STIs vs UTIs: How to Tell the Difference

When Symptoms Overlap

Burning or pain when you urinate is uncomfortable and worrying. The two most common causes – urinary tract infections (UTIs) and sexually transmitted infections (STIs) – can produce very similar symptoms.

Understanding the differences can help you seek appropriate care, though ultimately testing is often needed to know for certain.

Understanding UTIs

What Is a UTI?

A urinary tract infection is a bacterial infection of any part of the urinary system:

• Bladder (cystitis): Most common type
• Urethra (urethritis): Infection of the tube carrying urine out
• Kidneys (pyelonephritis): More serious, upper UTI

How UTIs Occur

• Bacteria (usually *E. coli* from the bowel) enter the urethra
• Not sexually transmitted, though sex can increase risk
• More common in women due to shorter urethra

Classic UTI Symptoms

• Burning or stinging when urinating – the hallmark symptom
• Frequent urge to urinate
• Passing small amounts of urine
• Cloudy or strong-smelling urine
• Blood in urine (pink or red tinge)
• Lower abdominal discomfort or pressure
• Feeling unwell (especially with kidney infection)

UTI Risk Factors

• Being female
• Sexual activity
• Using certain contraceptives (spermicides, diaphragms)
• Menopause
• Urinary tract abnormalities
• Recent urinary procedures

Understanding STIs That Cause Similar Symptoms

Several STIs can cause urinary symptoms:

Chlamydia

• Can infect the urethra in both sexes
• May cause burning urination, discharge, or no symptoms
• Often asymptomatic (especially in women)

Gonorrhoea

• Commonly causes urethral symptoms in men
• Burning urination, discharge (often yellow/green)
• May be asymptomatic in women

Trichomoniasis

• Parasitic infection
• Can cause urinary discomfort, discharge, irritation
• Often asymptomatic

Herpes

• If sores are near the urethra
• Can cause extreme pain on urination
• Usually accompanied by visible blisters/sores

Mycoplasma genitalium

• Increasingly recognised STI
• Causes urethritis symptoms similar to chlamydia

Key Differences: UTI vs STI

Discharge

UTI: Typically no unusual genital discharge

STI: Often accompanied by discharge

• Chlamydia/gonorrhoea: Discharge from penis or vagina
• Trichomoniasis: Frothy, yellow-green discharge with odour

Location of Discomfort

UTI: Focused on urinary tract

• Burning during urination
• Bladder pressure/discomfort
• Urinary urgency and frequency

STI: May involve genital area more broadly

• Discharge or irritation
• Itching
• Sores or unusual bumps
• Pelvic or testicular pain

Other Symptoms

UTI might include:

• Cloudy or bloody urine
• Strong urine odour
• Fever (especially with kidney infection)

STI might include:

• Bleeding between periods
• Pain during sex
• Swollen lymph nodes
• Symptoms in sexual partners

Sexual History Context

More likely UTI if:

• No recent new sexual partners
• Recurrent UTIs in the past
• Recent factors increasing UTI risk (dehydration, holding urine)

More likely STI if:

• Recent unprotected sex with new partner
• Partner has known STI
• Symptoms in your partner too

The Overlap Problem

Here's the challenge: the symptoms genuinely overlap, and you can have both at the same time.

When It's Unclear

• Urethritis (infection of the urethra) can be caused by UTI bacteria OR STI bacteria
• Both cause burning urination
• Both may cause urinary frequency
• You cannot distinguish by symptoms alone in many cases

What Happens in Practice

Healthcare providers often:

• Test for both if symptoms are ambiguous
• Consider sexual history and risk factors
• May treat presumptively while awaiting results

Getting the Right Diagnosis

When to See a Doctor

Seek medical advice if you have:

• Painful urination lasting more than a day
• Blood in your urine
• Fever alongside urinary symptoms
• Lower back pain (possible kidney infection)
• Any unusual discharge
• Symptoms after unprotected sex

Testing Options

For UTI:

• Urine dipstick test (quick, in-clinic)
• Urine culture (confirms bacteria and guides treatment)

For STI:

• Urine sample test for chlamydia and gonorrhoea
• Swab tests if indicated
• Blood tests for HIV, syphilis, etc.

Where to Get Tested

• GP surgery
• Sexual health clinic (GUM clinic)
• Walk-in centres
• Online STI testing services

Treatment Differences

UTI Treatment

• Antibiotics (trimethoprim, nitrofurantoin commonly)
• Short course (3 days typical for women)
• Symptoms often improve within 1-2 days
• Drinking plenty of fluids helps

STI Treatment

• Specific antibiotics depending on the infection
• Chlamydia: Usually doxycycline or azithromycin
• Gonorrhoea: Ceftriaxone injection
• Partners need treatment too
• Test of cure may be recommended

What If You Treat the Wrong Thing?

• Taking UTI antibiotics won't cure an STI
• This delays proper treatment
• You may continue to transmit infection to partners
• Complications can develop

Prevention Strategies

Preventing UTIs

• Stay well hydrated
• Urinate when you need to (don't hold it)
• Urinate after sex
• Wipe front to back
• Avoid irritating products near the urethra

Preventing STIs

• Use condoms consistently
• Regular STI testing
• Open communication with partners
• Limiting number of partners

When to Consider Both

Get tested for STIs as well as UTIs if:

• UTI treatment doesn't resolve symptoms
• You have risk factors for STIs
• You have unusual discharge alongside urinary symptoms
• Your partner has symptoms too
• This is your first "UTI" and you're sexually active

The Bottom Line

Burning urination is uncomfortable and concerning, whether it's a UTI or an STI. Since symptoms overlap significantly, don't guess – get tested.

If you have risk factors for STIs, request STI testing alongside UTI testing. Proper diagnosis means proper treatment, faster recovery, and protection for your partners.

Get Tested Today

Don't let uncertainty linger. Our comprehensive testing covers both UTIs and STIs, ensuring you get the right diagnosis and treatment. Book your confidential test now.