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Cystitis and thrush affect more women than men due to the unique characteristics of the female urinary tract and genitalia. Women have a short urethra; external, open genitalia and warm, humid conditions within the vagina and uterus : ideal conditions for these infections to flourish!. Some medical conditions like diabetes can increase your risk from urinary tract infections.

Condition Cystitis
Symptoms Mild:
- Pricking or stinging pain around the opening of the urethra
- Burning sensation during urination.
- Frequent urge to go to the toilet but there may be very little urine to pass.
- Urine may be dark and cloudy
- Urine may have an unpleasant smell
- Pain in the lower back is common
- The sufferer may have a raised temperature.
OTC Treatment OTC treatments contain alkali to neutralise the acidity in the urine, which eases the stinging, burning sensation.
The active ingredient in OTC medicines is sodium citrate, potassium citrate, sodium carbonate or sodium bicarbonate.
All form an alkaline solution when dissolved in water to make a drink. As they contain large amounts of sodium, these products should not be taken by people with high blood pressure, or impaired kidney function.
In severe cases, when the infection is more developed, antibiotic treatment may be required; this is available only form a GP.
For OTC products, read Cystitis
Other self-help

Sufferers should drink plenty of fluid throughout the day. However, it is important that the fluid is not provided by acidic drinks such as strong tea, coffee and citrus fruit drinks. The extra fluid dilutes the urine, increasing the volume produced and the increased output can then help to flush-out the bacteria. Cranberry juice may be helpful.
After a bowel movement, care should be taken to wipe away from the urethra to prevent infection. Holding a hot water bottle against the abdomen can help to relieve the pain.
Alternative remedies containing herbal extracts are also available. The herbs used include bearberry, buchu leaf, couchgrass, equisetum, shepherd’s purse and uva ursi. These have a tradition of use for symptomatic relief of bladder and urinary tract discomfort. Some of the herbs have a slight diuretic effect, which helps to flush-out the infection.

Other information

Cystitis is an acute inflammation of the bladder and urethra. It is usually caused by bacterial infection. Although cystitis can affect men, it is usually much more common among women because of the:
- Warm, humid conditions in the vagina and uterus, which provide an ideal environment for bacterial growth and multiplication.
- Open, external genitalia, which make infection more likely that it is in men
- Short urethra, which enables rapid infection of the bladder.
Infection by the bacteria found in or around the anus is the most common cause of cystitis. The bacteria can be transferred to the urethra during sexual intercourse, by wiping the bottom from the anus towards the urethra, or during menstruation.
The pain experienced by people with cystitis is due partly to inflammation and partly to the irritant effects of the urine, which the bacteria make more acidic than normal.
NB: Medical advice is needed for:
- Men or children with symptoms of cystitis
- Women with cystitis who are also vomiting, have an unusual vaginal discharge, have blood in the urine, or are pregnant
- Women with recurrent symptoms, plus increased thirst, weight loss and thrush

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Thrush (also known as candida infection)
Condition Thrush (also known as candida infection)

- Thick, creamy discharge, or a yellow, watery discharge
- Discharge is usually odourless
- Vulva and vaginal walls can become red and inflammed, often with visible white patches
- Intense itching
- Pain in the vagina when having sexual intercourse
- Painful stinging of the vulva area when passing urine
NB: In those who suffer frequently, the symptom pattern may change and the discharge may be minimal.

OTC Treatment

OTC treatments include:
- Fluconazole, a single-dose treatment in capsule form. A single capsule should be effective. It should not be used:
- During pregnancy
- By sexually active women of child-bearing age without adequate contraception
- By women under 16 years old or over 60 years old
- Clotrimazole and Miconazole for vulval and vaginal treatment. These are available as creams and vaginal pessaries that can be used together. A single overnight treatment with intravaginal cream or pessary should be effective.
A lower strength cream can be used externally to relieve itching and any inflammation caused by discharge.
NB: sufferers should feel an improvement within a day or two. If symptoms persist after 7 days you should see your GP.
For OTC products, read Vaginal Thrush

Other self-help

Women with thrush should wear loose, comfortable clothing and avoid wearing tights or tight trousers. This is to avoid creating the warm, moist conditions that helps thrush develop.
Women should also avoid using bath salts, vaginal deodorants and bubble baths that can encourage the development of thrush by removing competing bacteria.
Some women find that live yoghurt applied to the vagina can help. This works by introducing harmless bacteria that compete with the thrush.
As thrush also lives in the bowel, women should wipe from front to back after a bowel movement.

