UTI Symptoms: How to Recognize a Urinary Tract Infection

That burning sensation when you pee. The constant feeling like you need to go, even though barely anything comes out. Maybe some lower belly pain or cloudy, smelly urine. If this sounds familiar, you might have a urinary tract infection (UTI).

UTIs are incredibly common - about 40% of women will experience at least one during their lifetime, and some deal with them repeatedly. They're less common in men but can happen. The good news? UTIs are easily treatable with antibiotics, and catching them early prevents complications.

Let's break down what a UTI feels like, what causes them, and when you need to see a doctor.

What It Feels Like

UTI symptoms range from mildly annoying to seriously uncomfortable:

Classic symptoms:

Burning or pain during urination (dysuria): This is the hallmark symptom. It feels like stinging, burning, or sharp pain as urine passes through the urethra. Some people describe it as peeing razor blades.

Urinary frequency: Needing to pee all the time - sometimes every few minutes - even though very little comes out when you try.

Urgency: Sudden, intense need to urinate right now. You might worry you won't make it to the bathroom in time.

Lower abdominal or pelvic pain: Pressure, aching, or cramping in your lower belly or pelvic area. May feel similar to period cramps.

Cloudy or strong-smelling urine: Urine that's murky instead of clear, or has a particularly foul odor.

Blood in urine (hematuria): Pinkish, red, or cola-colored urine from blood. May be visible or only detected under microscope.

Feeling generally unwell: Fatigue, feeling run-down, or just "off."

If infection reaches kidneys (pyelonephritis):

• Fever and chills
• Back or side pain (flank pain)
• nausea and vomiting
• Severe fatigue

This is serious and needs immediate medical attention.

What Causes UTIs

UTIs happen when bacteria (usually from your digestive tract) enter the urinary tract and multiply.

The Bacteria

E. coli causes about 80-90% of UTIs. It normally lives harmlessly in your intestines but becomes problematic when it gets into the urinary system. Other bacteria like Enterococcus, Klebsiella, or Staphylococcus can also cause UTIs.

Why Women Get More UTIs

Women have a lifetime risk of 53% for UTI, compared to much lower rates in men. Why?

Anatomy: Women have shorter urethras (about 4cm vs. 20cm in men). Bacteria have a shorter distance to travel to reach the bladder.

Location: The urethral opening is close to the anus, making it easier for bacteria to spread from the digestive tract.

Common Risk Factors

Sexual activity: Sex pushes bacteria toward the urethra. Using diaphragms or spermicides increases risk further. UTIs used to be called "honeymoon cystitis" for a reason.

Menopause: Declining estrogen changes vaginal pH and reduces protective bacteria, increasing UTI susceptibility.

Pregnancy: Hormonal changes and pressure on the bladder increase UTI risk.

Urinary tract abnormalities: Kidney stones, enlarged prostate (in men), or structural issues that prevent complete bladder emptying.

Catheter use: Urinary catheters significantly increase infection risk.

Weakened immune system: Diabetes, HIV/AIDS, or immunosuppressive medications make you more vulnerable.

Holding urine too long: Not peeing when you need to allows bacteria to multiply.

Dehydration: Not drinking enough water concentrates urine and reduces how often you flush out bacteria.

Certain contraceptives: Diaphragms and spermicide-coated condoms are associated with higher UTI rates.

When to See a Doctor

See a healthcare provider if you have:

• Burning, pain, frequency, or urgency when urinating
• Blood in urine
• Cloudy or foul-smelling urine
• Lower abdominal or pelvic pain
• Symptoms of a previous UTI returning

UTIs require antibiotics. They won't go away on their own, and untreated infections can spread to kidneys.

Diagnosis

Urine test (urinalysis): You'll pee in a cup. The lab checks for white blood cells, red blood cells, and bacteria - all indicators of infection.

Urine culture: Identifies exactly which bacteria is causing the infection and which antibiotics will work best. Takes 24-48 hours but ensures targeted treatment.

