Photo by JC Gellidon on Unsplash

Picture this: you’re curled up on the couch, clutching your abdomen, convinced you have a pesky urinary tract infection (UTI) yet again.

But if you’ve been doing all the right things to take care of UTIs, why do those familiar symptoms keep popping up? What if a UTI didn’t cause them?

Endometriosis and urinary tract infections are two totally different conditions, but the symptoms can sometimes be similar. In rare cases, some women are even diagnosed with endometriosis of the urinary tract or bladder endometriosis, which can cause symptoms that are strikingly similar to that of a UTI. They can’t make it any more confusing for us, can they? 

Here’s the thing. UTIs can be easily treated with antibiotics or d-mannose supplements, but endometriosis is a more severe condition that requires a more intensive approach. Often, women with endometriosis are misdiagnosed with UTIs.1 For this reason, it is imperative to understand the connection between the two and distinguish their symptoms to better advocate for yourself when seeking treatment or advice from a medical professional to help with your diagnosis. 

Let’s explore the link between endometriosis and UTIs so you can move forward with all the necessary knowledge to get the relief you deserve. 

Can Endometriosis Cause UTIs?

Although some studies have shown that women with endometriosis suffer from UTIs more frequently than those who do not, endometriosis is not a direct cause of a UTI.1  As mentioned, the symptoms of both endometriosis and UTI can be similar, but don’t worry – you’ll get a thorough explanation of both to clear up any confusion.

What is Endometriosis?

Every time you get your period, your uterus sheds its inner lining— also known as the endometrium. The endometrial tissue can sometimes grow outside its designated area, leading to an all-too-common but overlooked condition called endometriosis. Symptoms of endometriosis vary, with pain being one of the most common types experienced. 

Truthfully speaking, the exact cause of endometriosis is not fully understood, but some experts think it may be related to hormonal imbalances that cause abnormal growth of endometrial tissue.2

There also seems to be a strong genetic component to endometriosis. This means you’re much more likely to have endometriosis if your mother, sister, or another relative also has it. This is something you, in fact, do not hope to get from your mama.  

Some other common symptoms of endometriosis can include:

  • Pain during sex
  • Heavy menstrual periods
  • Severely painful periods
  • Nausea
  • Fatigue
  • Anxiety
  • Depression
  • Difficulty conceiving

Endometriosis can affect many different body areas. The endometrial tissue can commonly be found on the ovaries, fallopian tubes, outer surface of the uterus, and pelvic lining, and in rare cases, it may spread to other organs in the abdomen or pelvis.

For this reason, symptoms of endometriosis can vary depending on what part of the body is being affected. This is why it’s pretty unsurprising that the symptoms of these two very different conditions (endometriosis and UTIs) can be similar in certain circumstances. 

So, which diagnoses are remarkably alike? Bladder endometriosis, or endometriosis of the urinary tract, occurs when the endometrial tissue grows into and around the bladder wall. This can cause bladder pain and painful urination, which are symptoms that could easily be confused with a UTI. It’s also common to be confused with other bladder conditions known as bladder pain syndrome or interstitial cystitis.

What is a UTI?

Urinary tract infections occur when any area of the urinary tract comes into contact with harmful bacteria, causing an infection. A UTI can affect any part of the urinary tract, including the urethra, ureters, bladder, and kidneys. Women are more often affected by UTIs due to shorter urethras, but they can happen to men as well.3

Common symptoms of a UTI will vary from person to person but can include:

  • Painful urination and pelvic pain
  • Difficulty urinating
  • Hematuria or blood in the urine
  • Urinary frequency
  • Low back pain

Do you notice any similarities between this list of symptoms and the one for endometriosis? 

Fortunately, your doctor can test you for a UTI using a simple urine test. Most UTIs can be easily treated with antibiotics, and some mild cases may even be treatable with natural remedies like d-mannose and cranberry supplements. 

The unfortunate part? Left untreated, UTIs can lead to more severe issues like a kidney infection, so it’s important to seek medical attention if you think you may have a UTI.

Needless to say, it is painfully easy for endometriosis symptoms to be mixed up with those of urinary tract infections. The pain experienced in and around the lower abdomen and pelvis when you have endometriosis can have the same triggers as pain from a UTI, including sex or going to the bathroom. However, as we’ve mentioned, it’s important to know that these two conditions are very different. 

To recap: 

  • Endometriosis is related to the uterus lining, and the cause isn’t entirely known. 
  • UTIs affect the urinary tract (such as the ureters, urethra, or bladder) and are caused by an overgrowth of “bad” bacteria in the urinary tract.  