Other information Thrush is one of the most common forms of vaginal infection. Roughly 50% of women aged between 16 and 60 years will suffer a thrush infection at some time, and nearly one third will have at least one episode a year.
NB: When thrush causes chronic symptoms it is important that a woman’s sexual partner is also treated. Men can be symptomless carriers, who infect their partner every time they have sexual intercourse. Men should be referred to a GP as thrush treatment in men is not an OTC indication.
Thrush is caused by the yeast candida albicans. It is a normal inhabitant of the digestive and reproductive tracts and is usually suppressed by bacteria. Thrush tends to proliferate when bacteria are reduced in number, for example, when antibiotics are being taken for another condition.
NB: Topical thrush treatments can reduce the effectiveness of contraceptives made from rubber.
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Topical Barrier Contraception
Condition Topical Barrier Contraception
OTC Treatment

Most OTC contraceptives use the barrier method to prevent pregnancy. These are male condoms, female condoms and diaphragms.
The effectiveness of barrier methods can be increased by using spermicidal creams or pessaries such as nonoxynol.
For OTC products, read Contraception/Vaginal Creams

Other information

Barrier methods of contraception help prevent pregnancy and also help to avoid the transmission of sexually transmitted diseases, such as HIV infection, during intercourse.

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Period Pains
Condition Period Pains
Symptoms - Cramping, colicky pains in the lower abdomen, back and possibly legs, starting within a day or two of the start of bleeding and going on until a day or two after.
- There may be other symptoms, including nausea, vomiting, stomach discomfort, constipation, headache, backache, fatigue, faintness and dizziness.
OTC Treatment - All the main OTC pain relievers -aspirin, ibuprofen and paracetamol - can be used.
- Aspirin and ibuprofen directly counteract the prostaglandins that cause the contractions of the uterus and hence the pain, and should in theory be more effective than paracetamol. However, paracetamol is found to be just as or more effective by many women. Aspirin should not be used by girls under the age of 16.
- Some women find that taking a product containing codeine as well as ibuprofen or paracetamol is more effective than either on its own.
For OTC products, read Period Pains
Other self-help

- Taking moderate exercise may help period pain, as it raises the levels of endorphins, the body's own natural 'painkillers'.
- Simple measures, such as a hot water bottle held across the abdomen (but not in direct contact with the skin), can also help with the pain.

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Pre-menstrual tension
Condition Pre-menstrual Tension (PMT)
Symptoms - PMS does not usually affect women under 30. It may worsen with age, and sometimes becomes continuous during the menopause, stopping finally when the menopause is over
- Symptoms start a week or more before menstruation and subside once a period has started
- Symptoms fall into three groups: physical, psychological and neurological (affecting the body’s nervous system)
- Physical symptoms include: water retention causing bloating, swelling of the abdomen and ankles, a feeling of heaviness, breast tenderness, constipation, nausea and vomiting
- Psychological symptoms include: anxiety, irritability, nervousness, agitation, anger, insomnia, difficulty in concentrating, lack of energy, depression, tiredness, and increased or decreased appetite
- Neurological symptoms include: headache, dizziness, fainting, tingling in the hands and/or feet, and palpitations
OTC Treatment - There is little of proven value available for self-treatment of PMS
- Vitamin B6 is thought to be of some help for psychological symptoms, but very high doses for long periods should not be taken as it can cause nerve damage
- Vitamin A, magnesium and calcium may be helpful, but more scientific evidence is needed
- Evening primrose oil has been recommended for PMS, especially breast tenderness, but recent research has found it not to be very effective
- A herbal preparation made from Agnus castus (Chaste tree) fruit, has been traditionally used to treat PMS, and there is some evidence that it is effective, although more proof is needed
Other Treatment - Cutting down on salt and fluid intake for a few days before a period can help reduce ‘heaviness’ and bloating
- Relaxation and stress relieving activities, e.g. yoga
- Physical activities – sports, gym, etc – stimulate production of endorphins by the body, which relieve pain and lift mood
- Changes to diet and lifestyle, including reducing alcohol and caffeine intake and cutting down on cigarettes
- ‘Complementary’ therapies, such as hypnosis and acupuncture, may work for some sufferers
Prescription Treatment