Additional testing: For recurrent UTIs or suspected complications, your doctor might order imaging (ultrasound, CT scan) to check for abnormalities.

Treatment

Antibiotics (Essential)

UTIs require antibiotics. Common first-line options:

• Nitrofurantoin (Macrobid) - 5-7 days
• Trimethoprim/sulfamethoxazole (Bactrim) - 3 days
• Fosfomycin (Monurol) - single dose
• Trimethoprim alone - 3 days

Take the full course, even after symptoms improve (usually within 1-2 days). Stopping early allows bacteria to return and potentially develop resistance.

Complicated UTIs or kidney infections need longer courses (7-14 days) or IV antibiotics in severe cases.

Symptom Relief

Phenazopyridine (AZO, Pyridium): Over-the-counter or prescription pain reliever specifically for urinary tract pain. Turns urine bright orange but provides relief while antibiotics work. Use for 2-3 days max.

hydration: Drink plenty of water. It dilutes urine (less painful) and helps flush bacteria.

Heat: Heating pad on lower abdomen can ease cramping and discomfort.

Avoid irritants: Skip caffeine, alcohol, and spicy foods until infection clears - they irritate the bladder.

Prevention

If you're prone to UTIs, these strategies help:

Hydration: Drink 6-8 glasses of water daily. This keeps urine flowing and flushes bacteria regularly.

Bathroom habits:

• Don't hold urine when you need to go
• Empty bladder completely
• Wipe front to back (women) to prevent spreading bacteria from anus to urethra

Post-sex urination: Pee within 30 minutes after sex. This flushes out any bacteria that may have been pushed toward the urethra.

Avoid irritants:

• Skip douches and feminine hygiene sprays (they disrupt natural bacteria)
• Choose unscented products for genital area
• Avoid bubble baths and bath oils

Cotton underwear: Breathable fabric reduces moisture that bacteria love. Avoid tight pants.

Contraception choices: If using diaphragm or spermicide, consider alternatives if you get frequent UTIs.

Cranberry products: Some evidence suggests cranberry juice or supplements might help prevent UTIs (not treat active infections). The science is mixed, but it's safe to try.

For postmenopausal women: Topical vaginal estrogen can help prevent recurrent UTIs by restoring protective vaginal bacteria.

Prophylactic antibiotics: If you get UTIs frequently (3+ per year), your doctor might prescribe:

• Low-dose daily antibiotics
• Post-sex antibiotics
• Self-start antibiotics at first symptom

Recurrent UTIs

If you're dealing with frequent UTIs, you're not alone. About 25% of women experience recurrent UTIs.

When to see a specialist:

• 3+ UTIs in a year
• 2+ UTIs in 6 months
• UTIs not responding to standard antibiotics

A urologist can investigate underlying causes (kidney stones, anatomical issues, etc.) and create a prevention plan.

Men and UTIs

UTIs are less common in men under 50 (due to longer urethra and prostate fluid with antibacterial properties). When they do occur:

• Often indicate underlying issue (enlarged prostate, kidney stones)
• More likely to involve kidneys
• Should always be investigated by a doctor

The Bottom Line

UTIs are common, uncomfortable, but very treatable. If you have burning when you pee, frequency, urgency, or other symptoms, see a doctor. Don't try to tough it out - untreated UTIs can lead to kidney infections.

Antibiotics work quickly (symptoms usually improve within 1-2 days), but take the full course. And if you're prone to UTIs, preventive strategies - especially hydration, post-sex urination, and proper wiping - can significantly reduce your risk.

References

1. Cleveland Clinic - Urinary Tract Infection (UTI): Causes, Symptoms & Treatment
2. NCBI StatPearls - Uncomplicated Urinary Tract Infections
3. Mayo Clinic - Urinary tract infection (UTI) diagnosis and treatment
4. AUA/CUA/SUFU - Recurrent Uncomplicated UTIs in Women Guideline (2025)
5. WebMD - Your Guide to Urinary Tract Infections
6. IDSA - Complicated Urinary Tract Infections Clinical Guidelines