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UTIs in Women

Types & Multiple Symptoms*

What You Should Know

The farther into the urinary tract the infection progresses, the greater the number of symptoms. As the infection becomes more severe, the signs tend to be cumulative.

The UTI symptoms can develop quite rapidly - over a matter of hours, or more slowly - nagging for several weeks. Although not everyone with a urinary tract infection has symptoms, most people get at least some, such as:

  • a frequent urge to urinate - having to go a lot, feeling that you have to urinate immediately during the day and/or night (sometimes incontinence may occur);
  • a sharp pain or painful, burning sensation with itching in the area of the bladder or urethra during urination (dysuria).

Mild cases of acute urinary tract infection, however, may disappear spontaneously without any treatment.

Cystitis / Urethritis

Cystitis and UTIs may require a brief clarification. Cystitis is an inflammation of the bladder which can be infectious or noninfectious.

UTIs on the other hand are always infectious – caused by an overgrowth of the pathogenic microorganisms, and may involve everything from the urethra to the bladder to the kidneys.

Symptoms (mild to severe) of cystitis or urethritis, often described as lower urinary tract infection, may include:

  • back pain, usually mid-way up the back on one side, even when not urinating,
  • lower stomach, abdominal pain (over bladder), especially during urination;
  • an uncomfortable pressure above the pubic bone,
  • abnormal urine color (dark, cloudy or milky),
  • foul or strong urine odor (stinky urine),
  • bloody, pink urine (hematuria),
  • inability to urinate (despite the urge, only a small amount of urine is passed),
  • slight fever (mild infections often will not cause fever, but moderate to severe infections that involve the kidneys do cause fever),
  • painful or uncomfortable sexual intercourse,
  • malaise (general discomfort),
  • fatigue (feeling bad all over, tired, shaky, washed out),
  • mental changes or confusion (in the elderly, they are often the only signs of a possible urinary tract infection).

These symptoms, however, do not necessarily mean there is a bladder infection. They only suggest that there might be a bladder infection.

Noninfectious Cystitis

When no bacteria can be identified as the cause of the symptoms, a noninfectious cystitis is usually assumed. It is also called abacterial cystitis or urethral syndrome. In other words, this is an irritation of the bladder not caused by a UTI. Only the symptoms are similar to those caused by a urinary tract infection.

The exact causes of noninfectious cystitis, the most common type of cystitis in women of childbearing years, are often unknown. However, they may be due to:

  • radiation therapy to the pelvic area,
  • chemotherapy medications,
  • some irritants, such as bubble baths, feminine hygiene sprays, sanitary napkins, or spermicidal jellies.

Emphysematous Cystitis

Emphysematous cystitis (EC) is a rare form of complicated infection of the lower or upper urinary tract. It is characterized by multiple air blebs – hemispherical blisters filled with air- within the bladder mucosa and wall.

EC is more common in elderly women and often associated with severe diabetes mellitus (70 percent) which is a major risk factor. Other risk factors include neurogenic bladder and being in an immunocompromised state.

The causes of EC are poorly understood, although elevated tissue glucose levels my provide a more favorable microenvironment for gas-forming bacteria or fungi, such as Escherichia coli, Klebsiella pneumoniae and – rarely - Candida. Other causative organisms include Proteus, Enterococcus, Pseudomonas, Clostridium.

Signs and symptoms can vary greatly from patient to patient, which makes the disease difficult to diagnose. The urinary symptoms include:

  • blood in the urine (hematuria): gross hematuria - when you can see the blood in your pee, microscopic hematuria - when you cannot see the blood in your pee, yet it is seen under a microscope;
  • urinary frequency - the need to urinate many times during the day, at night (nocturia), or both in normal or less-than-normal volumes; it may be accompanied by a urinary urgency;
  • urinary urgency - a sensation of an urgent need to void,
  • occasional incontinence - the loss of bladder control, it ranges from leaking urine when you cough or sneeze to having a sudden and strong urge, so you cant’ get to a toilet in time;
  • difficulty voiding (urinating),
  • burning sensation (micturition) - a type of pain that's distinct from dull, stabbing, or aching pain.

Due to the atypical presentation and rarity of the infection, it takes a physician longer to diagnose than more common types of bladder infections. Early medical intervention, however, can contribute to achieving a favorable prognosis without the need for surgical intervention.

Most cases of emphysematous cystitis are treated with a combination of

  • antibiotics,
  • bladder drainage and
  • good control of blood glucose.

EC is potentially life-threatening with a mortality rate of 7 percent.

Urethral Syndrome

Urethral syndrome, also known as urethral pain syndrome, is the term for a group of symptoms that can occur when the urethra becomes inflamed and, therefore, irritated. A close examination reveals an inflammatory status of the bladder neck and trigone, described as trigonitis.

When the urethra becomes inflamed and irritated, it swells up and the tube narrows, which can make it more difficult for a person to pass urine.

