- Infection
Urinary Tract Infections in Women: Symptoms, Causes and Preventing Recurrence
A urinary tract infection (UTI) usually occurs when bacteria from the bowel enter the urinary tract, most often affecting the bladder (cystitis). Typical symptoms include burning when passing urine, frequent and sudden urges to urinate, and cloudy urine. Seek medical advice promptly if you have fever, chills, pain in your back below the ribs or blood in your urine.
care with .ki5 min readContent principles
In brief:
- More than half of adult women have a urinary tract infection at least once in their lifetime.
- A doctor diagnoses and treats the infection; do not decide on your own to take leftover antibiotics.
- Two infections in six months or three in 12 months are classed as recurrent and need medical assessment.
- Studies suggest that drinking more water and cranberry products may help reduce recurrences; the largest placebo-controlled study of D-mannose found no benefit.
How common is it?
More than half of adult women (50–60%) have a urinary tract infection at least once in their lifetime (Medina and Castillo-Pino, 2019). One reason UTIs are more common in women is that their urethra is shorter than men's (NHS).
What are the symptoms?
Symptoms listed by the NHS include:
- Pain or burning when passing urine
- Needing to urinate more often than usual, including at night
- A sudden, strong urge to urinate
- Cloudy urine
- Blood in the urine
- Pain in the lower abdomen or back, just below the ribs
- High temperature, chills or a body temperature below 36 °C
- Tiredness or weakness
When should you seek medical advice promptly?
The NHS recommends prompt medical assessment if you have:
- A high or very low temperature, or chills
- Pain in the lower abdomen or back, below the ribs
- Blood in the urine; it may look pink, red or dark brown
- Pregnancy
- Age 65 or over
- Diabetes or a weakened immune system
- A urinary catheter
- Symptoms that worsen quickly or do not improve within 48 hours of starting treatment
- Frequent recurrence: two infections in six months or three in 12 months
UTIs in men and children aged 15 or under should also always be assessed by a doctor. If there is confusion, extreme drowsiness or difficulty speaking, call 112 without delay.
What causes it, and what increases the risk?
UTIs usually occur when bacteria from faeces enter the urinary tract (NHS). Risk factors include:
- Pregnancy
- Wiping from back to front after using the toilet
- Conditions that block the urinary tract, such as kidney stones
- Not emptying the bladder completely
- A urinary catheter
- A weakened immune system
- Menopause
- Contraceptive methods that use spermicide
- Not drinking enough fluids
How is it treated?
A doctor diagnoses and treats the infection. They may request a urine test and will often prescribe a short course of antibiotics. Sometimes they may suggest waiting 48 hours to see whether symptoms clear on their own. Finish the prescribed medicine even if you feel better (NHS).
Only take antibiotics prescribed for you; do not decide on your own to use leftover antibiotics or someone else's prescription (NHS). Your doctor decides which medicine is needed.
What is a recurrent urinary tract infection?
Two infections within six months or three within 12 months are classed as recurrent UTIs. You need to see a doctor in this situation (NHS). They investigate the cause and discuss preventive options with you. In perimenopausal or postmenopausal women, vaginal oestrogen is one option when behavioural and hygiene measures are insufficient (NICE NG112). A doctor makes this decision.
What helps prevent recurrence? What does research say?
| Measure | What does research say? |
|---|---|
| Drinking more water | In a study of 140 premenopausal women who drank less than 1.5 litres of fluid daily and had frequent cystitis, those drinking an extra 1.5 litres of water each day had an average of 1.7 episodes in a year, compared with 3.2 without extra water (Hooton et al., 2018). The study was unblinded and funded by a water manufacturer. |
| Cranberry products | A Cochrane review (2023) found that they reduced the risk by around a quarter in women with recurrent infections. No benefit was demonstrated in older people living in care homes, pregnant women or people who have difficulty emptying their bladder. Avoid cranberry products if you take warfarin (NHS). |
| D-mannose | In a placebo-controlled study of 598 women with recurrent infections, it did not reduce recurrences (Hayward et al., 2024). |
| Wiping from front to back, urinating after sex and not holding urine | These are among the NHS recommendations. There are few strong studies measuring their effects separately. |
| Avoiding spermicidal condoms and diaphragms | Spermicide is among the factors that increase the risk (NHS). |
Cranberry products do not treat an infection that has already started (NHS). If you are pregnant, speak to your doctor before using cranberry or D-mannose (NHS).
The link with intimate hygiene
To help prevent UTIs, the NHS recommends:
- Keep the genital area clean and dry.
- Do not use scented soap in the area.
- Wash the external area with water before and after sex.
- Wear cotton underwear.
For everyday care, see Basic Rules for Genital Hygiene and our Intimate Area Care Guide.
Frequently asked
Can a urinary tract infection clear up on its own?
Mild infections may sometimes clear within a few days, which is why a doctor may suggest waiting 48 hours (NHS). If you have fever, back pain or blood in the urine, seek medical advice promptly.
Does cranberry juice cure a urinary tract infection?
No. Cranberry products do not treat an infection that has already started; evidence suggests they may lower the risk of recurrent infections (Cochrane, 2023; NHS).
Why do UTIs become more common during menopause?
UTIs or similar symptoms may become more frequent during menopause (NHS). If they recur, a doctor may consider options including vaginal oestrogen (NICE NG112). For other menopause symptoms, see What Are the Symptoms of Menopause?.
References
- NHS. Urinary tract infections (UTIs). Last reviewed 11 July 2025. https://www.nhs.uk/conditions/urinary-tract-infections-utis/
- Medina M, Castillo-Pino E. An introduction to the epidemiology and burden of urinary tract infections. Therapeutic Advances in Urology, 2019;11:1756287219832172. doi:10.1177/1756287219832172
- Hooton TM, Vecchio M, Iroz A et al. Effect of increased daily water intake in premenopausal women with recurrent urinary tract infections: a randomized clinical trial. JAMA Internal Medicine, 2018;178(11):1509–1515. doi:10.1001/jamainternmed.2018.4204
- Williams G et al. Cranberries for preventing urinary tract infections. Cochrane Database of Systematic Reviews, 2023;11:CD001321. doi:10.1002/14651858.CD001321.pub7
- Hayward G et al. d-Mannose for prevention of recurrent urinary tract infection among women: a randomized clinical trial. JAMA Internal Medicine, 2024;184(6):619–628. doi:10.1001/jamainternmed.2024.0264
- NICE. Urinary tract infection (recurrent): antimicrobial prescribing (NG112). Published 31 October 2018; updated 12 December 2024. https://www.nice.org.uk/guidance/ng112
- NHS. Symptoms of menopause and perimenopause. Last reviewed 19 May 2026. https://www.nhs.uk/conditions/menopause-and-perimenopause/symptoms/
- NHS. Antibiotics. Last reviewed 11 November 2022. https://www.nhs.uk/medicines/antibiotics/
