Do I have a UTI or an STI?

UTIs and STIs can have very similar symptoms and both require a visit to the doctor

UTI or STI — some facts first

In the United States, urinary tract infections (UTI) account for 6 million patient visits annually, whereas all sexual transmitted infections (STI) amount to around 3 million cases, with roughly 80% of them being for chlamydia, gonorrhea and syphilis. And that’s 3 million for men and women combined, whereas over 90% of the 6 million UTI are women. So, statistically speaking, when you notice something is wrong with your pee or the process of peeing — a burning sensation, pain, strange color or odor — it’s more likely that it’s “just” a UTI. Of course, UTI is a very serious condition in its own right, with risks of complications and chronic reoccurrence, and absolutely requires a doctor’s visit. But it’s probably still better news than an STI.

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How to tell a UTI from an STI?

Well, only a doctor can do so with certainty after she ran some urine and blood tests on you. UTI and some STI have symptoms that overlap, so you can’t tell by simply looking at it. Even with testing it can be tricky at times. The American Society for Microbiology has noted that UTI and STI often are misdiagnosed, particularly in emergency rooms where’s not enough time for proper testing. One study concluded that ~65% of patients where an existing STI wasn’t discovered were diagnosed with UTI instead.

As you can see, thorough testing is very important and you definitely need to visit a doctor. However, here are a few guidelines on how a UTI is similar to STI and how it’s different. 

First let’s take a look which symptoms are similar:

  • Burning feeling during when urinating
  • Higher urination frequency and generally greater urge to urinate
  • Dark-colored, opaque urine
  • Strong, abnormal urine odor
  • Pain in the pelvic area

Essentially, all of the above are the typical symptoms of a simple UTI. But they also can be experienced with some STI. In the event that you have additional symptoms on top of the above list, it’s getting more likely that you may have an STI. These additional symptoms include:

  • Blisters inside the vagina and/or on the vulva
  • Blood in the urine even when you don’t have your period
  • Unusual vaginal discharge other than blood
  • Pain during sexual intercourse
  • Swollen joints
  • Sore throat 
  • Fever 

Any combination of these additional symptoms makes it more likely that you have an STI rather than a UTI. However, there’s one important caveat: fever can also occur because of a kidney infection that was triggered by a simple UTI. That’s then called a “complicated UTI” and it happens when the immune system is weakened so much that bacteria can move from your bladder into your kidneys. Aside from the UTI symptoms and fever, other signature symptoms of kidney infections are whole body chills and pain in the flanks and back.  

Without treatment, a kidney infection will often end in death. However, kidney infections are quite rare: in the United States only about 100,000 women have kidney infections every year. That’s 1.7% of all annual UTI cases. Kidney infections usually are successfully treated and fatalities are rare. But it’s important that you see a physician right away when you suspect a kidney infection. 
  

References

  1. Storme, Oscar, et al. “Risk Factors and Predisposing Conditions for Urinary Tract Infection.” Therapeutic Advances in Urology, vol. 11, Jan. 2019, p. 175628721881438, www.ncbi.nlm.nih.gov/pmc/articles/PMC6502981/, 10.1177/1756287218814382. Accessed 11 Feb. 2020.
  2. Tomas, Myreen E., et al. “Overdiagnosis of Urinary Tract Infection and Underdiagnosis of Sexually Transmitted Infection in Adult Women Presenting to an Emergency Department.” Journal of Clinical Microbiology, vol. 53, no. 8, 1 Aug. 2015, pp. 2686–2692, www.ncbi.nlm.nih.gov/pubmed/26063863, 10.1128/JCM.00670-15. Accessed 11 Feb. 2020.
  3. Ayan Sabih, and Stephen W Leslie. “Complicated Urinary Tract Infections.” Nih.Gov, StatPearls Publishing, 5 Mar. 2019, www.ncbi.nlm.nih.gov/books/NBK436013/. Accessed 11 Feb. 2020.

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