- Controlled trials and studies are often limited in complementary and alternative medicine and involve small numbers of participants. They are often conducted under less rigorous controls, guidelines and environments than those undertaken for the development of new pharmaceutical medications such as antibiotics. Do your research, there should be clear, peer reviewed, empiric evidence as to the efficacy of D Mannose rather than theorisation about how it may be beneficial in the treatment of a chronic UTI.
- There are very limited patient research trial studies. More are needed and several are currently in trial publishing in 2020.
- Length of study and size of participant groups. Current studies available have shown trials of under one year and in small patient trial groups. This studypublished in the World Journal of Urology in 2013 noted that in their patient cohort of 399 women those taking D-mannose powder alone showed effectiveness in preventing UTI. However it fared no better than those women taking a daily prophylactic dose of nitrofurantoin and the recurrence rate did not differ between patients who took standard Nitrofurantoin prophylaxis and those who took D-mannose powder. This lack of scientific and clinical rigor applied to study design and outcomes is common with alternative therapies.
- In Vitro vs In Vivo. Most studies undertaken are either in laboratory known as “test tube conditions” or with the use of mice rather than human participants. Human behavioural, genetic, and environmental differences in comparison to those of mice mean it is difficult to compare like with like.
- Different strains of bacteria. Infections are now recognised to be polymicrobial (comprised of more than one bacteria). Not all bacterial strains have these Pili (grappling hooks) and thus D-Mannose molecules in the urine won’t be effective in binding these bacteria to them and expelling them through urination. Instead the bacteria will bind to the urothelium and form bacterial colonies. Indeed certain strains of UPEC do not create Pili.
- Once bacteria have attached to the cells of the bladder wall and started to reproduce, D-Mannose will not prevent the infection developing further.
- There has been insufficient research into the optimum dosage for the prevention of recurrent infections.
- For those with gastric issues such as Crohns or colitis, D-mannose may not be absorbed. Additionally, pathogenic e coli in the intestines may bind to most D-mannose available preventing sufficient molecules being filtered through the kidneys and into the bladder. Different people will react differently to the same D-mannose dose due to their age, weight, and overall health.
- Commercial D-Mannose powder is often made from corn, particularly the less expensive versions. For those with allergies, a reaction to D-Mannose derived from corn may include a mild rash headaches and stomach aches.
- Cost – as with any usage of a supplement on an intermittent or ongoing basis, there is a cost to you financially.
Archives: UTI Info Accordion
This is the UTI Info Accordion post type
Combined pill
Combined pill
There are many different brands of the combined pill, made up of three main types – combined 21 day pills, phasic 21 day pills and everyday (ED) pills.
21-day pills
This is the most common type. Each pill has the same amount of hormone in it. One pill is taken each day for 21 days and then stoped for the next seven days. Microgynon, Marvelon, Yasmine and Cilest are examples of this type of pill.
Phasic 21-day pills
Phasic pills contain two or three sections of different coloured pills in a pack. Each section contains a different amount of hormones. One pill is taken each day for 21 days and then stopped for the next seven days. Phasic pills need to be taken in the right order. Logynon is an example of this type of pill.
Every day (ED) pills
There are 21 active pills and seven inactive (dummy) pills in a pack. The two types of pill look different. One pill is taken each day for 28 days with no break between packets of pills. Every day pills need to be taken in the right order. Microgynon ED is an example of this type of pill.
Progesterone pill
The “traditional” progestogen-only pill (POP) prevents pregnancy by thickening the mucus in the cervix to stop sperm reaching an egg. The desogestrel progestogen-only pill can also stop ovulation. Progestogen-only pills contain the hormone progestogen, but don’t contain oestrogen.
Key points
You only have to use a diaphragm or cap when you have sex, but you must leave it in for at least 6 hours after the last time you had sex. You can leave it in for longer than this, but don’t take it out before.
You need to apply more spermicide if:
- you have sex again with the diaphragm or cap in place
the diaphragm or cap has been in place for three hours or more before you have sex - Don’t take the diaphragm or cap out to reapply spermicide.
You shouldn’t use a diaphragm or cap during your period as there is a possible link with toxic shock syndrome (TSS), a rare condition that can be life threatening.
Most women are able to use a diaphragm or cap, but it may not be suitable for you if you:
- have an unusually shaped or positioned cervix (entrance to the womb), or if you can’t reach your cervix
- have weakened vaginal muscles (possibly as a result of giving birth) that can’t hold a diaphragm in place
- have a sensitivity or an allergy to latex or the chemicals in spermicide
- have ever had toxic shock syndrome
- have repeated urinary tract infections
- currently have a vaginal infection (wait until your infection clears before using a diaphragm or cap)
aren’t comfortable touching your vagina - have a high risk of getting an STI – for example, if you have multiple sexual partners
Research shows spermicides that contain the chemical nonoxynol-9 don’t protect against STIs, and may even increase your risk of getting an infection.
