Urinary Tract Infections (UTIs) in Women: Symptoms, Causes, and More

Urinary tract infection (or UTI) is a common health problem. Between 40% and 60% of women will have at least one UTI in their lifetime. A UTI happens when bacteria from the skin or rectum get into the urinary tract. This can lead to infection and inflammation in the urinary tract. 

UTIs are most common in women who have a vulva and vagina. But they can happen in women with other types of genitals as well. Every woman’s anatomy is unique, which means some women are more prone to infections than others.

Some women may have recurrent UTI, defined as three or more UTIs in a year. Fortunately, there are steps you can take to help prevent UTI. Here’s a guide to everything you need to know about UTIs.

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What causes UTIs in women?

A UTI is caused by bacteria from your skin or rectum entering the urinary tract and causing an infection. Bacteria can enter and thrive in the urinary tract for a variety of reasons. Common reasons women may get a UTI include:

• Holding in urine for an extended period of time

• Being dehydrated

• Engaging in sexual activity

• Using unlubricated condoms

The female urinary system

Some women have different types of genitals. Depending on your anatomy, you may be more or less likely to get UTIs. People with female genitals are more likely than other people to get UTIs. That’s because of the female anatomy. 

In most women, the urethra (the tube that passes urine from the bladder out of the body) is shorter and closer to the rectum. This means that bacteria don’t have as far to travel when they enter the urinary tract. And it’s much easier for an infection to start. 

What are the symptoms of UTI in women?

Symptoms of UTI in women are similar to symptoms in most adults. They often include: 

• A burning sensation when you pee (dysuria)

• Lower belly or pelvic pain

• A frequent need to pee

• A strong urge to pee immediately

• Cloudy or bloody urine

• Foul-smelling urine

Sometimes a UTI can become serious, and you need to seek treatment immediately. Signs of a serious infection include:

• Fever

• Chills

• Nausea

• Vomiting

• Pain in your lower back or side

What are the risk factors for UTI in women?

There are certain factors that make you more likely to get a UTI. These include:

• Having a condition that affects the immune system (such as HIV or diabetes)

• Being sexually active

• Being pregnant

• Having had a UTI in the past

• Having a heavier body weight

• Using a urinary catheter

• Experiencing anything that blocks the flow of urine, such as a kidney stone

• Using spermicide as birth control

• Going through menopause

How do you diagnose a UTI in women?

If you think you might have a UTI, it’s best to get it checked out. Your healthcare provider can help confirm the diagnosis with some quick and easy tests. 

Urine tests

In your visit, your provider will ask about your symptoms and get a urine sample. Your urine will be tested in the office for white blood cells and nitrites, which are produced by bacteria. Both of these are signs of an infection. The combination of symptoms and urine test results will help confirm the diagnosis.

Your urine sample might also be sent to a lab to see if any bacteria grow from it. This test can help make sure you get the right antibiotic for your infection. This is usually needed if:

• You have started antibiotics, but your symptoms aren’t getting better.

• Your provider thinks you have a more serious infection, such as pyelonephritis (infection of the kidneys).

• You have recurrent UTIs.

Other tests

You may also need to have imaging tests if you have other symptoms or you don’t get better with antibiotic treatment. Tests may include:

• CT scan: This looks for any blockage to your urine flow.

• Cystoscopy: This looks inside the bladder.

• Ultrasound: This looks for any problems with the structure of the kidneys or urinary tract. 

• Voiding cystourethrogram (VCUG): A VCUG tracks how urine flows through the urinary tract.

How can you tell if it’s a UTI or another type of infection?

Sometimes it can be hard to tell based on symptoms alone. Your provider will make sure your symptoms aren’t from a different type of infection. Infections that can look like a UTI include sexually transmitted infections (STI) and yeast infections.

Both UTI and other vaginal infections can cause burning when you pee. But vaginal infections are more likely to have symptoms like:

• Vaginal discharge

• Vaginal itching

• Vaginal irritation

Are UTIs dangerous in women?

