Surprising Symptoms That Doctors Say Can Signal a UTI

Many women are all-too-familiar with urinary tract infections: Half of all women will experience at least one urinary tract infection, or UTI, in their lifetime, while 25% of them will have repeat infections.

UTIs are uncomfortable to deal with—and can even cause permanent damage if they’re left untreated, according to the National Institute for Diabetes and Digestive and Kidney Diseases (NIDDK). That’s why it’s so crucial to recognize the signs of an infection and act quickly.

But there’s a plethora of misinformation out there about UTIs, making it hard for women to know what they’re looking for or feel comfortable speaking up about having the infection.

Meet the experts: Kavita Mishra, M.D., a urogynecologist at Stanford Medicine; Lisa Dabney, M.D., the director of urogynecology and pelvic reconstructive surgery at Mount Sinai West and Mount Sinai Morningside in New York; David Kaufman, M.D., director of Central Park Urology, a division of Maiden Lane Medical

Knowing the signs of a UTI can help you get treatment before the infection becomes something serious. So we tapped doctors to break down the most common UTI symptoms to look out for—plus what to do to get rid of them.

Discomfort when you pee

Pain, burning, or stinging when urinating is often the first sign of a UTI or bacteria in the urethra or bladder, says Kavita Mishra, M.D., a urogynecologist at Stanford Medicine. However, it doesn’t necessarily mean you have a full-blown UTI—unless it becomes persistent. If you only feel pain once during the day and don’t show any other symptoms of a UTI, your body has likely already flushed out the bacteria.

Drinking extra water as soon as the burning starts may help flush out small amounts of bacteria and help prevent the infection from growing, according to Lisa Dabney, M.D., the director of urogynecology and pelvic reconstructive surgery at Mount Sinai West and Mount Sinai Morningside in New York.

A strong urge to pee all the time

If all you can think about is how badly you have to pee—especially if you just went and are experiencing other symptoms, such as painful urination—you may have a UTI. Bacteria can irritate the urethra and the lining of the bladder and make you feel like you desperately need to go constantly, says Dr. Mishra.

Still, many women will experience an overactive bladder without an infection, so be sure to note if the urge is not typical for you when speaking with a doctor.

Frequent urination despite a nearly empty bladder

Frequent urination is another symptom of a urinary tract infection, per the Mayo Clinic. A UTI can make you feel like you have a full bladder, but only dribbles come out when you go. Frequent trips to the bathroom and little to no relief are telltale signs to look out for.

Cloudy, bloody, or discolored urine

The color of your pee can point to a lot of things, including whether you have an infection. Anything off the yellow or clear spectrum should be a red flag. Cloudy, red, or brown urine can all be signs of infection, says Dr. Mishra.

But before you panic, take stock of what you ate in the past 24 hours. Beets and other foods can also make your pee a frightening pink, orange, or red color. If these foods are the culprit, though, you won’t have any pain, and the color will quickly pass.

Strong-smelling urine

You don’t have to sniff the bowl every time you go, but a strong, pungent smell is a common UTI symptom, according to the Cleveland Clinic. However, some foods may also cause your pee to smell. Coffee and asparagus are two likely culprits. If your urine still smells after going a couple of times, or it’s paired with a cloudy or red color, it’s time to call the doctor.

Pressure, cramping, or pain in your pelvis

Older women in particular may have cramping, pressure, or abdominal pain when they have a UTI. In some women, pain, cramping, and muscle aches—which can also be felt in your flank or lower back, the Cleveland Clinic says—may be the most pronounced symptoms. These symptoms are often easy to ignore or attribute to something else—say, something you ate or PMS—but it’s important to pay attention to them and bring them up with your doctor, who can help you find the cause.

Extreme fatigue or fever

As with any type of infection, once the body detects that something is wrong, it goes into a state of inflammation. Along with other protective measures, this triggers the release of white blood cells that can cause feelings of fatigue, which can be associated with a UTI if you have also noticed other symptoms.

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Likewise, a fever accompanied by some of the other symptoms above is often a sign that the infection has become more serious and spread to the kidneys, says Dr. Mirsha. If you have a fever over 101°F or and are experiencing chills or night sweats, seek medical help immediately.

Even though you may have heard that cranberry juice is the magical cure for UTIs, don’t fall into the hype. While cranberry juice contains an active ingredient to prevent bacteria from attaching itself to the walls of your bladder, the juice doesn’t contain enough of that ingredient to really make a difference (plus, it’s packed with added sugar), says Dr. Mishra.

