Please note that I am not a doctor and nothing in this post is intended to constitute medical advice. Always consult with a qualified healthcare practitioner before embarking on any treatments or making dietary or lifestyle changes. 

The clue to this month’s blog is in the title really!  I often speak to people who are unwittingly doing things that could be aggravating their bladder pain symptoms.  They might even be doing some of them under the advice of their health professional, because many health professionals are not aware that certain ingredients can be irritating to the bladder.  If you already know a lot about cystitis and interstitial cystitis, there won’t be anything new for you in this list.  However, a lot of people who visit the Tiny Pioneer site are only just starting out on their journey and I thought they might appreciate a list of exacerbating factors!  So here they are:  ten ways to make bladder conditions worse.  Lots of them can also apply to persistent genital arousal disorder, vulvodynia, lichens sclerosus and various other genitourinary conditions. 

1. Use toilet paper that has been impregnated with fragrance or lotion.  All that wiping of unnecessary chemicals around your secret places is bound to help and everyone knows a bit of artificial jasmine fragrance leaves you shower-clean after a bowel movement, right?! 
2. Following on from the above, use sanitary towels and panty liners that have been impregnated with fragrance too.  The UK market leading brand is the worst offender for this and I have no idea why they do it, because if any woman got close enough to another woman’s crotch to be able to smell it, I’m sure she’d recognise right away the distinctive smell of perfumed sanitary products that have been warming down there for a couple of hours.  They are fooling nobody! 
3. Use tampons and mooncups.  There won’t be anything irritating at all about walking round all day with something stuck up your vagina, where it can chafe your sensitive tissue and squash against your urethra. 
4. Take bubble baths and use plenty of soap to keep your intimate places clean.  Who cares if they dry out an area that’s meant to be moist and get yet more fragrance up a body part that actually cleans itself?  And what does the pH balance of your vagina matter to the good bacteria that live in it anyway?
5. Have lots of penetrative sex, especially roughly and in positions that you know to be high risk.  This can vary from person to person, but if it feels like your partner is repeatedly smacking into your urethra and bladder and you’re not really comfortable with it, it’s probably rough and risky enough.  Bonus points if you do it with a full bladder, don’t wee afterwards, and don’t take D-mannose before or after the event.     
6. Don’t drink enough/any water.  Becoming dehydrated is one of the very best ways to bring on a bout of cystitis.  It makes my hair stand on end now to think that as a teenager, I used to leave the house for school at 8am and not return home until 4.25pm, during which time I would take one small bottle of water to last me all day.  I can remember that sometimes in summer my throat would be dry from thirst, so it’s little wonder that I regularly got bladder infections.  The real wonder is that we didn’t ALL get bladder infections, as it was fairly standard practice for us all to have only one drink to last all day! The fact we’d regularly ask each other, “Have you got any drink left?” or, “Can I have some of your drink?” shows we were clearly all thirsty a lot of the time!
7. Drink plenty of coffee.  Lots of people with cystitis find it very irritating to the bladder.  Be sure to go somewhere like Costa or Starbucks at least a couple of times a week, even if you don’t drink any coffee at home.  This should be enough to keep any inflammation and irritation ticking over nicely all week long.  If you don’t like coffee, orange juice or alcohol should work instead. 
8. Eat lots of sugary foods.  They promote inflammation and infections in all sorts of ways.  Sugar is very bad for your gut microbiome and if that takes a hit, you increase your chances of leaky gut, which promotes body-wide inflammatory responses.  As cystitis is essentially inflammation of the bladder, having leaky gut should push your IC symptoms up a notch in no time.  Bonus points if the sugar is taken as part of foods that contain gluten and/or pasteurised dairy products, which are also highly irritating to the gut and promote inflammation.      
9. Take ascorbic acid – this is known to be very irritating to the bladder for lots of people, me included.  I think I’ve written before that I knew ascorbic acid made me feel cystitis-y long before I discovered that it is a known bladder irritant.  Ascorbic acid is a commonly used form of vitamin C (though vitamin C does also come in bladder-friendly forms, such as calcium ascorbate, magnesium ascorbate and sodium ascorbate).  Don’t just check your vitamin C though – check any and all of the supplements you take to see if they contain ascorbic acid.  In fact check your medications as well – one of the popular hot lemon drinks sold for cold and flu relief definitely has it in.  Doctors, urologists and nutritionists are NOT always aware that ascorbic acid is irritating to the bladder, so if they have recommended you to take a certain product, don’t automatically assume that it is free from ascorbic acid. 
10. Take vitamin B6 – this too is irritating to the bladder for lots of IC patients.  As with ascorbic acid, check all your medications and supplements for it.  Don’t assume that because your health professional advised you to take a certain product, that it does not contain vitamin B6.  Fewer people are aware that B6 can be a bladder irritant than for ascorbic acid.  I must say that I am fine with it, but I’ll only take it in the more readily absorbed P5P form and I do spread it out by a few hours (37.5mg in a morning with my multivitamin and B-complex and the same again in the afternoon).  For a few years in the worst of the PGAD days I eliminated it from my regime, but I started to get very bad PMS without it and eventually reintroduced it.

Obviously the above list is really a list of what NOT to do if you have cystitis, interstitial cystitis, or similar pelvic pain conditions!  As I said at the top, I know that most seasoned interstitial cystitis sufferers will know all of this already.  I know too that avoiding the things on the list alone is not normally enough to rid you of your cystitis symptoms; there are usually things you will need to proactively do and take to experience improvements.  However, continuing to regularly do even just a couple of items from the list can greatly hinder your healing process.  If you want to do them anyway, fully armed with the knowledge that they might be making your symptoms worse, that’s obviously your choice and you’ll get no judgement from me.  But I always feel sorry for people who think they are doing everything correctly and then realise with horror that their toilet paper or vitamin tablets could be keeping their symptoms active! 

This list is by no means exhaustive, but it represents a really solid start for the cystitis newcomer and hopefully someone somewhere will find it helpful.

Wishing you the best of health,

Tiny x

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