How often should I have an STD test?

The simple answer is: every time you have unprotected sex with a new partner. Those people who find this advice alarming have (to my mind at least), not thought things through. The take home message is: if you have unprotected sex with strangers on holiday: (ANY mucous membrane (moist surface) contact at all!!), then attend your local GUM clinic once you get home, where you will receive excellent, confidential and professional care. As regards Cystitis: clearly prevention is better than treatment.

What can I do to avoid Cystitis on holiday?

The same advice your GP and your Mum gave: have a shower before bedtime, drink lots of water before sex, empty the bladder before (for reasons of comfort) and as soon as possible after sex, to empty the bladder again. This is to wash out any germs that may have gained entry to the bladder during sex. It is also important to avoid dehydration, as a more diluted germ laden urine is less likely to infect you.

What about Cranberry?

Cranberry has in fact been to show reasonable preventative action in UTI. However Cranberries are quite sour and not palatable to most people. If you can bite a lime or a lemon, you can take Cranberry. To make Cranberry palatable to most consumers, then either sugar is added or artificial sweeteners. The sugar can increase the chance of infection, especially in large amounts and the sweetener, depending on the type, may make the bladder more irritable.

How does Cranberry help?

The main germ seen in UTI is the patient’s own E Coli, the main bowel germ. AS E Coli has flagellae (like little legs), it can swim upstream into the bladder even without the mechanical assistance from sex. Cranberry makes the bladder wall more effectively “slippery” to the E Coli and they are washed out before they get a hold. It is a little like greasing a pole before someone tries to climb it.

Is there something more “chemical” to do this?

Yes, the sugar d-Mannose taken in doses of 1- 2 heaped teaspoons in water prior to intercourse, has the same action but acts more reliably in practice. Internet search will locate the cheapest sources of this. Only buy the powder, or it is too expensive.