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UTIs and STDs

Are they the SAME?
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Urinary tract infections (UTIs) and sexually transmitted diseases (STDs) are often confused for one another by patients or even physicians due to their overlapping symptoms. Understanding both conditions and identifying the differences between the two are important as the management and treatment for both differ.

What is a UTI (Urinary Tract Infection)?

The urinary tract system consists of the kidneys, the ureter, the bladder, and the urethra. An individual can develop a UTI when bacteria invade and infect any part of the urinary tract system.

UTI
Urinary tract infections occur when bacteria infect any part of the urinary tract.

Types of UTIs

The types of UTIs are named according to the part of the urinary tract that has been infected, these are:

  • Cystitis: UTI that involves an infection of the bladder.
  • Urethritis: UTI that involves an infection of the urethra which is the connecting passageway between the bladder and the outside body.
  • Pyelonephritis: UTI that involves an ascending infection to the kidneys.

What are STDs (Sexually Transmitted Diseases)?

STDs are a constellation of pathogens (bacteria/virus/fungi) that can be passed on during sexual intercourse or sexual contact, leading to an infection of the sexual partner. STDs are usually transmitted from one infected individual to another, thus requiring a source. 

Types of STDs

There are various types of STDs, some common STDs include:

  • Chlamydia
  • Gonorrhoea
  • Trichomonas
  • Mycoplasma genitalium
  • Human Papillomavirus (HPV)
  • Herpes Simplex Virus
  • Syphilis
  • Human immunodeficiency virus (HIV)
  • Hepatitis B/C
  • Molluscum Contagiosum
  • Genital warts
  • Pubic lice
  • Scabies
STDs
STDs can be caused by bacteria, viruses, or fungi.

What is the difference between UTIs and STDs?

There are overlapping symptoms between UTIs and STDs, though, there are also differences in both presentations. It is imperative to tease out the differences between the 2 conditions as their treatment varies.

These are some symptoms that may differ between UTIs and STDs:

SymptomsUTISTDs
Painful urination
Increased urge and frequency of urination
Fever√ (less common)
Blood in the urineUnlikely
Cloudy and smelly urineUnlikely
Vagina/urethral/abnormal rectal dischargeUnlikely
Genital itchUnlikely
Genital rash/sores/blistersUnlikely
Spotting/bleeding between periodsUnlikely
Painful intercourseUnlikely
Vaginal/rectal painUnlikely

If you are experiencing any of the symptoms above or other unusual symptoms relating to the urinary or genital region, it is important to speak to your doctor to evaluate your symptoms further.

Can STDs lead to a UTI?

Yes, some bacteria from STDs can affect the urinary tract system, leading to urethral discomfort, discharge, or even painful urination. The treatment for STDs and UTIs is different, therefore it is essential to administer the right test based on a person’s symptoms presentation.

Can a UTI lead to STDs?

No, the bacteria that cause urinary tract infections are usually the bacteria floral found in the genito-urinary system or even the gastrointestinal system. They are generally not directly passed on through contact and are not transmissible through sexual activities. Likewise, treatment for UTIs and STDs differs, and it is equally important to see your doctor to evaluate your clinical symptoms and ensure you are receiving the right treatment.

urinate
UTIs are characterised by an increased urge and frequency to urinate.

What should I do if I suspect that I have a UTI?

If you have any abnormal urinary symptoms suggestive of a UTI, you should speak to your doctor and consider getting medical treatment for UTI before the symptoms deteriorate. Although there are possibilities of a mild UTI resolving spontaneously over time, severe cases of UTI can lead to ascending bladder infection, kidney infections, or even blood infection (sepsis) that can be dangerous. Hence, you should not delay seeking medical treatment if you suspect a UTI. Most uncomplicated cases of UTIs can be managed by your primary doctor with appropriate antibiotics and lifestyle modification advice.

What should I do if I suspect that I have an STD?

Generally, STDs can be asymptomatic, or present with genitourinary symptoms (this was discussed in a previous article). It may even have symptoms that overlap with a UTI. If you have a risk of exposure to STDs or concerning symptoms, you are advised to speak to your doctor to guide you on the appropriate STD screening tests to consider. Your doctor can also advise you on measures in both medication and lifestyle to reduce your risk of acquiring STDs.

What would happen if I did not seek treatment for a UTI or STDs?

In the case of UTIs, as previously discussed, there is a chance of your UTI infection not resolving and resulting in an ascending infection – affecting the bladder, kidneys, or even bloodstream. In such circumstances, you can become unwell with symptoms such as a fever, chill and rigors, worsening urinary discomfort pain, blood in urine, and inability to pass urine, which may lead to hospitalisation or even potential life danger if an infection of the bloodstream occurs.

In terms of STDs, while most of the common STDs are treatable, there are some STDs that have more major implications for your long-term health as they may not be curable (such as HIV, Hepatitis infections, etc). Therefore, seeking medical assistance for both UTIs and STDs is paramount in preventing long-term detrimental health effects.

kidney damage
Untreated UTIs can lead to kidney damage.

How do I reduce my risk of UTI following sexual intercourse?

The following advice can be considered to reduce developing UTI after intercourse:

  • Adequate hydration
  • Passing urine after intercourse
  • Exercise good hygiene – wiping front to back
  • Avoid douching
  • Avoid deodorant/panty liner which has chemicals, fragrances, and scents
  • Certain birth control options such as diaphragm which increase the risk of UTI
  • Passing urine regularly
  • Avoid holding your bladder
  • Avoid wearing tight undergarments

How do I reduce my risk of STDs?

The below practice(s) helps to minimise the transmission of STDs:

  • Using barrier contraception during intercourse (using condoms correctly)
  • Going for regular STDs screening and treatment between both yourself and your partner(s)
  • Reduce the number of sexual partners
  • Avoid intercourse after excessive alcohol or after drugs that may cloud your decision making
  • Preventive measures such as HPV vaccination (if you are eligible) and anti-retroviral risk-reducing medications (PrEP)

References

  1. CDC, “Urinary Tract Infection,” Centers for Disease Control and Prevention, January 14, 2022, https://www.cdc.gov/antibiotic-use/uti.html.
  2. “Urinary Tract Infection (UTI) - Conditions & Treatments | SingHealth,” Singhealth.com.sg, 2019, https://www.singhealth.com.sg/patient-care/conditions-treatments/urinary-tract-infections.
  3. “Sexually Transmitted Diseases - Information from CDC,” 2023, https://www.cdc.gov/std/default.htm.
  4. Flores-Mireles AL, Walker JN, Caparon M, Hultgren SJ. Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nat Rev Microbiol. 2015 May;13(5):269-84. doi: 10.1038/nrmicro3432. Epub 2015 Apr 8. PMID: 25853778; PMCID: PMC4457377.

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