UTI or STI? How to spot the difference

A sudden burning sensation while urinating can get your mind racing back to activities of the past few weeks. ‘Did I wipe front to back? Did I use a condom?’ These are perfectly normal thoughts that may go through your head before seeing a doctor for a potential urinary tract infection (UTI) or sexually transmitted infection (STI).

To help you spot the difference between the two easily mistaken infections and better understand your health, I’ve compared the common symptoms of each and shared tips for prevention and next steps. Two things to remember before reading further: you should never be ashamed about discussing UTIs and STIs with your doctor, and it’s possible to have both at the same time.

What’s a UTI?

A UTI is an infection that happens along your urinary tract or in the kidneys. It’s a very common condition, affecting more than 150 million people every year. Bacteria around your genitals (e.g. from your skin or fecal matter) that enters your urinary tract is the most common cause. Some people can get a UTI after sex — this doesn’t necessarily mean it’s an STI — sex can be another way for bacteria to enter your body from the outside.

The bladder is a very nice and accommodating place for bacteria to grow, and stagnant urine helps them multiply. There are several common bacterial strains that can cause a UTI, from Escherichia coli to Enterococcus faecalis — read more to get to know them by name.

Women are more likely than men to have UTIs because their urethras — the tube that connects the bladder to the outside world — are shorter.

Signs it’s more likely to be a UTI:

• Burning sensation while urinating
• Passing urine more frequently than usual
• Cloudy urine, although infection is still possible if urine is clear
• Slight pain in the lower abdomen or pelvis
• No abnormal discharge
• Blood in the urine is more common in UTIs, but also a symptom of some STIs

Best mode of prevention:

• Wipe from front to back after going to the toilet — this is especially important for women.
• Pee within 20 minutes after vaginal sex.
• Drink plenty of water so fluid is always moving through your system.

Best mode of action after infection:

• If your symptoms are mild and you don’t have a fever, keep well hydrated (2–3 liters of water a day, but no need to overdo it).
• If the symptoms are severe or persist after 24 hours, see your doctor for a consultation and potential treatment.
• Try not to hold in your pee, even if it hurts. Keep it going!
• It’s common for women to get UTIs every now and then, but if they occur very frequently, or become severe often, you should see your doctor.

What’s an STI?

Transmitted through unprotected — and sometimes protected — sex, STIs may not cause symptoms right away. They are also very common — more than 1 million STIs are acquired every day, worldwide. Several sexually transmitted bacteria and parasites such as chlamydia, gonorrhea and trichomonas vulvovaginitis share some similar symptoms with UTIs, including a burning sensation while peeing and pain in the lower abdomen. Viruses can also be transmitted through unprotected sex, including herpes, HIV, Hepatitis B, and HPV (human papillomavirus).

Signs it’s more likely to be an STI:

• Abnormal discharge — 50% of women will get vaginal discharge if they have gonorrhea, and men may get discharge from the penis
• Blisters and/or genital rash
• Pain during intercourse
• Itchiness
• Lumps in the groin
• Heavier, more painful periods (and in some cases bleeding outside of normal periods)

Best mode of prevention:

• Condoms! However, nothing is 100% secure. If you are concerned you might have an STI even after safe sex, check with your doctor.

Best mode of action after symptoms:

• Even if you’re sure about whether it’s a UTI or an STI, see your doctor.
• If it does turn out to be an STI, inform your partner(s) if possible, so they can get tested too.

At the clinic, we ask specific questions such as ‘Did you use a condom?’ or ‘Did you have multiple sexual partners?’ — not so we can judge you, but to help organize what further tests you may need to guide the correct, effective treatment. So don’t be shy or feel ashamed about your answers. We’re here to help!

To your health,

Dr. Shubs

The personal opinions of our writers are their own. All interviewees are trained medical experts, but all information should be regarded as helpful suggestions and not a formal medical diagnosis or advice.