Unfortunately, it can take many years to reach a diagnosis of endometriosis. A study published by the American Journal of Obstetrics and Gynecology found that the average time between the onset of symptoms and an accurate diagnosis of endometriosis was 6.7 years.4

But don’t you worry! There are protocols in place to get to the bottom of your diagnosis. 

Diagnosing Endometriosis and UTIs

Diagnosing endometriosis will start with a physical examination and a detailed review of your medical history. Your doctor may also want to do a pelvic exam and imaging tests such as an MRI. However, laparoscopic surgery is the most accurate method for diagnosing endometriosis.5 

As for UTIs, these infections are diagnosed using simple urine tests in which the urine is tested for any bacteria and other abnormal substances, such as blood cells. There are many other infections other than UTIs that commonly affect women, such as yeast infections and bacterial vaginosis. So you should work closely with your doctor to distinguish a clear diagnosis for proper treatment. 

UTIs shouldn’t be left untreated since they can quickly escalate into more severe infections and spread to the kidneys. Because endometriosis symptoms are uncomfortable and can get in the way of day-to-day life, it is important to determine if you have it when experiencing symptoms. Unfortunately, endometriosis that is left untreated can potentially lead to infertility. 

So, if you’re experiencing symptoms that could be a UTI or endometriosis and are unsure which one it is, you’ll most likely first be screened for a UTI since it’s easier to rule out. If the symptoms persist even after the infection is treated or if the UTI test shows that you don’t have an infection, this will warrant further investigation into the cause of the symptoms. 

Treating Endometriosis and UTI

Luckily, both conditions have treatment options. It is important to work closely with your primary healthcare provider or any other specialists you may need (such as a gynecologist or urologist) if you feel that your vaginal health or urinary tract health is not where it should be. 

Treating endometriosis focuses on pain management. Sometimes endometriosis does not require treatment when symptoms are mild, and there are no fertility problems. Your doctor may recommend hormonal therapy for endometriosis, and when pain is severe, surgery is sometimes required. 

Hormonal medications help to suppress ovulation to prevent the endometrial tissue from growing any more than it already has. However, ongoing treatment may be necessary to manage symptoms and prevent complications. 

Overall, a prompt diagnosis and treatment of endometriosis has been found to produce better patient outcomes.6 

With UTIs, antibiotics are often able to treat these infections quickly. But like we said earlier, if you experience recurrent UTIs or have mild symptoms, you may benefit from trying a natural remedy like d-mannose or cranberry supplements. 

Photo by Priscilla Du Preez on Unsplash

Final Thoughts

Endometriosis is not a direct cause of UTIs though some studies have found that women with endometriosis suffer from UTIs more frequently.1 It isn’t uncommon for endometriosis to cause symptoms similar to those of a UTI and vice versa. For this reason, it is important to remain informed about your body and any potential conditions you may be experiencing to clearly understand what’s going on to best advocate for yourself and find a definitive diagnosis. 

Sources

  1. Reference: Agarwal, S. K., Chapron, C., Giudice, L. C., Laufer, M. R., Leyland, N., Missmer, S. A., … & Taylor, H. S. (2018). Clinical diagnosis of endometriosis: a call to action. American journal of obstetrics and gynecology, 218(4), 347-e1. https://www.sciencedirect.com/science/article/pii/S000293781930002X
  2. Treloar, S. A., O’Connor, D. T., O’Connor, V. M., Martin, N. G., & Kennedy, S. H. (1999). Genetic influences on endometriosis in an Australian twin sample. issue Human Reproduction, 14(2), 756-760.
  3. Flores-Mireles, A. L., Walker, J. N., Caparon, M., & Hultgren, S. J. (2015). Urinary tract infections: epidemiology, mechanisms of infection and treatment options. Nature Reviews Microbiology, 13(5), 269-284.
  4. Agarwal, S. K., Chapron, C., Giudice, L. C., Laufer, M. R., Leyland, N., Missmer, S. A., … & Taylor, H. S. (2018). Clinical diagnosis of endometriosis: a call to action. American journal of obstetrics and gynecology, 218(4), 411-e1.
  5. Johnson, N. P., Hummelshoj, L., & Adamson, G. D. (2017). Diagnostic criteria for endometriosis: time for a rethink?. Fertility and sterility, 108(4), 730-731.
  6. Nnoaham, K. E., Hummelshoj, L., Webster, P., d’Hooghe, T., de Cicco Nardone, F., de Cicco Nardone, C., … & Zondervan, K. T. (2011). Impact of endometriosis on quality of life and work productivity: a multicenter study across ten countries. Journal of women’s health, 20(10), 1609-1618.