People can sometimes develop urethral syndrome after recently having a UTI. This is because the urethra can be very sensitive while recovering from an infection.

This is still an ill-understood disease responsible for lower urinary tract symptoms, such as:

  • urinary frequency,
  • urinary urgency,
  • burning micturition (painful urination),
  • hematuria (blood in urine), and
  • pelvic pain associated with negative urine cultures, meaning no signs of a bacterial infection.

Diagnosis can be difficult because the symptoms are often similar to those of other conditions, such as UTI, cystitis, or urethritis, which can also affect the urethra. For this reason, urethral syndrome is most often misdiagnosed.

As patients have no bacteria in their urine, they do not respond to antibiotic therapy. It is not uncommon, then, for the diagnosis to be delayed until antibiotics have failed to cure the symptoms.

Medical therapies available today are mainly symptomatic. And most of them are not effective and do not significantly improve the quality of life of urethral syndrome sufferers. They also often do not respond to oral administration of conventional steroidal and non-steroidal anti-inflammatory drugs.

This is also the consequence of the fact that urethral syndrome has had several nicknames, which have led to much confusion over its existence and the treatment options.

Urethral syndrome can occur in both males and females. Most patients, however, are women, typically aged 30-50 years.

Women who have given birth to several children may also be at greater risk of urethral syndrome. Having a delivery without an episiotomy, which is when a doctor makes an incision in the tissue between the vagina and the anus, can also increase a woman's risk of developing urethral syndrome.

Interstitial Cystitis (IC)

Although more common in women than in men, the symptoms of a bladder infection can be mimicked by a chronic bladder disorder called interstitial cystitis (IC), also known as painful bladder syndrome (PBS).

As a matter of fact, a history of bladder infections have more than two-thirds of all IC sufferers. In this disorder the bladder is overly sensitive. The major symptoms are:

  • pain in the pelvic area (the lower abdomen, urethra or vagina) – the predominant symptom;
  • urgent need to urinate often (up to 60 times a day);
  • painful intercourse (dyspareunia) - persistent or recurrent genital pain occurring just before, during or after intercourse.

The pain and urgency can be so severe that may make work, sexual activity and normal social functioning difficult or impossible.

Interstitial cystitis may stay about the same or get worse with time. Some people may go into remission for extended periods.

Unlike ordinary bladder infections, the cause or, rather, the causes of interstitial cystitis continue to baffle medical researchers. It is believed that IC may be the result of:

  • vascular (blood vessel) disease,
  • autoimmune disease,
  • an acid-alkali imbalance brought about by environmental factors and diet,
  • presence of abnormal substances in the urine,
  • an infection caused by a more elusive strain of bacteria (undetected by standard tests),
  • nerve function disorders,
  • defective cells in the bladder lining,
  • allergic reactions.

Currently, an estimated 700,000 – 1 million Americans suffer from this disease.

Other conditions that have symptoms similar to interstitial cystitis are:

  • bladder cancer (although in most cases, blood in the urine is the first sign of bladder cancer),
  • gonorrhea (an infection caused by a sexually transmitted bacterium) and/or
  • irritable bladder / overactive bladder (a sudden urge to urinate, also triggering involuntary loss of urine, known as incontinence).

Excruciating pain across the abdomen or the back may signal the presence of kidney stones. Therefore, you are strongly advised to act at the onset of any of these symptoms rather than take the “wait-and-see” approach.

A professional diagnosis is essential.


The trigone is the neck of the bladder – a triangular tissue located in the lower part of bladder. It is near the opening of the urethra. When it becomes inflamed, it is known as trigonitis, causing painful and inconvenient symptoms.

However, trigonitis is not always the result of inflammation. Sometimes it is due to benign cellular changes in the trigone called nonkeratinizing squamous metaplasia. This condition is known as pseudomembranous trigonitis. It is thought that female hormones estrogen and progesterone may play a role here.

Pseudomembranous trigonitis occurs in 40 percent of adult women (mainly of childbearing age) — but fewer than 5 percent of men who are undergoing hormone therapy, for example for prostate cancer.

The symptoms of trigonitis are similar to those for other bladder issues, such as:

  • an urgent need to urinate (urinary urgency),
  • pelvic pain or pressure (arising from reproductive organs),
  • difficulty urinating (urinary retention),
  • pain during urination (dysuria),
  • blood in the urine (hematuria).

The chances of trigonitis can be increased by:

  • a long-term use of a catheter (the longer a catheter stays in place, the higher the risk for irritation and inflammation).
  • recurrent urinary tract infections (they can irritate the trigone, leading to chronic inflammation).

