the last 6 weeks, my urethra had taken it upon itself (herself?) to throw fortnightly hissy fits of epic proportions. This meant my antibiotic consumption had skyrocketed. What was going on?!

I left the GP practice cursing my vagina. As I walked to the pharmacy to pick up yet another short course of antibiotics, I resolved myself to find another solution. After I’d found a toilet, of course.

Armed with my antibiotics, a hot water bottle, cranberry juice and my laptop, I curled up ready to find the miracle cure that would save me from a lifetime of compulsory antibiotic aphrodisiacs. Half an hour later, finding nothing new, I googled “Caitlin Moran cystitis” in an effort to cheer myself up. For those of you who haven’t heard of her, Caitlin Moran is an author, columnist and broadcaster, and the only woman I know of who has written candidly about the horrors of cystitis. As well as being incredibly bright and laugh-out-loud hilarious, Caitlin Moran also turned out to be my cystitis guru, lighting the path to urethral enlightenment.

My initial scepticism regarding supplements was quickly erased by my desperation. I figured it was worth a shot, and I had absolutely nothing to lose. I followed Caitlin Moran’s advice and only took a capsule of D-Mannose when I felt that familiar “twinge” of doom. Unfortunately, this didn’t prove incredibly useful and so I turned to the internet for further inspiration. After reading some more about D-Mannose and supplement taking more generally, I realised my mistake: I was approaching supplements with the same ‘make me well’ mentality with which I approached medication. Unlike medication, supplements help you build, maintain and strengthen your body so that when your urethra goes off the rails, your body is in a better position to deal with it. I made the decision to become a #RegularSupplementTaker, a title which until then I had thought was reserved exclusively for bodybuilders, athletes and hypochondriacs. A month later, cystitis-free and going strong, I was converted.

So, what is D-Mannose and how does it work?

I’m glad you asked!

D-Mannose is a naturally occurring sugar which is found in berries, many fruits and some vegetables. And it is, quite simply and in my opinion, magical. D-Mannose is similar to glucose in terms of its structure, but different in that our body only absorbs miniscule amounts of it. This means it moves through us very quickly, and this is a big part of what makes it so effective in treating UTIs like cystitis! Let me explain further.

Ninety percent of UTIs are caused by E. coli, a bacteria which is found in many parts of our bodies. E. coli can become a painful problem when it latches onto the urinary tract lining. Luckily, when D-Mannose reaches our urinary tract, the E. coli will bind to it rather than the bladder walls or lining, and because our bodies rapidly excrete D-Mannose in our pee, the attached E. coli are flushed out with it. This greatly minimises the chance that harmful bacteria will grow, leading to infection. See? Magic!

Are there any health risks?

Sugar is bad for you, right? Not necessarily! Whilst glucose is a sugar with many associated health problems, D-Mannose is a very different kind of sugar, mainly due to the fact that it doesn’t hang around. In other words, it doesn’t get absorbed into our bloodstream or cells as much, and what is left is very quickly flushed out.

Furthermore, a recent paper published in Nature has suggested that in addition to helping with UTIs, D-Mannose can actually serve to improve your health by boosting your immune system, thus helping in the prevention and treatment of autoimmune diabetes as well as asthma. Wahey!

Despite the fact that D-Mannose has only a minimal effect on blood sugar levels, this could be problematic if you have diabetes and are monitoring blood sugar levels more closely. If this applies to you, avoid taking D-Mannose until you have discussed it with your doctor.

Why can’t I just get my D-Mannose through fruit?

D-Mannose proved to be a game changer for me and it might just be one for you as well. So my advice to you, weary cystitis sufferer, is this: try it and see what happens! There are three main things which I would urge you to remember:

1. When it comes to supplements, we all feel the effects differently. For some people they are instantly helpful, while for others it can take a bit longer.
2. The magical effects of D-Mannose work alongside other prevention measures. Don’t forget that junior doctor’s advice, and keep drinking lots and peeing after sex!
3. If you are prone to UTIs, you need to act mindfully even when everything is okay. So if the supplements work, keep taking them regularly.

D-Mannose: My UTI Fighting Hero was originally published in Burning Issues on Medium, where people are continuing the conversation by highlighting and responding to this story.

Let me paint you a picture. It’s midweek, and you’ve had a nightmare day at work. Maybe you’ve been too tired, busy and distracted to drink anything apart from coffee (and let’s face it, at this stage that’s just necessary for good work performance right?)

On the train home, you feel that familiar twinge down below. Panicking, you quickly neck down a bottle of water and leg it home from the station, trying to ignore the fact that the twinge is steadily growing into a “definitely something there” pain and that your bladder feels like its about to explode into a fiery ball of pain. After an hour (or three) on the toilet, you finally summon every ounce of courage you have and drag yourself out of the bathroom and towards a laptop or phone.* You deserve a medal.

Once armed with your technology, you google your symptoms along with phrases such as “quick cure” or “instant relief”, scanning each page expectantly and waiting for that miracle remedy to just float up onto the page. If you’re lucky, there will be a partner, flat mate, friend or family member at your disposal who will dutifully run to Tesco in search of cranberries and inevitably appear 20 minutes later, red faced, carrying copious amounts of cranberry juice drink. “Sorry, nowhere seems to sell actual cranberries!”

Sound familiar? I thought so.

