Magazine 15 June 2021

Causes of cystitis

  1. Anatomical Causes
  2. Infectious Causes
  3. Physiological Causes
  4. Other causes and risk factors
  5. Summary

Dear Reader,
Bacterial cystitis, as you probably already know, is an inflammation of the bladder and urinary tract.
It manifests itself through a series of symptoms such as burning, frequent and urgent urination, suprapubic pain and thick urine. The causes may vary from subject to subject also depending on age, sex and the presence of certain physiological or pathological conditions.

Most cystitis is caused by bacteria from the gut, mainly Escherichia Coli.

Bacterial infection is just one of the many factors that contribute to triggering cystitis.

If we only fight the bacteria, without acting on the other risk factors, sooner or later they will come back to bother us.

Today, I want to go over with you all the real causes of cystitis and make you more aware of the aspects you really need to work on!


Anatomical Causes

  • Germs can get into the bladder by traveling up from the external genitals to the urethra, especially in women. The anus in women is much closer to the urethra than in men.
    The urethra, the conduit through which we urinate, is 3 to 5 cm long in women, making it much easier for bacteria to come up from outside than in men.
  • Germs pass from the gut to the bladder internally.
    The intestinal wall normally acts as a selective barrier. The passage is allowed to small molecules, which have already been processed, but not to large molecules or germs.
    When there is inflammation of the intestine, as in irritable bowel syndrome, a so-called barrier violation takes place. The inflammatory state makes the wall of the intestine less efficient in performing its barrier role and, as a result, a passage of bacteria from the intestine into the blood and from the blood into the bladder takes place.

Infectious Causes

Cystitis can result from an infection of the bladder caused by bacteria (80% E.Coli), viruses and, in a minority form, by candida or other mycetes.
Bacteria, in particular, have a fibrous “armor” (called pili) that allows them to attach themselves to the cells that form the walls of the bladder, causing and facilitating inflammation.

Infection by these pathogens is not always and only related to anatomical reasons that see the transfer of bacteria from outside or internally. In fact, in a very similar way, the insertion of catheters, tampons or diaphragm for contraceptive purposes, can pave the way for bacteria increasing the risk of developing episodes of cystitis.

Physiological Causes

  • Menopause

The woman has estrogen receptors throughout her body, including the urinary tract. Estrogens are hormones that have the very important role of creating the ideal environment for the woman’s body to naturally defend itself from attacks by pathogens, such as bacteria.
In menopausa il livello degli estrogeni si riduce gradualmente, rendendo il corpo della donna più vulnerabile allo sviluppo di infezioni. The urinary tract, therefore, is also affected by these changes resulting in an increased likelihood of being a victim of cystitis.

The physical changes, which occur at this particular time in a woman’s life journey, make her more prone to urinary tract infections. As we age, the structure of the vagina and surrounding areas changes (including the bladder mucous membranes): as estrogen levels drop, the lining of theurethra thins and becomes more sensitive and the urethral muscles lose strength and tone. The result can be a weak bladder in which bacteria can easily proliferate, partly because of the change in pH levels typical of this phase.

  • Pregnancy

During pregnancy both progesterone and estrogen levels increase, reducing the tone of the urethra and bladder. The latter, as it expands, increases the tendency to develop infections.
In most cases, pregnant women develop asymptomatic bacteriuria: they have bacteria in their urine without the presence of any particular symptoms.

Other causes and risk factors for cystitis

  • Withholding Urine
    Withholding urine means not removing bacteria from the bladder. Stagnant urine is the ideal territory for bacteria to reproduce.
    Holding back urine is very common among men who have an enlarged prostate: the prostate gland is located around the neck of the bladder so the swelling of the gland increases the pressure on the bladder. This will make it impossible for the bladder itself to fill completely.
  • Change in the balance of bacteria
    The urinary tract has a very delicate balance of bacteria that is essential for keeping the system healthy. When one type of bacteria begins to prevail over the others, it is possible for cystitis to develop.
  • Stitichezza
    La stitichezza gioca un ruolo non indifferente nell’aumentare il rischio di cistite. The slowing and stagnation of stool creates a large accumulation of bacteria and a consequent high presence of these around the anal area as well.
  • Nutrition
    Poor nutrition is a factor that can contribute to the development or worsening of cystitis. A diet high in sugar or inflammatory foods, including caffeine or alcohol, intensifies symptoms. In addition, a diet low in fruits and vegetables can change the pH of urine, making it more alkaline. Alkaline urine is a more suitable environment for the growth of “bad” bacteria, while a slightly acidic environment would make it difficult for them to survive.
  • Sexual intercourse
    Sexual intercourse is not the direct cause of cystitis but, following it, irritation , micro-lesions and the passage of bacteria can occur which can trigger, in the 24-72 hours following intercourse, an attack of post-coital cystitis also known as honeymoon cystitis.
  • Low immune defenses
    If the immune system is weak, for example after an infection, the likelihood of cystitis incidence is higher because the “bad” bacteria go unnoticed.
  • Stress
    Stress is a factor that can worsen the symptoms of cystitis.

Now that you’ve come this far, I hope that
you’re more aware that fighting cystitis means
work on several fronts to solve the root causes
your own personal triggers.

Remember that true freedom is awareness!

Take a moment to think about which of the factors I’ve listed you feel are closest to your case and remember you can contact me in chat or by email 😊

Also take a look at all the Cystitis Treatment and Prevention Kits.

I’ll see you soon.



Cystitis can be triggered by a variety of causes, beyond the invasion of the urinary tract by pathogens:

  • In women, the proximity of the anus to the urethra and the short length of the latter, facilitates the passage of bacteria to the bladder from the outside.
  • Situations that lead to a physiological change in oestrogen levels such as menopause and pregnancy
  • Wrong behaviours such as holding back urine, eating a diet based on sugar and inflammatory foods, failure to take care of intestinal well-being
  • Pathological situations such as diabetes
  • Weak immune defenses and stress
  • Microlesions and passage of bacteria from sexual intercourse

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