Chlamydia vs UTI: How to tell the difference

Chlamydia and urinary tract infections (UTIs) are common but distinct infections. They often share similar symptoms such as burning during urination and lower abdominal pain and affect the urinary and genital tracts, which is why they are often confused. However, a clear diagnosis and timely detection are extremely important, as the causes, transmission routes, and treatment approaches differ. Untreated or incorrectly treated infections can lead to long-term health problems. In this blog, you will learn everything about the differences between chlamydia and a urinary tract infection.

Table of contents

• What is a chlamydia infection?
• What is a urinary tract infection (UTI)?
• Causes and transmission routes
• Symptoms: How do chlamydia and UTIs differ?
• Diagnosis: How to tell the difference
• Why is the right treatment important?
• Tips for effective prevention
• Summary

What is a chlamydia infection?

A chlamydia infection is a sexually transmitted infection (STI) caused by the bacterium Chlamydia trachomatis. It is one of the most common STIs and often goes unnoticed because it is asymptomatic in many cases. Around 70% of infected women and 50% of infected men show no or only mild symptoms. Untreated chlamydia infections can have serious health consequences, such as chronic inflammation of the reproductive organs, infertility, or complications during childbirth in pregnant women (Cleveland Clinic, 2023).

What is a urinary tract infection (UTI)?

A urinary tract infection (UTI) is a bacterial infection of the urinary tract, most commonly caused by bacteria such as Escherichia coli. The abbreviation UTI stands for “urinary tract infection.” It typically affects the lower urinary tract—the urethra and bladder—and is then referred to as cystitis. Less commonly, it can also affect the upper urinary tract, such as the kidneys, which is known as pyelonephritis. UTIs are not sexually transmitted but can be triggered by sexual activity. If left untreated, they can lead to serious infections, especially when the kidneys are involved (CDC, 2024).

Causes and transmission routes

How is chlamydia transmitted?

Chlamydia is mainly transmitted through unprotected sexual intercourse (vaginal, anal, or oral). The pathogen Chlamydia trachomatis enters the body through mucous membrane contact. Transmission can also occur from an infected mother to the newborn during childbirth (Cleveland Clinic, 2023).

How does a urinary tract infection develop?

A urinary tract infection (UTI) usually develops when bacteria—often Escherichia coli from the intestines—enter the urinary tract through the urethra and multiply. Factors such as inadequate intimate hygiene, frequent sexual activity, lack of fluid intake, or a weakened immune system can promote infection. The risk is particularly high in women because the shorter urethra allows bacteria to reach the bladder more easily (NHS, 2022).

Can a UTI be triggered by sexual activity?

Yes, a urinary tract infection (UTI) can be triggered or facilitated by sexual activity. Intercourse can introduce bacteria, usually from the intestines, into the urethra, where they can cause an infection.

Symptoms: How do chlamydia and UTIs differ?

Chlamydia and urinary tract infections (UTIs) differ in their symptoms: Chlamydia often causes no symptoms at all, whereas UTIs almost always cause noticeable complaints. Chlamydia is typically associated with unusual discharge, as well as lower abdominal pain and pain during intercourse. UTIs, on the other hand, usually lead to cloudy, foul-smelling, or bloody urine and primarily cause pain during urination and in the bladder area. Below you’ll find a detailed overview of the symptoms:

Symptoms of a chlamydia infection

If symptoms occur with a chlamydia infection, they may include:

• Unusual, often pus-like or clear discharge from the urethra or vagina.
• Pain or burning during urination.
• Lower abdominal pain or a feeling of pressure.
• Pain or burning during sexual intercourse.
• In men: pain and swelling in the testicular area, which may indicate epididymitis.

Symptoms of a urinary tract infection (UTI)

UTIs usually cause clear and immediately noticeable symptoms because the urinary tract is irritated and inflamed. Typical symptoms include:

• Strong, frequent, or urgent need to urinate, often in small amounts.
• Burning and pain during urination.
• Cloudy, foul-smelling, or bloody urine.
• Pain in the lower abdomen or pelvic region.
• In advanced cases: fever, chills, and flank pain (a sign of kidney involvement).

Knowing the characteristic differences in symptoms can help you more clearly identify the cause when symptoms appear (Mayo Clinic, 2024; Cleveland Clinic, 2023).

When should you see a doctor?