Even though I’d dealt with it many times before, the tragic cycle of cystitis misery always seemed to creep up on me. As I was again and again faced with the unhappy task of peeling myself off the toilet seat, I would sadly ask myself: “How did I get here again?” Because surely, I should’ve worked all of this out by now?

In asking the question, I came to realise something really important. Just as it’s well known that the pain of childbirth is quickly forgotten, I realised that I too would instantly forget the pain of cystitis once it had passed. But unlike the evolutionary advantage of forgetting the pain of childbirth (i.e. the continuation of humanity), I could see no reason for my apparent cystitis amnesia. Why didn’t I remember the pain even though I knew I was often affected by it?

After some soul searching, I came to realise that this cystitis-related forgetfulness was linked to two things:

1. The shame I felt of not being able to fulfil my ‘role’ in life when I had cystitis, and
2. The feeling that this should not be happening to me.

This felt like an epiphany. I realised that following each horrible bout of cystitis, I would defiantly throw myself into all the tasks which I had been unable to do when I was unwell. In doing so I would conveniently forget that I was someone who got UTIs, because I did not like that I was limited by anything, and resume cystitis-causing behaviours. I now realise that what I should have done was take some time to understand what was causing and triggering my (what I once considered) embarrassing problem.

Once I accepted that cystitis was a part of my life, I finally let it in. And things became a lot simpler from that point onward. I decided to switch things up. Rather than desperately googling “miracle cures for UTIs” while I was sitting in agony on the toilet, I started reading about cystitis even when I didn’t have it. And believe me, it’s much easier to think critically about what you’re reading when you’re not pissing razor blades.

When I did have cystitis, I tried (with a lot of encouragement) to remember patterns and triggers. What was I doing which triggered this bout? Or what wasn’t I doing?

I started drinking far more water, and far fewer sugary juices and fizzy drinks. For my birthday, I asked for a “good water bottle” so that I could carry water with me everywhere I went without fear of it leaking. Lastly, I started regularly taking recommended supplements to boost my urinary health, and — here’s the best part — actually following the guidance instructions!

The first supplement most sufferers try is cranberry. I had previously become disillusioned with cranberry when one tablet had failed to rid me of an infection that eventually needed a course of antibiotics… shocking! I now understand that the correct relationship to have with supplements, such as cranberry extract, is to take them regularly so that their beneficial effects have a chance of taking hold.

I first learnt about D-Mannose after watching an interview with one of my favourite writers, Caitlin Moran. As a fellow long-term sufferer, I felt her descriptions of cystitis very much mapped onto my own. So when she mentioned D-Mannose, I naturally embarked upon a rigorous research crusade where I learnt that D-Mannose is a naturally occurring sugar that tricks bacteria in your bladder and urinary tract to attach to it rather than your urinary linings. When you pee, you flush out both the D-Mannose sugar and its bacterial passengers! Delighted with this description of bacterial warfare, I decided to give it a shot. And the rest is history!

I suppose that for me, and I suspect for many of you too, the biggest take home from all of this is that the key to fighting cystitis lies in mindfulness, maintenance and prevention. Being aware of my behaviours and paying attention to the things which trigger my cystitis means I can stay ahead of the game and reduce my chance of becoming unwell in the first place. Taking D-Mannose and Cranberry supplements on a regular daily basis (rather than only when s**t hits the fan) allows me to maintain better urinary health, meaning I become unwell far less frequently. It also helps me to strengthen my body so that when I do feel that familiar panic-inducing twinge, I know I will be better able to fight it.

It seems ironic but by allowing cystitis into my life, I have actually given myself the best chance of fighting it.

* Why not take your phone into the bathroom to avoid the torturous ‘peeling away’ charade? No one will judge you. I actually wrote this whole article on the toilet (just kidding).

My Urethral Epiphany was originally published in Burning Issues on Medium, where people are continuing the conversation by highlighting and responding to this story.

We’re going to change that. By talking about cystitis, we want to connect both sufferers (of all genders!) and non-sufferers alike. We will welcome them all to share in a discussion where there has not been one before. Our stories aim to raise awareness of difficult experiences and issues which cystitis sufferers face, which we can all learn from together. Because no one should face cystitis alone.

Why the name?

Well… there’s no easy way to say this, but having cystitis feels like your downstairs department is on fire. And not “on fire” in a good way. Some sufferers also liken the sensation of peeing with cystitis to being internally stabbed with razor blades. Not fun.

Just as fire can devastate, so too can cystitis. Life grinds to a halt for sufferers, as the internal fire stops them from focusing on daily tasks which other people might take for granted. This can have detrimental effects on that individual’s relationships, family life, and career, becoming a burning issue for wider society.

Who are we?

Burning Issues is supported by the team behind Chickpea, a startup looking to promote urinary health and on a mission to bring an end to cystisy misery. We also welcome contributions by anyone with something to add to this discussion — both directly and tangentially related to cystitis, UTIs and urinary tract health.

What’s in store for followers?

We have a wealth of stories, advice and expert insight to share. This isn’t going to be a monologue of woe (though there is bound to be some when any burning sensation is involved!) but a campaign of awareness, hope and solidarity.

Introducing Burning Issues was originally published in Burning Issues on Medium, where people are continuing the conversation by highlighting and responding to this story.