Cranberry juice 'offers little protection against cystitis' For women who keep their fridges permanently stocked with Ocean Spray as a fail-safe against cystitis, this research will cause dismay. Cranberry juice is a traditional remedy which has long had scientific backing, the theory being that substances in it, called proantho-cyanidins, stop bacteria from sticking to the bladder lining. Only this summer, a review of 10 trials, published in the Archives of Internal Medicine, endorsed it as having a protective effect. Cystitis, characterised by the constant urge to pass urine and a painful burning sensation on trying to do so, strikes most women in Britain (and less commonly, men and children) at some point, with one in five suffering repeated attacks. The design of the female anatomy is partly to blame: women have a shorter urethra (the tube that carries urine from the bladder out of the body), allowing bacteria into the bladder more easily. Also, the urethral opening is close to the vagina and the back passage, which makes it easier for bacteria from this area to reach the bladder. "Most urine infections are caused by bugs from the anal area that have made their way into the urethra - the perfect haven to overproduce," explains Dr Helen Stokes-Lampard, a GP in Lichfield with a special interest in women's health. The urethra is also subject to friction during sexual intercourse. This leads to fine abrasions that can help the bacteria enter. All of which explains why strict personal hygiene is key to preventing cystitis, particularly when it comes to sex. "Washing the genital area before and after sex should be as routine as cleaning your teeth every night," advises the author and campaigner Angela Kilmartin. Dr Stokes-Lampard adds: "Emptying the bladder directly after sex will flush out bacteria, while for postmenopausal women, a lubricant during sex or HRT can both be protective." Drinking plenty of fluids and always emptying the bladder properly are also key to prevention. Women need to relax properly [when passing urine] and to ask themselves - have I really finished? Since cystitis can also be caused by irritation, the standard advice is to wear cotton underwear, as well as avoid perfumed soap on the genitals, tight jeans and any foods which might make it worse, such as coffee and spicy meals. Cystitis is easily treated with antibiotics. Anyone who feels unwell or feverish should see a doctor, as the infection may have travelled to the kidneys. "Patients shouldn't have unrealistic expectations about cranberry juice, but the research didn't show there is any harm in drinking it, so if you feel it helps, there is no reason to stop," says Dr Lampard-Stokes. Medical evidence is evolving as more research emerges. Next year, there may be another study - and the pendulum may swing the other way.