- Diuretics for water retention and bloating
- Hormones to correct imbalances causing PMS
- Antidepressants for psychological and some physical symptoms

Vaginal Dryness
Condition Vaginal Dryess
Symptoms Vaginal dryness is one of the effects of the menopause. As the ovaries reach the end of their functioning life production of the hormone oestrogen decreases. Among the many changes in women’s bodies caused by lack of oestrogen are thinning of vaginal skin and drying up of the secretions that lubricate the vagina. This can lead to soreness and irritation and can make sexual intercourse uncomfortable or even painful. As vaginal secretions decrease they also lose the acidity that helps protect the vagina against bacterial infections (although this change actually also reduces the risk of vaginal thrush).
OTC Treatment - Vaginal lubricants
- K-Y Jelly (Johnson & Johnson MSD) is a short-acting lubricant that can be used just before intercourse
- Replens MD (Anglian Pharma S&M) is a specially formulated vaginal lubricant. It attaches itself to the vaginal wall, and absorbs water and moisturises it. It also makes the vaginal wall more acidic, providing protection against infection. An application works for up to 72 hours, and it is intended to be used three times a week continuously.

Prescription Treatment

Hormone replacement therapy (HRT) counteracts the symptoms of the menopause, including vaginal dryness.

Emergency Contraception
Condition Emergency Contraception
OTC Treatment - Emergency contraception is available without prescription at pharmacies in the form of Levonelle One-Step (Schering Health Care). It consists of a single tablet containing levonorgestrel, a female hormone that is also used in a smaller dose in the ‘mini-pill’ contraceptive. Over many years of use levonorgestrel has been found to be safe and virtually trouble free.
- To be effective Levonelle must be taken as soon as possible, and no more than 72 hours after unprotected intercourse. If taken within 24 hrs, it is 95% successful; between 25-48 hrs, 85%; and between 49-72 hrs, 58%. If your period is more than five days late after taking Levonelle you should have a pregnancy test.
- Levonelle works in one of three ways, depending on the stage in the menstrual cycle that it is taken. It may prevent ovulation, i.e. stop an egg being released from the ovary, it may prevent sperm from fertilising an egg that has already been released, or it may stop a fertilised egg from attaching itself to the lining of the womb.
- Levonelle will not abort an established pregnancy. If you are already pregnant from a previous intercourse when you take it, the pregnancy will continue.
- Levonelle is available for women aged 16 and over. Under 16s would need either to see their GP or visit a family planning or NHS Walk-in Centre for a supply. If all of these are closed it may be possible to get Levonelle from a hospital A&E department. In some areas of the country there are schemes that allow girls under 16 to be supplied with Levonelle from pharmacies.
- When you go to a pharmacy for Levonelle you will be asked some questions by the pharmacist, or you may be asked to fill in a short questionnaire, to make sure that it is safe for you to take it and that you are not already pregnant. The pharmacist should talk to you in a part of the pharmacy where there is some privacy.
- The most common side-effect of Levonelle is nausea (feeling sick), which about one in five women who take it experience. Vomiting is very rare, but if you are sick within three hours of taking the tablet you should take another one immediately. Other possible side-effects are bleeding outside of normal menstruation, low abdominal pain, headache, dizziness and breast tenderness, but they are usually mild and do not last long.
- Some medicines should not be taken with Levonelle. The pharmacist will ask you about any medicines you are taking, and will consult your GP or ask you to go to see him or her if you are taking something that could cause a problem.
- You should only not take Levonelle if you have had a reaction to levonorgestrel in the past, if you suffer from a bowel disease such as Crohn’s disease that can prevent proper absorption of medicines, or if you have liver disease.
- Levonelle can be used repeatedly, but should only be used in ‘emergency’ situations and not as a regular contraceptive.
- If for any reason you cannot use Levonelle, emergency contraception can be provided by the fitting of an interuterine device (IUD) within five days of unprotected intercourse. This is nearly 100% effective and also provides long term contraception. is a directory of medicines and food supplements that are available 'over the counter' (OTC) from your pharmacist. The links below will take you to pages detailing products which may help treat or relieve the following symptoms:

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