Urinary tract infections (UTIs) and chlamydia are two common conditions that affect the urinary and reproductive systems. Both can cause similar symptoms like painful urination, which makes it difficult to tell the difference between the two. However, there are some key ways to help discern whether you’re experiencing a UTI or chlamydia.
What is a UTI?
A urinary tract infection is an infection of any part of the urinary system, including the kidneys, ureters, bladder and urethra. Most UTIs involve the lower urinary tract, specifically the bladder and urethra. The most common cause of UTIs is bacteria, usually E. coli from the gastrointestinal tract that enters the urinary tract and adheres to the bladder wall. Once the bacteria latches on, it multiplies and causes inflammation and infection of the lining of the bladder and urethra. Some common symptoms of a UTI include:
- A burning feeling when urinating
- Frequent urge to urinate
- Passing only small amounts of urine
- Cloudy, dark, bloody or strange-smelling urine
- Pelvic pain or pressure
UTIs are very common, affecting about 40-60% of women at some point in their lives. They are much less common in men, except in infants and the elderly. Risk factors for developing a UTI include being female, sexual activity, using a diaphragm, diabetes, and problems emptying the bladder completely.
What is chlamydia?
Chlamydia is a sexually transmitted bacterial infection caused by the bacteria Chlamydia trachomatis. It can infect both men and women and is spread through vaginal, oral or anal sex with an infected partner. Many people with chlamydia don’t experience symptoms, which allows it to go undetected and spread easily. When symptoms do occur, they may include:
- Burning/pain during urination
- Vaginal discharge or bleeding
- Lower abdominal pain
- Pain during sexual intercourse
- Bleeding between periods
If left untreated, chlamydia can spread to the uterus and fallopian tubes in women, causing pelvic inflammatory disease (PID). This can lead to long-term complications like infertility, ectopic pregnancy and chronic pelvic pain. In men, untreated chlamydia can cause epididymitis, an infection of the coiled tube behind the testicles.
How to Tell the Difference
While UTIs and chlamydia share some general symptoms like painful urination, there are some key differences that can help distinguish between the two:
1. Type of pain
UTIs typically cause a burning pain or discomfort during urination and an intense urge to urinate frequently. The pain and urgency tends to worsen as the bladder fills. With chlamydia, the urination pain is often less pronounced and tends to occur at the end of urination instead.
2. Discharge
Vaginal discharge is common with chlamydia but not present with UTIs. The discharge is usually yellow or milky in color. Discharge may also be accompanied by spotting between periods.
3. Location of pain
While both can cause pelvic pain, the location may be different. With UTIs, the pain is typically felt in the lower abdomen or around the pubic bone region. Chlamydia tends to cause pain that is higher and deeper in the abdomen.
4. Sexual activity
UTIs are not sexually transmitted, though sexual activity can increase the risk. Chlamydia is only transmitted through sexual contact with an infected partner.
5. Risk factors
Women are much more prone to UTIs, while chlamydia affects men and women. Other UTI risk factors like diabetes and functional problems emptying the bladder are not risk factors for chlamydia.
6. Timeline
UTI symptoms tend to come on suddenly and worsen quickly over hours or days. Chlamydia symptoms may develop more gradually, often weeks after infection occurred.
7. Other symptoms
UTIs may also cause fever, chills, nausea, vomiting and fatigue. Chlamydia can cause testicular pain and swelling, bleeding between periods, and lower back pain.
When to See a Doctor
It’s important to see a doctor if you experience any persistent urinary symptoms or have been exposed to an STI like chlamydia. Your doctor can do a urine test and pelvic exam to check for infection and determine the cause of your symptoms.
Some key times to seek medical care include:
- Burning with urination lasts more than 24 hours
- Inability to urinate at all
- Fever over 101°F (38°C)
- Flank or low back pain
- Blood in urine
- Foul-smelling urine
- Unexplained vaginal bleeding or discharge
- Pain with sex
- Exposure to STI
Prompt treatment is important, especially for infections like chlamydia, to prevent complications and transmission to partners.
Diagnosis
To diagnose the cause of urinary symptoms, the doctor will:
- Take a medical history – Discuss your symptoms, sexual history, history of UTIs or STIs, and any relevant risk factors.
- Conduct a pelvic exam – Look for signs of infection, discharge or bleeding.
- Analyze a urine sample – Check for presence of bacteria, white blood cells and blood that may indicate infection.
- Order lab tests – May include a urine culture to identify bacteria causing a UTI or tests like a nucleic acid amplification test (NAAT) to detect chlamydia.
Based on your symptoms, exam findings and test results, the doctor can diagnose the condition and prescribe the appropriate treatment.
Treatment
UTI Treatment
Uncomplicated UTIs are usually easily treated with a short course (3-7 days) of antibiotics, which can provide rapid relief of symptoms. Some commonly prescribed antibiotics for UTIs include:
| Antibiotic | Dosage | Duration |
|---|---|---|
| Trimethoprim/sulfamethoxazole | 160/800 mg twice daily | 3 days |
| Amoxicillin | 500 mg three times daily | 5-7 days |
| Nitrofurantoin | 100 mg twice daily | 5-7 days |
| Fosfomycin | 3 grams single dose | 1 day |
For recurrent or complicated UTIs, a longer 14 day course may be prescribed. Your partner generally does not need treatment unless they develop symptoms.
Chlamydia Treatment
Chlamydia is treated with antibiotics, usually azithromycin or doxycycline. All sexual partners should also be notified, tested and treated to prevent reinfection and further spread:
| Antibiotic | Dosage | Duration |
|---|---|---|
| Azithromycin | 1 gram single dose | 1 day |
| Doxycycline | 100 mg twice daily | 7 days |
In addition to taking medication, you should avoid sexual activity for 7 days after starting treatment to allow the medication to work. Make sure to finish the entire course as prescribed, even if symptoms go away earlier.
Follow up testing is recommended 3 months after finishing treatment to confirm the infection has cleared.
Prevention
Preventing UTIs
Some ways to help prevent recurrent UTIs include:
- Drink plenty of fluids, especially water
- Urinate before and after sex
- Wipe front to back after using the toilet
- Avoid holding urine for long periods
- Take showers instead of baths
- Wear cotton underwear and loose clothes
- Avoid feminine hygiene products
- Take antibiotics as prescribed for a current UTI
For postmenopausal women with recurrent UTIs, low-dose antibiotics taken daily or after sex may help prevent infections. Your doctor may also recommend estrogen cream to reduce UTIs.
Preventing Chlamydia
You can lower your risk of getting chlamydia by:
- Using condoms correctly every time you have sex
- Limiting your number of sexual partners
- Asking partners to get tested before sex
- Avoiding douches which can irritate the vagina
- Not sharing sex toys
Annual chlamydia screening is recommended for sexually active women under 25. All pregnant women should also be screened to prevent transmission to infants.
Conclusion
While UTIs and chlamydia can both cause uncomfortable urinary symptoms, there are some noticeable differences between the two conditions. Factors like type of pain, discharge, sexual history and timeline of symptoms can provide clues if the cause is a UTI or an STI like chlamydia. Seeing a doctor promptly for diagnosis and treatment is important to relieve symptoms, prevent complications and avoid passing infections to partners. With proper antibiotic treatment and some preventive lifestyle measures, both UTIs and chlamydia can be effectively cured and managed.