Usually a UTI isn’t serious and can be treated easily. But sometimes a UTI can be dangerous. If a UTI that affects the bladder (cystitis) is not treated soon enough or with the right antibiotic, it can travel to the kidneys (pyelonephritis). This is a more serious infection that may cause hospitalization. It can also cause long-term damage to the kidneys.

UTI in pregnancy

During pregnancy, even simple UTIs can be concerning. Cystitis in pregnancy can cause harm to both the mother and the baby. Complications of UTI in pregnancy include: 

• Preterm labor

• Anemia

• Sepsis 

This is why urine samples are a part of prenatal visits — to check for a UTI. Sometimes people may need to be retested after treatment to be sure the infection is gone.

Although it may sound scary, the good news is that UTI in pregnancy is treatable. Several antibiotics work well against UTI in pregnancy. Just be sure to follow your provider’s advice and finish all of your medication.

How do you treat a UTI in women?

The treatment for a simple UTI is a short course of antibiotics, such as:

• Nitrofurantoin (Macrobid)

• Trimethoprim/sulfamethoxazole (Bactrim)

• Fosfomycin (Monurol)

• Ciprofloxacin (Cipro)

• Levofloxacin (Levaquin)

How long you need to take the antibiotic depends on which one your healthcare provider prescribes. The average length of time you’ll need to take the medication can vary between 1 and 7 days. 

Most symptoms start to go away after 1 or 2 days of treatment with antibiotics. But it’s important to take all of the medication — no matter what. Otherwise the infection could come back. Don’t save any pills for later or share them. If you experience side effects from your antibiotics and can’t continue taking them, let your healthcare provider know.

Longer treatment is needed if your infection travels beyond the bladder and becomes a kidney infection. In some cases, you may even need treatment with IV (intravenous) antibiotics in the hospital. This is commonly the case with a UTI in pregnancy.

Can a UTI go away on its own?

It’s possible for a simple UTI to go away on its own, but it’s difficult to predict when this can happen. That’s why providers recommend treating UTIs with antibiotics when you begin having symptoms. This is especially true if: 

• You have chronic medical conditions (like diabetes or kidney disease).

• You are pregnant.

• You are older in age.

• You are experiencing a fever or vomiting.

Can you prevent a UTI in women?

UTIs can be very uncomfortable. If you’ve ever had one, you probably want to know how to keep it from coming back. The good news is that there are steps you can take to help prevent UTI:

• Change your birth control method. If you use a spermicide-based birth control, consider switching to a different method.

• Improve your bathroom habits. Recommendations include wiping from front to back after you pee, not holding urine when you feel the need to go, and urinating right after sex. The evidence to support these tips is not robust, but there’s no harm in following these habits.

• Try vaginal estrogen. Estrogen replacement after menopause can help prevent UTIs.

• Consider antiseptics. Antiseptics like methenamine hippurate can help prevent bacteria growth in the urine. This may be helpful for UTI prevention.

• Drink more water. If you drink less than 1.5 liters of water a day, doubling your fluid intake can reduce your risk of repeat UTI by as much as 50%.

Natural alternatives for UTI prevention

You may also consider natural alternatives or supplements for UTI prevention. These include:

• Probiotics: Probiotics may be useful in UTI prevention, but the evidence is mixed. More research is needed to tease out which probiotics might be most beneficial.

• Cranberry: Cranberry juice or supplements may also help prevent UTIs. But the evidence is weak.

Antibiotics for UTI prevention

If you keep getting UTIs, it’s important to speak with your healthcare provider. You may need preventive antibiotics. Some experts recommend a daily antibiotic for several months to prevent recurrent UTI. 

If you experience UTIs frequently after sex, taking an antibiotic each time you’re sexually active may also be an option.

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Written by:

Mandy Armitage, MD

Mandy Armitage, MD, has combined her interests in clinical medicine with her passion for education and content development for many years. She served as medical director for the health technology companies HealthLoop (now Get Well) and Doximity.

Edited by:

Karla Robinson, MD

Karla Robinson, MD, is a medical editor for GoodRx. She is a licensed, board-certified family physician with almost 20 years of experience in health through varied clinical, administrative, and educational roles.

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