A UTI can be incredibly painful and interrupt your daily life, but these infections are easy to treat once you seek the help of a doctor, who will test your urine to ensure you’re dealing with a UTI. Symptoms usually clear up entirely within a few days of taking prescribed antibiotics. Here are a few more things you can do to feel better ASAP:

• Drink lots of fluids. This is especially important once you have started taking antibiotics. Extra fluids will help antibiotics reach the infected area faster and help remove bacteria. Drinking six to eight 8-ounce glasses of water daily can also help prevent future infections, according to the NIDDK.
• Consider OTC pain relief. Dr. Mishra recommended popping a urinary pain relief medication, such as AZO. These medications numb the bladder, relieve burning, and reduce the constant urge to go. Just be warned: They will turn your urine a shocking shade of orange. “You can always use over-the-counter pain medications like Tylenol or Motrin, but they don’t seem to work as well as AZO,” says Dr. Mishra.
• Skip the coffee, soda, alcohol, and citrus juice. Stick to water to avoid irritating your bladder.
• Use a heating pad. If you’re experiencing cramps or painful pressure, a heating pad can help ease your discomfort.

There are a few things that raise your risk of a UTI, including having diarrhea or loose stools, explains David Kaufman, M.D., director of Central Park Urology, a division of Maiden Lane Medical. “But the primary cause of UTIs in sexually-active women is sex,” he says. “Simply put, bacteria colonizing the vagina is pushed into the urethra during the act of sex.”

From the urethra, the bacteria can work its way into the bladder and multiply, causing a UTI, Dr. Kaufman explains.

If you’re postmenopausal, your likelihood of having a UTI increases. “In women after menopause, an average of one UTI a year is pretty common,” Dr. Mishra says. Changes in the pH of the vagina can alter the balance of bacteria and yeast in postmenopausal women and make it easier for bacteria to make their way into the urethra, a.k.a. the lower urinary tract.

Having an abnormality in your urinary tract, diabetes, or immune system complications can also raise the risk of a UTI, according to the NIDDK.

Some factors that raise the risk of developing a UTI that are out of your control, like having a urinary tract abnormality. But there are a few things that most people can do to lower the risk of a future UTI:

• Don’t pee before sex. Peeing before and after sex is common advice for avoiding a UTI, but Dr. Kaufman says it’s best to focus on the “after” part. (Waiting to pee after sex allows you to pee “like a firehose” to push out any bacteria that may have gotten into your urethra, he explains.) If you need to pee before sex, Dr. Kaufman suggests drinking plenty of water before you go again to create a forceful stream.
• Drink plenty of liquids. This helps you to pee regularly, which can push potentially harmful bacteria out of your urinary tract.
• Fully empty your bladder when you go. Leftover urine can serve as a breeding ground for bacteria, according to Dr. Kaufman.
• Rinse off before sex. If you have access to a bidet or hand-held shower head, Dr. Kaufman suggests rinsing off your vagina before sex to wash out any bacteria that may have colonized there.
• Wear loose-fitting clothes. Loose-fitting clothes and cotton underwear won’t trap moisture, which may increase the risk of a UTI, per the NIDDK.
• Reconsider your birth control method. Diaphragms, unlubricated condoms, and spermicide can raise your risk of an infection, according to the NIDDK.
• Consider using vaginal estrogen. If you’re in perimenopause or menopause and struggling with repeat UTIs, low-dose vaginal estrogen can help increase good bacteria and prevent an infection, per the NIDDK.

It’s common for women to have a UTI here and there. But recurrent UTIs are a different story. These are when you have two or more UTIs within six months.

“You should see a doctor or go to a urgent care clinic every time you think you may have a UTI,” Dr. Kaufman says. “The longer you wait, the more the bacteria proliferate and the more challenging it is to treat.” Waiting too long also raises the risk the bacteria can get into your kidneys, creating a more serious and potentially deadly infection.

“It’s imperative that a urine sample for a ‘culture and sensitivity’ test is sent to the lab by the doctor’s office so that the presence of a UTI can be confirmed, and more importantly, the bacteria identified, and tested against a panel of antibiotics so that the best and safest antibiotic can be chosen to treat the infection,” Dr. Kaufman says. (Your doctor may prescribe an antibiotic to start if you’re uncomfortable and then switch it to a more targeted one once your test results come back, if needed, he says.)

“It has been my experience that ‘complicated UTIs’—that is, those that are persistent or recurrent—typically occur because the wrong antibiotic was prescribed, or the antibiotic was not taken long enough,” Dr. Kaufman says.

However, if you’re dealing with frequent UTIs, there could be an underlying issue that’s fueling them, making it crucial to talk to a urologist to try to get to the bottom of things.