A Question of Health: New solutions to the old cystitis problem

Q. Are there any new treatments for cystitis? I have tried nearly everything - cranberry juice, drinking plenty of fluids, avoiding alcohol and sugar, abstinence from sex - but I still seem to get it at least six times a year.

Q. Are there any new treatments for cystitis? I have tried nearly everything - cranberry juice, drinking plenty of fluids, avoiding alcohol and sugar, abstinence from sex - but I still seem to get it at least six times a year.

A. I can contribute a couple of new ideas and one very old suggestion to your list of treatments for women who are plagued by cystitis (I assume you are a woman, because cystitis is much more common in women than in men).

First, if you ever decide to take up sex again, you should empty your bladder both before and after intercourse. Second, you should talk with a doctor about the possibility of keeping a supply of antibiotics in your medicine cupboard. A single dose of antibiotic at the first sign of cystitis will often prevent it from developing. Some women who get cystitis after sex even take an antibiotic tablet just before having sex, and this can prevent cystitis the next day.

The old suggestion is that you get hold of a copy of Cystitis, by Angela Kilmartin (published by Thorsons). It is the bible of cystitis sufferers and although it was published more than 25 years ago, it is still available, and still full of good ideas.

Q. I took the contraceptive pill (Dianette) for eight years, and stopped about nine months ago. Since then I have been trying to get pregnant, without any success. I am 33 and my periods have never been very regular, apart from when I was taking the pill. Since stopping the pill, they seem to be even more irregular than previously. How long after stopping the pill does it take for fertility to return to normal?

A. The contraceptive pill does not cause infertility, but it can delay the return of fertility by up to a year. But I wonder if your difficulty getting pregnant is being caused by some underlying factor that is nothing to do with the pill.

Dianette is a pill that is often used for women who suffer from acne or too much body hair. If your periods have always been irregular, and you were put on Dianette to help one of these other problems, you could have a condition known as Polycystic Ovary Syndrome. This also interferes with ovulation, which is an essential part of conceiving. The time is now right to have a few tests to find out why you are not getting pregnant.

Q. I want to get fit by taking up either jogging or swimming, but I don't know how to begin. Any suggestions?

A. There is no absolute rule about how to start exercising, apart from "start slowly and build up gradually". If you are pretty unfit, you should start with brisk walking or gentle swimming for about half an hour, three times a week. Over the first few weeks, you can speed up in the pool, or intersperse jogging with walking. By week four it will become much easier.

You can calculate your target pulse-rate when you are exercising by subtracting your age from 220, and then taking 70 per cent of that figure. If you are 30, this would be 133 beats per minute, at 40 you should aim for 126 beats per minute, and at 50, 119 beats per minute.

Please send your questions to A Question of Health, 'The Independent', Independent House, 191 Marsh Wall, London E14 9RS; fax: 020-7005 2182; or e-mail to: health@ independent.co.uk.

Dr Kavalier regrets that he is unable to respond personally to questions