UTI Symptoms: Early Signs, Causes & When to See a Doctor

A urinary tract infection (UTI) is an infection that can affect any part of the urinary system, which includes your:

• kidneys – the organ responsible for producing urine
• ureters – the tube that carries urine from the kidneys to the bladder
• urethra – the tube that carries urine from your body
• bladder – the organ that stores urine

Most UTIs involve the lower urinary tract, affecting the bladder and urethra, and are called a lower UTI. Less commonly, the infection can spread upwards towards the ureters and kidneys. Upper UTIs are more serious than lower UTIs.

Here are some of the differences between upper and lower UTIs:

What is a chronic UTI?

A chronic UTI is an infection that does not go away with treatment or keeps coming back. Some people can get UTIs several times a year.

Chronic UTIs can be caused by the bacteria becoming resistant to the antibiotics you are given, underlying health conditions, or issues within the urinary tract that make it easier for infections to develop.

Chronic UTIs can have a significant impact on your quality of life and may require more specialised tests to diagnose, and long-term treatments and management strategies to stop them coming back.

Is cystitis the same as a UTI?

Yes, cystitis is a type of UTI that affects the bladder and is caused by bacteria. It can cause symptoms like painful urination and needing to pee more often and more urgently than usual.

It’s different to interstitial cystitis, also known as bladder pain syndrome (BPS), which is a chronic condition that causes similar symptoms but has no clear cause.

The most common cause of a UTI is bacteria, usually Escherichia coli (E. coli). It’s estimated that E. coli is responsible for causing around 75% of uncomplicated UTIs and more than 50% of complicated ones.

It commonly lives in the bowel, so can be transferred from the anus into the urinary tract causing an infection. Women are most at risk of UTIs because they have a shorter urethra and the urinary tract is closer to the anus than in men.

Rarely, UTIs can be caused by fungi or by viruses, especially in people with weakened immune systems.

Who is at risk of getting a UTI?

Some people are more at risk of developing a UTI because of their health, anatomy or lifestyle. Common risk factors include:

• age – older adults are more susceptible to UTIs because of immune system changes, reduced bladder emptying, and in some cases, the use of catheters or other medical devices
• a history of UTIs – if you’ve had a UTI before, you’re more likely to get another one, with 25% to 30% of women reporting their infection returning within 6 months
• pregnancy – hormonal changes during pregnancy can slow the flow of urine, increase the physical pressure on the bladder, and a weakened immune system can increase your risk of developing a UTI
• diabetes – high blood sugar levels can weaken your immune system, and make it more difficult for your body to fight off infections, including those in the urinary tract
• kidney stones – kidney stones can block or irritate the urinary tract, increasing the risk of infections
• weakened immune system – if your immune system is weak, it can increase the risk of UTIs because your body is unable to fight them off as well as someone whose immune system is working as it should
• dehydration – if you do not drink enough fluid, your urine production lessens, making it more concentrated, which can irritate the urinary tract and provide an environment where bacteria can thrive

Women are at a higher risk of developing a UTI than men because of the following factors:

• anatomy – women have a shorter urethra than men, which means bacteria have a shorter distance to travel to reach the bladder, making a UTI more likely
• sexual activity – sexual intercourse can introduce bacteria into the urethra, increasing the risk of infection
• use of diaphragms – certain contraception methods, like diaphragms, can put pressure on the urethra and reduce bladder emptying, which can encourage bacterial growth
• post-menopause hormonal changes – following menopause, oestrogen levels decrease, which can thin and weaken the tissues of the urinary tract, reducing its natural defence against infections

Common symptoms of a lower urinary tract infection include:

• pain or burning sensation when going for a pee (dysuria)
• needing to pee more often than usual, including at night (nocturia)
• sudden urge to pee or more urgently than usual
• cloudy or strong-smelling pee
• lower abdominal pain or back pain
• a raised temperature

Recognising the symptoms of a UTI can help you self-manage or seek early treatment, if needed, to avoid complications.

Men and women will experience similar UTI symptoms, including pain or burning when going for a pee, and an increase in frequency and urgency.

Common upper tract UTI symptoms

If a UTI spreads to the kidneys, it’s called an upper urinary tract infection, and this can cause more severe symptoms, such as:

• high fever
• chills and shivering
• pain in the back or side, just below your ribs
• feeling and being sick
• generally feeling unwell
• weakness
• confusion

If you are experiencing any of these symptoms, you should ask for an urgent GP appointment or call the NHS 111 service.

Can you have a UTI without symptoms?

Yes, it is possible to have a UTI and not have any symptoms. This is known as asymptomatic bacteriuria, a very common condition where the risk of developing it increases with age. For example, the incidence rate is:

• at least 15% in men and women aged 65 to 80
• as high as 40 to 50% in people over the age of 80

Even if there are no symptoms, bacteria are still present in the urinary tract. However, most people do not require treatment unless they are undergoing specific urological treatments or are pregnant.

How long does a UTI last?

Although they can be uncomfortable, UTIs usually pass within a few days to a week. If you require antibiotic treatments, you should notice an improvement in your symptoms within 3 to 5 days.

Chronic or complicated UTIs may need a longer course of antibiotics, or you may need further tests to identify the underlying cause.

Spotting the signs of a UTI early can help stop it from developing into a more severe infection. Early or mild symptoms can be easily overlooked, but paying attention to these subtle changes in your habits or the way you feel can make a big difference. Look out for:

• a mild burning or stinging sensation when you pee
• a sudden need to urinate or making extra trips to the bathroom, even if you only pass a small amount of urine
• mild lower abdominal or pelvic pain or discomfort, like a dull ache or a feeling of pressure in your stomach
• cloudy or darker urine than usual or strong-smelling pee
• feeling like you haven’t fully emptied your bladder

You should contact a doctor if:

• this is your first UTI
• your symptoms do not get better within a few days
• your symptoms are getting worse, including a high temperature, back pain, or being sick
• you’re pregnant and suspect you have a UTI
• you are a man and you have UTI symptoms
• your symptoms have returned after antibiotic treatment
• you have an underlying health condition that affects your immune system, like diabetes or HIV
• you have blood in your pee

While some mild UTIs can clear up on their own, it’s important to know when to see a doctor for treatment. They will be able to test your urine to diagnose a UTI or provide antibiotic treatment if your symptoms are persistent or getting worse.

How are UTIs diagnosed?

Doctors can diagnose a UTI based on your symptoms and a simple urine test. You will need to provide a pee sample, and your doctor can test it using a simple dipstick analysis kit during your appointment. They may also send it to the lab for further testing to check what bacteria could be present.

Alternatively, you can quickly and conveniently test your urine yourself by requesting an at-home UTI TestCard from Superdrug Online Doctor. Each kit comes with everything you need to test your pee, and using an app on your phone, you’ll receive your results almost straight away.

Can a pharmacist prescribe antibiotics for a UTI?

Yes, pharmacists can prescribe antibiotics to women aged 16 to 64 who have an uncomplicated UTI. If you are a man and you have UTI symptoms, you will need to see a doctor.