• If you have UTI-specific symptoms such as intense burning or pain during urination and changes in urine.
• If UTI symptoms do not improve after one to two days despite adequate fluid intake.
• If you have chlamydia-specific symptoms such as unusual discharge.
• After unprotected sex with changing partners, especially if chlamydia is suspected.
• If you experience persistent discomfort in the lower abdomen or pelvic region.
• Because chlamydia often causes no symptoms, regular STI screenings are recommended.

Early medical consultation is important to ensure the correct diagnosis and treatment and to prevent complications (Mayo Clinic, 2024; Cleveland Clinic, 2023).

Diagnosis: How to tell the difference

The diagnosis of chlamydia and urinary tract infections (UTIs) differs in the types of samples and tests used:

How is chlamydia diagnosed?

Chlamydia is diagnosed through specialized laboratory tests. Urine samples or swabs from affected mucous membranes (e.g., cervix, urethra, throat) are collected and tested for the bacterium Chlamydia trachomatis. In Germany, chlamydia tests can be performed by general practitioners, gynecologists, or urologists. Alternatively, self-tests for home use are also available.

How is a UTI diagnosed?

A urinary tract infection (UTI) is usually diagnosed through a urine test. The doctor takes a urine sample and checks it with test strips for signs of inflammation. If a complicated infection is suspected, a urine culture is performed in the laboratory to identify the exact pathogen, allowing for more targeted treatment (NHS, 2022).

Want to check for yourself?

If you suspect that you may have a sexually transmitted infection (STI) or simply want peace of mind about your sexual health, Homed-IQ’s home tests offer a discreet and reliable solution. With the comprehensive STI test, you can conveniently test yourself for multiple STIs from home. Alternatively, there are specialized tests available for individual STIs, such as the chlamydia or syphilis test. All tests are delivered in 100% discreet packaging and the results are analyzed in ISO-certified laboratories.

Why is the right treatment important?

Proper treatment of chlamydia and urinary tract infections (UTIs) is essential to prevent the infections from spreading and causing serious long-term damage. Untreated chlamydia can lead to inflammation of the uterus and fallopian tubes and, in the worst case, cause infertility in women. Untreated UTIs can develop into kidney infections and, if chronic, cause permanent kidney damage.

How is chlamydia treated?

Chlamydia is treated with antibiotics that must be taken in a fixed dosage and for a specific duration as prescribed by a doctor. It is important to take the antibiotic regularly and for the full course, even if symptoms improve earlier, to ensure complete recovery. In addition, all sexual partners should be treated to prevent reinfection. Sexual activity should be avoided during treatment to prevent further transmission.

What is the treatment for a urinary tract infection?

Mild urinary tract infections (UTIs) do not always require antibiotics. Sometimes they can resolve on their own with plenty of fluids, rest, and symptom-relieving measures. However, if symptoms are persistent, severe, or recurrent, antibiotic treatment is recommended. The medication is typically taken over several days, exactly as prescribed by a doctor. In addition, pain-relieving medication and high fluid intake can help alleviate symptoms and flush bacteria from the urinary tract more quickly.

Tips for effective prevention

To prevent urinary tract infections (UTIs), the following measures can help:

• Drink plenty of fluids: Drinking lots of water helps flush the urinary tract regularly.
• Hygiene: Wipe from front to back after using the toilet to keep intestinal bacteria away.
• Urinate after sexual intercourse: This helps flush out any bacteria that may have entered.
• Intimate hygiene: Use mild products, as harsh soaps can disrupt the natural balance.
• Breathable underwear: Cotton underwear helps maintain a dry environment and reduces bacterial growth.

Source: NHS, 2022

Chlamydia infections can be prevented with the following measures:

• Use condoms: Condoms offer reliable protection by reducing direct mucous membrane contact—though only when used correctly.
• Regular screening tests: STI tests are advisable with frequent partner changes, in a new relationship, or after unprotected sex. Testing is also important because chlamydia often causes no symptoms and can only be detected and treated in time this way.
• Open communication: Honest conversations about sexual health build trust and help prevent the unintentional transmission of infections.

Source: Cleveland Clinic, 2023

Summary

Chlamydia and urinary tract infections (UTIs) are common but distinct infections that often share similar symptoms, such as burning during urination and lower abdominal pain. While chlamydia is often asymptomatic and sexually transmitted, UTIs usually result from bacteria in the urinary tract and cause clearly noticeable symptoms. However, the causes and treatment approaches differ, which is why a clear diagnosis is essential to avoid long-term health consequences.