A diaphragm or cap may be less effective if:
- it’s damaged – for example, it’s torn or has holes
- it’s not the right size for you
- you use it without spermicide
- you don’t use extra spermicide with your diaphragm or cap every time you have more sex
- you remove it too soon (less than 6 hours after the last time you had sex)
- you use oil-based products, such as baby lotion, bath oils, moisturiser or some vaginal medicines (for example, pessaries) with latex diaphragms – these can damage the latex
If any of these things happen or you’ve had sex without contraception, you may need to use emergency contraception.
Key points
Advantages and disadvantages
- each injection lasts for either 8 or 13 weeks
- it does not interrupt sex
- it’s an option if you can’t use oestrogen-based contraception
- you do not have to remember to take a pill every day
- it’s safe to use while you’re breastfeeding
- it’s not affected by other medicines
- it may reduce heavy, painful periods and help with premenstrual symptoms for some women
Disadvantages:
- your periods may change and become irregular, heavier, shorter, lighter or stop altogether – this can carry on for some months after you stop the injections
- Using Depo-Provera affects your natural oestrogen levels, which can cause thinning of the bones, but it does not increase your risk of breaking a bone. Sometimes the doctor may recommend that you stop after 2 years so there’s no long-term effect on your bones.
- it does not protect you against STIs
- there can be a delay of up to 1 year before your periods return to normal and you can become pregnant
- some people may put on weight when they use Depo-Provera or Sayana Press contraceptive injections
- you may experience side effects like headaches, acne, hair loss, decreased sex drive and mood swings
- any side effects can continue for as long as the injection lasts (8 or 13 weeks) and for some time after
Advantages and disadvantages
Advantages:
- it works for 3 years
- it doesn’t interrupt sex
- it’s an option if you can’t use oestrogen-based contraception, such as the combined contraceptive pill, contraceptive patch or vaginal ring
- it’s safe to use while you’re breastfeeding
- your fertility will return to normal as soon as the implant is taken out
- it may reduce heavy periods or painful periods
Disadvantages:
- you may experience temporary side effects during the first few months, like headaches, nausea, breast tenderness and mood swings
- your periods may be irregular or stop altogether
- you may get acne or your acne might get worse
- you’ll need a small procedure to have it fitted and removed
- it doesn’t protect you against sexually transmitted infections (STIs), so you may need to use additional contraception (such as condoms) as well
Key points
- don’t want your periods to change
- some medicines can make the implant less effective. These include complementary remedies, such as St John’s Wort, some antibiotics such as rifabutin or rifampicintake and medicines for HIV, epilepsy and tuberculosis. If you’re taking any of these medicines, you’ll need additional contraception (such as condoms), or you may wish to use a different method of contraception that isn’t affected by your medicine.
- have unexplained bleeding in between periods or after sex
- have arterial disease or a history of heart disease or stroke
- have liver disease
- have breast cancer or have had it in the past
- have a medical condition that may affect which contraception you can use – speak to your GP or practice nurse, or visit your nearest sexual health clinic to discuss further
Advantages and disadvantages
Advantages and disadvantages of the IUS
- It works for 5 years or 3 years, depending on the brand.
- Your periods can become lighter, shorter and less painful – they may stop completely after the first year of use.
- It’s safe to use an IUS if you’re breastfeeding.
- It’s not affected by other medicines.
- It may be a good option if you cannot take the hormone oestrogen, which is used in the combined contraceptive pill.
- It’s possible to get pregnant as soon as the IUS is removed.
Disadvantages:
- There’s a small risk of getting an infection after it’s been fitted. If you get an infection when you have an IUS fitted, it could lead to a pelvic infection or UTI if not treated.
- If you have an IUS fitted, you may have a slightly higher chance of getting thrush that keeps coming back. This is because candida spores can anchor to the strings of the IUS and despite treatment, the spores can keep causing reinfections. Speak to a GP if you keep getting thrush. You might want to think about trying a different type of contraception.
- Your periods may become irregular or stop completely, which may not be suitable for some women.
- Some women experience headaches, acne and breast tenderness after having the IUS fitted.
- Some women experience changes in mood and libido, but these changes are very small.
- An uncommon side effect of the IUS is that some women can develop small fluid-filled cysts on the ovaries – these usually disappear without treatment.
- An IUS does not protect you against STIs, so you may need to use condoms as well.
- If you get an infection when you have an IUS fitted, it could lead to a pelvic infection if it’s not treated.
- Most women who stop using an IUS do so because of vaginal bleeding and pain, although this is less common.
Key points
Key points
- breast cancer, or have had it in the past 5 years
- cervical cancer or womb (uterus) cancer
- liver disease
- unexplained bleeding between periods or after sex
- arterial disease or a history of serious heart disease or stroke
- an untreated sexually transmitted infection (STI) or pelvic infection
- problems with your womb or cervix