How to Recognize Silent UTIs

Last summer, as I sat at my desk at work, something dawned on me: I was very, very cold. This wasn’t necessarily out of the ordinary (I was in a corporate office, most of which are uncomfortably cold, especially for women), but when I went out into the midday August sun and still felt very, very cold, I knew something was amiss. I took my temperature, saw it was 103 degrees Fahrenheit, and decided to take the rest of the day off to go to urgent care.

As soon as I got there, the doctor sized up my symptoms — the fever, plus an embarrassing vomiting and fainting spell that had struck me in the lobby — as a sign of possible meningitis, and immediately packed me into an ambulance to go to the emergency room.

Long story short, I did not have meningitis. Several hours (and a hefty bill) later, I was presented with a diagnosis: the only thing wrong with me, as far as the doctors could tell, was...a urinary tract infection.

I was shocked. I tried to rack my brain for signals I had missed, like painful urination, but over the course of the previous month, the E.coli bacteria that had apparently burrowed into my urethra and made its way up to my kidneys had, as far as I could tell, given me no indication whatsoever of its existence.

A urinary tract infection is a type of bacterial infection that can be treated with antibiotics. According to Dr. Mary Jane Minkin, clinical professor of obstetrics and gynecology at Yale University, these kinds of UTIs (often called “silent” UTIs) are more common than one might think. And, although they can happen to anyone of any age (I was 24 at the time of my hospitalization) the symptoms of a UTI tend to be less noticeable in older patients, meaning they are easier to miss. But UTIs are never truly silent — you just have to know what to look for. Here are some silent UTI symptoms and signs you may have a UTI without realizing it.

increased confusion

One of the most commonly misunderstood signs of UTIs in older women is a noticeable uptick in confusion. Relatives and doctors may assume this disorientation is just a symptom of old age, but it could point to a UTI that, if left untreated, might lead to much more serious medical conditions such as a kidney infection.

Many women also doubt or can’t recognize their own symptoms, too. That’s why, Minkin says, she has “a very low threshold [for testing UTIs]. If someone’s having any symptoms, I want them to go ahead and get a test.”

nausea and high fever

If a UTI has gone untreated for some time, it may travel up to the kidneys, causing nausea and a high fever.

“If someone’s got a high fever, think urinary tract. That’s something that should flash through the brain of a healthcare provider,” Minkin said.

If you are experiencing a high fever and some nausea, you should go to the doctor — no matter what, you’ll probably need some kind of treatment.

increased urge to urinate

Frequent urination is one of the better-known UTI symptoms. But sometimes it’s difficult to pick up on, particularly if you’re making an effort to drink more fluids or your bladder and pelvic floor capacity has changed.

But if you notice that your urination urges have shifted from “Huh, I should probably find a bathroom” to “I need to find a bathroom now, or else,” you may want to visit a doctor. This is especially true if, every time you sit down to use the toilet, your urine is cloudy or bloody, has a funny smell, or you feel you can’t fully empty your bladder. Chances are, your doctor will run a test for a UTI, either to rule it out or treat it ASAP.

high blood sugar

People with diabetes can be more susceptible to UTIs. In a study of people diagnosed with UTIs, 9.4% of those diagnosed had diabetes, as opposed to 5.7% diagnosed who did not have diabetes.

People whose diabetes isn’t well controlled or hasn’t been diagnosed yet are especially at risk. Of course, this does not mean that all those who have diabetes and vaginas are cursed to endure UTIs for the rest of their lives. But if you have higher blood sugar than usual and you’re experiencing some other symptoms of a UTI, it’s worth getting checked out.

Likewise, an increased occurrence of UTIs can sometimes be an indicator of diabetes.

“If somebody starts getting a UTI and nothing else has changed, get checked, particularly if your family has a medical history of diabetes,” Minkin said.

what else can you do?

Fortunately, you don’t have to wait and see if you’ll experience UTI symptoms — there are many simple ways to lessen your odds. Minkin recommended staying hydrated, urinating after sexual intercourse, and always making sure to pee right when you get the urge to do so, instead of letting it stagnate in your bladder (barring, of course, people navigating overactive bladder syndrome or other conditions where training yourself to take longer breaks between bathroom trips is key).

Over time, as estrogen levels decline, vaginal tissue tends to get thinner, which can make you more susceptible to bacteria and infection than you were at other points in your life. For that reason, Minkin said a vaginal moisturizer or estrogen cream can be a really helpful tool to prevent infection.

To find out which vaginal moisturizer is best for you, just have a conversation with your doctor.

An untreated UTI can lead to a number of health issues involving the kidney, so it is important to see a doctor about your symptoms and start UTI treatment.

Have you ever had a UTI without realizing it? How do you pick up on your UTI symptoms? Share in the comments section! 

Sara Hendricks is a writer who lives in Brooklyn. When she’s not writing, she’s probably running, reading, or working hard at not getting a UTI.

Dr. Brandi Jones, DO is a board certified Obstetrician Gynecologist serving some of the most vulnerable residents of the District of Columbia in a community health center based practice. She is a graduate of Hampton University, and earned her medical degree from Philadelphia College of Osteopathic Medicine. Dr. Jones is an outdoor cycling novice with big goals, and enjoys international travel experiences.

At Thinx, we strive to provide our readers with the most up-to-date, objective, and research-based information. Our content is crafted by experienced contributors who ground their work in research and data. All information has been fact-checked and extensively reviewed by our team of medical professionals to ensure content is accurate. Articles contain trusted third-party sources that are either directly linked within the text or listed at the bottom to lead readers to the original source.