Let’s get the basic facts out of the way: It is no fun getting a urinary tract infection (UTI). It is also no fun getting a sexually transmitted infection (STI) like, say, chlamydia. You know what else is no fun? Realizing that UTIs and chlamydia have similar symptoms and they’re both extremely common infections? Groan.
A urinary tract infection is usually caused by bacteria in any part of the urinary system — meaning it can affect the urethra, kidneys, or bladder. About 15 million American women are diagnosed with a UTI on an annual basis.
Chlamydia is also a bacterial infection, but it’s spread through sexual contact, which includes vaginal, anal, and oral sex. Nearly 3 million Americans contract chlamydia every year, with the common age range being among 14-to-24-year-olds.
While symptoms for both of these infections can vary, it’s imperative you seek treatment for UTIs and chlamydia to prevent further complications.
So how can we identify the differences between a UTI and chlamydia? Rescripted spoke with Cordelia Nwankwo, M.D. a board-certified OB/GYN based in Washington, D.C., who broke down what we need to know about these two highly common infections.
Can chlamydia be misdiagnosed as a UTI?
It is possible to mistake chlamydia for a UTI in some cases, specifically if the infection is urethra-based. Common symptoms for UTIs include pain while peeing and an urge to pee often, and these symptoms can sometimes show up in chlamydia: “Both a UTI and chlamydia affecting the urethra can cause increased urinary frequency and burning with urination,” says Dr. Nwankwo.
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These similar symptoms can sometimes cause an initial misdiagnosis because “UTIs are often treated empirically before or without urine culture results based on symptoms,” explains Dr. Nwankwo. But, she says, “it's less likely for a UTI to be misdiagnosed as chlamydia because chlamydia usually requires a positive culture prior to treatment.”
How to tell if it's a UTI or chlamydia
There are some significant symptomatic differences between UTIs and chlamydia, however. “Chlamydia in females can be asymptomatic,” says Dr. Nwankwo. But chlamydia can also present “vaginal discharge, spotting or bleeding after intercourse, or pelvic pain.” In addition to urinary frequency and burning with urination, other UTI symptoms “also include blood in the urine or pain/discomfort in the bladder (just above the pubic bone).”
If you think you have either a UTI or chlamydia, you need to make an appointment with your medical provider to discuss your symptoms. “The gold standard for UTI diagnosis is a urine culture,” says Dr. Nwankwo. This type of culture can “confirm bacteria in the urine in the presence of symptoms.” If you and your healthcare provider believe you’re at risk for chlamydia, this STI can be “diagnosed with PCR testing from a vaginal/cervical swab or a urine sample.”
Once the infection is confirmed, your doctor will likely prescribe antibiotics. If you are diagnosed with a UTI, the antibiotic treatment will be based on your culture results. “Chlamydia is usually treated with specific antibiotics,” says Dr. Nwankwo, “either azithromycin or doxycycline are first line.”
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Being proactive against UTIs and chlamydia
Even though both UTIs and chlamydia are common infections, there are plenty of proactive measures we can take. “The best form of prevention for chlamydia is barrier protection during intercourse, as it is an STI,” says Dr. Nwankwo. As for preventing UTIs, she recommends amending certain lifestyle and hygiene habits: “Hydrating avoiding holding your bladder for long periods of time, wiping front to back, urinating and cleaning up after intercourse can all help prevent UTIs.”
If you’re ultimately diagnosed with either a UTI or chlamydia, the most important course of action you can take is to complete the prescribed course of antibiotics. Untreated chlamydia can lead to pelvic inflammatory disease (which can damage your reproductive organs), pregnancy complications, and/or infertility. Untreated UTIs can lead to repeated infections, permanent kidney damage, and/or sepsis.
Sarene Leeds holds an M.S. in Professional Writing from NYU, and is a seasoned journalist, having written and reported on subjects ranging from TV and pop culture to health, wellness, and parenting over the course of her career. Her work has appeared in Rolling Stone, The Wall Street Journal, Vulture, SheKnows, and numerous other outlets. A staunch mental health advocate, Sarene also hosts the podcast “Emotional Abuse Is Real.” Visit her website here, or follow her on Instagram or Twitter.