Are the Diagnosis and Treatment of Acute Cystitis in the Premenopausal, Pregnant, and Postmenopausal Women the Same? A Review of the Literature

Obstet Gynecol Surv. 2022 Mar;77(3):174-187. doi: 10.1097/OGX.0000000000000993.


Importance: Acute cystitis is a common condition diagnosed in women. The diagnosis and treatment of this condition change throughout a woman's life. Understanding the differences in diagnosis and treatment in premenopausal, pregnant, and postmenopausal woman increases the likelihood of treatment success and decreases risk of complications from untreated or suboptimally treated infections.

Objective: The aim of this review is to describe the incidence, risk factor, pathophysiology, diagnosis, and management of acute cystitis and the similarities and differences of these aspects of the condition in the premenopausal, pregnant, and postmenopausal woman.

Evidence acquisition: A PubMed, Web of Science, and CINAHL search was undertaken with the years 1990 to 2020 searched.

Results: There were 393 articles identified, with 103 being the basis of review. Multiple risk factors for acute cystitis have been identified and are largely consistent throughout a woman's lifetime with few exceptions. The diagnoses by group with common diagnostic tools, such as urinalysis, vary in specificity and sensitivity between these groups. Management also varies between groups, with pregnancy having specific limitations related to drug safety in regard to possible fetal effects posed by certain medications commonly used to treat acute cystitis.

Conclusions: Acute cystitis not only varies in presentation throughout a woman's lifespan, but also in appropriate diagnosis and treatment. Treatment of acute cystitis does have some commonalities between the groups; however, there are contraindications unique to each group. These differences are paramount to not only ensuring appropriate treatment but also treatment success.

Relevance: Acute cystitis is a common condition with different diagnostic and management recommendations throughout a woman's lifespan.

Publication types

  • Review

MeSH terms

  • Acute Disease
  • Cystitis* / diagnosis
  • Cystitis* / drug therapy
  • Female
  • Humans
  • Postmenopause*
  • Pregnancy
  • Prenatal Care
  • Treatment Outcome