UTIs in women: symptoms, recurrences and when it is urgent
A urinary tract infection (UTI) is an infection of the bladder, urethra or kidneys and, according to the NHS, is most often caused by bacteria from the gut getting into the urethra. Women get them more often because their urethra is shorter. Recurrent infections (2 in 6 months or 3 in 12 months) need a doctor's appointment, while a high temperature, pain in the lower back under the ribs or blood in your urine are signals for urgent help.
- According to the NHS, the typical symptoms are pain or a burning sensation when peeing, needing to pee more often and more urgently, cloudy urine and pain low in the stomach.
- Women are more vulnerable because their urethra is shorter and bacteria reach the bladder or kidneys more easily.
- The NHS defines recurrent UTIs as 2 in 6 months or 3 in 12 months – at this frequency you need to see a doctor.
- An antibiotic is not always necessary – with mild symptoms the doctor may suggest waiting up to 48 hours, as the infection may clear up on its own.
- Pain in the lower back under the ribs, fever and shivering can mean a kidney infection, which without treatment can lead to sepsis.
What are the symptoms of a UTI in women?
According to the NHS, a UTI can affect the bladder (cystitis), the urethra (urethritis) or the kidneys. The most common signs in adults are:
- pain or a burning sensation when peeing;
- needing to pee more often than usual, including at night, or suddenly and urgently;
- cloudy urine or blood in your urine – pink, red or dark brown;
- pain low in the stomach or in the lower back just under the ribs;
- a raised temperature, feeling hot and shivery, or the opposite – an unusually low temperature;
- tiredness and feeling run down.
The NHS clarifies that dark or strong-smelling urine on its own may simply mean that you are not drinking enough fluids, not necessarily an infection.
Why do women get UTIs more often?
The cause is usually bacteria from poo getting into the urinary tract through the urethra. In women the urethra is shorter, so according to the NHS bacteria reach the bladder and kidneys more easily. The risk is also higher in pregnancy, after menopause, when using spermicide with contraception, with a weakened immune system (for example poorly controlled diabetes or chemotherapy), with kidney stones or other blockages that stop the bladder emptying, with a catheter, and when you do not drink enough fluids.
Why do UTIs come back and what can be done?
The NHS defines recurrent UTIs as 2 episodes in 6 months, 3 in 12 months, or an infection that comes back straight after treatment. In this case you should see a doctor rather than self-treat. Possible approaches according to the NHS include a different antibiotic or a low dose of antibiotic for up to 6 months, vaginal oestrogen (cream, gel, tablet, pessary or ring) for women in perimenopause or after menopause, tablets to treat and prevent recurrence, as well as referral to a specialist for further tests.
There are also chronic (long-term) UTIs, where the symptoms do not go away after a short course of antibiotics and urine tests may not show an infection. The NHS explains that these are difficult to diagnose and may need prolonged antibiotic treatment – if the complaints continue, ask for a referral to a specialist.
How is it treated and what can I do myself?
According to the NHS, the doctor may do a urine test, but this is not always needed. The options are self-care with painkillers, a short course of antibiotics, or waiting up to 48 hours before starting antibiotics, because the symptoms may clear up on their own. If you have been prescribed medicine, finish the whole course, even if you feel better sooner.
For relief the NHS recommends paracetamol (up to 4 times a day for adults), rest and plenty of fluids, so that you regularly pass pale urine. Avoid bladder irritants such as fruit juices, coffee and alcohol. Important: according to the NHS, there is no evidence that cystitis sachets or cranberry drinks relieve symptoms or treat an infection that has already started.
How can I reduce the risk of another UTI?
The NHS gives practical everyday advice:
- wipe from front to back and keep the genital area clean and dry;
- drink plenty of fluids, ideally water;
- wash the skin around the vagina with water before and after sex, and pee soon after sex;
- wear cotton underwear and avoid tight clothing;
- do not put off going to the toilet and do not rush – empty your bladder fully;
- do not use scented soaps in the genital area;
- avoid condoms, diaphragms or caps with spermicidal lubricant – use a non-spermicidal one or another method;
- cut down on large amounts of alcohol and sugary foods and drinks.
For recurrent cystitis, the NHS states that D-mannose or cranberry products may help according to some evidence, but both can contain a lot of sugar, and women on warfarin should avoid cranberry. If you are pregnant, talk to a doctor before taking them.
When should you see a doctor?
According to the NHS, women aged 16–64 who are not pregnant or breastfeeding can consult a pharmacist. However, get an urgent appointment with a doctor if:
- you are pregnant;
- you have a very high or low temperature, feel hot and shivery or are shaking;
- you have diabetes or a weakened immune system;
- your symptoms get worse quickly or do not improve within 48 hours of starting treatment;
- you have recurrent UTIs – 2 in 6 months or 3 in 12 months;
- you have pain low in the stomach or in the lower back under the ribs;
- you notice blood in your urine;
- you use a catheter or are over 65.
Pain in the lower back under the ribs, fever, shivering and feeling generally unwell can mean a kidney infection, which according to the NHS can become serious without treatment and lead to sepsis. Call the emergency services if you or someone close to you is confused, drowsy or has difficulty speaking. Do not drive yourself – have someone take you or call an ambulance.
Frequently asked questions
Do cranberry drinks help with a UTI that has already started?
According to the NHS, there is no evidence that cranberry drinks or cystitis sachets relieve symptoms or treat an established infection. They are only discussed as possible prevention for recurrent cystitis.
Do I always have to take antibiotics for a UTI?
No. The NHS states that antibiotics are not always necessary – with milder symptoms the doctor may suggest painkillers and waiting up to 48 hours, because the infection may clear up on its own.
Why do UTIs become more frequent after menopause?
The NHS lists menopause as a risk factor and recommends that, for recurrent infections in perimenopause or after menopause, you discuss vaginal oestrogen with a doctor, in the form of a cream, gel, tablet, pessary or ring.
Sources
- NHS – Urinary tract infections (UTIs) – last reviewed by the NHS: 11 July 2025
Informational article retold in our own words from the sources listed. It does not replace a consultation with a doctor; in an emergency call 112. If you spot an inaccuracy, write to [email protected].