Trigonitis vs. Interstitial Cystitis

While they share some of the same symptoms, trigonitis differs from interstitial cystitis (IC)in several ways:

  • The inflammation that occurs with trigonitis is only seen in the trigone region of the bladder. (IC can cause inflammation throughout the bladder).
  • Pain from trigonitis is felt deep into the pelvis, radiating to the urethra. (IC is generally felt in the lower abdomen).
  • Trigonitis produces pain upon passing urine. (IC is less likely to do so).

Irritable Bladder Syndrome (IBS)

The symptoms of irritable bladder are basically the same as interstitial cystitis. Yet again the main symptoms are:

  • frequency (having to urinate more often),
  • urgency (not being able to wait to urinate),
  • bladder discomfort,
  • pelvic pain, such as mild discomfort, pressure, and tenderness;
  • bladder instability (the bladder tries to empty before it has filled and you cannot control it),
  • nocturia (a frequent need to urinate at night).

Frequent emptying of the bladder can become a habit and this habit prevents the bladder from filling to its true capacity. It causes the bladder to become even more irritable. Therefore, a vicious circle is established.

However, you can retrain your bladder by holding on by contracting your pelvic floor muscles (a group of muscles found in the base of the bottom of your torso). If "holding on" is difficult, you can try to distract your attention from your bladder by doing something else. The feeling of urgency will subside as the bladder contraction dies away. Learn to hold your urine for longer periods. Start by choosing a time interval you are reasonably comfortable with.

People with painful bladder syndrome often find avoiding acids and caffeine in their diet helpful, as they can trigger flare-ups of symptoms.

Kidney Infection (Nephritis)

Occasionally the uropathogenic bacteria will ascend up into the kidneys, causing a kidney infection or inflammation, also known as upper urinary tract infection. This can be serious, since kidney infections can scar the kidneys.

Women who have recurrent, repeated urinary tract infections are more likely to get a kidney infection.

Here are signs, mild to severe, that a bladder infection has turned into a kidney infection:

  • lower back pain (below the ribs) or side pain (mid-way up the back, this is where the kidneys are located),
  • high fever accompanied by shaking chills and sweats (unlike "viral infections" in which the fever fluctuates between normal and very high, with kidney infections the fever stays high, usually 101º F or higher, and you look and act progressively sicker),
  • nausea and vomiting,
  • lower stomach, abdominal pain (over bladder), especially during urination;
  • an uncomfortable pressure above the pubic bone,
  • abnormal urine color (dark, cloudy or milky),
  • foul or strong urine odor (stinky urine),
  • bloody, pink urine (hematuria),
  • inability to urinate (despite the urge, only a small amount of urine is passed);
  • painful or uncomfortable sexual intercourse,
  • malaise (general discomfort),
  • fatigue (feeling bad all over, tired, shaky, washed out),
  • mental changes or confusion - in the elderly, they are often the only signs of a possible urinary tract infection).

Fortunately, most bladder infections do not turn into kidney infections, and a small scar in one kidney infection is harmless. However, kidney infections must be taken seriously and treated promptly. Left untreated, they can lead to reduced kidney function and, in severe cases, possibly even to death.

*Based on various available sources and studies, our research and practical experience. Last modified on August 13th, 2021.

Feel on Top of the World Again!

As you probably know by now, urinary tract infection (UTI) has become a common urological problem the last decades, with women being affected three times more than men. Also, children and young adults suffer from this painful and frustrating ailment.

In a nutshell, urinary tract infection is your body’s poor response to opportunistic uropathogenic bacteria. Unfortunately, most sufferers still have no idea that there are options other than medicinal drugs to address it.

Also, many UTI sufferers believe, and/or have been told, that their condition is much TOO SERIOUS for natural measures to be the proper solution.

That’s why you should know about Uribiotic Formula. Along with other specialty naturopathic UTI supplements, it can be the right way to remedy UTIs, naturally and effectively. This multi-herbal solution, accompanied by the time-tested practical steps, not only can help you fight the urinary infections, but also prevent them from coming back, so you will feel on top of the world again!

How Do I Know if I Have a UTI?

 (Female Symptom Checker)

Might have a urinary tract infection?

Interested in getting a second opinion?

Please fill in the five-part questionnaire below, answering all questions thoughtfully and to the best of your knowledge. By doing so, you will be much better prepared for an eventual doctor’s appointment. It might also help your doctor determine if you need a urine test, which is not always a routine practice.

As for the symptoms, they are sensations or perceptions of changes in health experienced by yourself or someone you know, or hold dear who too may be in need for help.

Within 12 to 24 hours, we will email* you back the results along with our brief recommendations (if necessary) that may help you get your urinary tract health back on track. The information given, however, is not intended to diagnose, prescribe or replace the advice of a physician or other healthcare professional.

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As privacy is one of the most important issues for all of us on the Internet, please rest assured that all your answers in this questionnaire are strictly confidential. We do not share any part of the completed questionnaire with anyone. Also, your email address is safe with us. We will never rent, sell, or exchange your contact information with anyone.

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