UTI vs thrush: telling a urine infection from a yeast infection

The quickest way to separate the two is to ask where the symptoms are and what they are doing. A UTI affects the urinary tract: the bladder, urethra or kidneys. Its signature is a change in how you pass urine, such as needing to go more often, more urgently, or at night, along with pain or burning when peeing and sometimes cloudy or bloody urine. Thrush affects the skin and lining around the vagina and vulva, or the head of the penis and foreskin in men. Its signature is itching, irritation and a thick white discharge.

The overlap is real, though. The NHS lists stinging when you pee as a thrush symptom in women, because urine passing over sore skin can sting, and burning when peeing is the best known UTI symptom. If urinary symptoms and discharge or itching occur together, it can be hard to know which is responsible, and the safest approach is to have it checked.

The NHS describes urinary tract infections as infections of different parts of the urinary tract, including cystitis (bladder infection), urethritis (infection of the urethra) and kidney infection. They are usually caused by bacteria from poo entering the urinary tract through the urethra. The NHS says women have a shorter urethra than men, so bacteria are more likely to reach the bladder or kidneys.

Thrush is a common yeast infection that affects men and women. The NHS says it is usually harmless but can be uncomfortable and keep coming back, and that it is not classed as a sexually transmitted infection (STI), although it can be triggered by sex. It is caused by a fungus called candida, which tends to grow in warm, moist conditions when the balance of bacteria changes.

The table uses only the symptoms the NHS lists for each. Not everyone has every symptom, and some people have none of the typical signs.

Both conditions can affect men. The NHS lists thrush symptoms in men as irritation, burning and redness around the head of the penis and under the foreskin, a white discharge like cottage cheese, an unpleasant smell and difficulty pulling back the foreskin. The NHS UTI advice says a man who thinks he may have a UTI should ask for an urgent GP appointment or call NHS 111, rather than treat it himself.

In older, frail people and people with a urinary catheter, the NHS says UTI symptoms may include changes in behaviour such as agitation or confusion, leaking pee that is worse than usual, and new shivering or shaking. Children with a UTI may have a high temperature, seem generally unwell, wet themselves or be sick.

For a UTI, the NHS says a pharmacist can give the same medicines as a GP to a woman or girl aged 16 to 64 who is not pregnant or breastfeeding. A GP may do a urine test, which is not always needed, and may offer self-care advice and a painkiller, prescribe a short course of antibiotics, or ask you to wait for 48 hours before starting antibiotics in case your symptoms go away. The NHS suggests paracetamol, resting, drinking enough fluids to pass pale pee regularly, and avoiding drinks that may irritate the bladder such as fruit juice, coffee and alcohol.

For thrush, you usually need antifungal medicine, either a tablet you take, a tablet you put into the vagina (pessary) or a cream to relieve irritation. The NHS says thrush should clear within 7 to 14 days of starting treatment and that partners do not need treatment unless they have symptoms. You can buy antifungal medicine from a pharmacy if you have had thrush diagnosed before and know the symptoms. The NHS warns that antifungal creams can damage condoms and diaphragms, so contraception might not work.

Antibiotics are listed by the NHS among the things that can trigger thrush, and an antifungal medicine targets a fungus rather than the bacteria behind a UTI. That is the main practical reason to be sure which problem you have.

For a suspected UTI, the NHS says to ask for an urgent GP appointment or get help from NHS 111 if you are aged 65 or over, your child is 15 or younger, you have a very high or low temperature or are shivering, you are a man, you have diabetes, your symptoms get worse quickly or do not improve within 48 hours, you keep getting UTIs, you use a catheter, you are pregnant, you have pain in the lower tummy or back, you have blood in your pee or you have a weakened immune system. Call 999 or go to A&E if you or your child are confused, drowsy or have difficulty speaking.

For thrush, the NHS says to see a GP if you have symptoms for the first time, are under 16 or over 60, thrush keeps coming back (more than 4 times in 12 months), treatment has not worked, you are pregnant or breastfeeding, or you have a weakened immune system. A sexual health clinic may also be able to help.