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The chances of a woman’s pelvic pain being a UTI are far greater than having an ovarian cyst — but the symptoms are similar. What do you need to know?

A urinary tract infection, more often shortened to UTI, is an infection that can involve any single element of the urinary tract, or all of it. While it is known that almost all women have a urinary tract infection almost once in their lives, many are plagued by recurrent infections that have a significant impact on their quality of life. It is especially frustrating when you receive treatment for a UTI, only for the symptoms to return soon after. In these cases, you may wonder if you have an ovarian cyst instead, especially after searching the web for possible causes of your symptoms. 

The urinary tract is composed of the urethra, bladder, ureters, and also the kidneys. A simple UTI is an infection that only affects the urethra and bladder, while a complex urinary tract infection has reached the kidneys. Once the kidneys are subject to an infection, the pain and severity become more urgent. If left untreated, the infection may spread to the blood. That condition is called sepsis and is a full-blown medical emergency.

A urinary tract infection is most often attributed to the bacteria E. coli. These bacteria live in the intestines and in a healthy person seldom cause problems. However, if E. coli manages to make its way into the urethra, these bacteria can bring on a painful UTI. A UTI can also be caused by malformations or blockages in the urinary tract, as well as by other bacteria, though this is less likely.

What is an ovarian cyst?

Ovarian cysts can be asymptomatic to the point that a woman never realizes she has them. Ovarian cysts can go away on their own, and some are completely harmless or even "functional". Others, of course, may cause pain, pressure, and need intervention before they cause more complex issues.

An ovarian cyst is a pocket, or sac, of fluid, gas, or even a semi-solid substance that grows in or on a female’s ovaries. Most ovarian cysts are benign; meaning they are not cancerous. If they are large, there may be some symptoms that affect the urinary tract and the reproductive system.

If larger ovarian cysts are located in the proximity of the bladder, they may put pressure on it, which in turn will give a woman discomfort and even pain. This discomfort has the ability to mimic the symptoms of a urinary tract infection. Sometimes, the pressure bestowed upon the bladder can actually cause a UTI, thus confusing the situation even more.

Ovarian cysts are either simple or complex. The ovarian cysts referred to as simple hold only fluid, while those deemed complex are filled with fluid and solid components.

Comparing the symptoms of a UTI and ovarian cysts

Many of the symptoms that plague a woman who suffers from ovarian cysts are also present during a urinary tract infection. This may bring on confusion, and sometimes, unnecessary worry.

The symptoms that are the same in both urinary tract infections and ovarian cysts include:

  • A sensation of pressure or a feeling of fullness in the lower abdomen
  • A more frequent or urgent need to urinate
  • A feeling that something is pushing on the bladder
  • Pain during sex or urination

Urinary tract infection symptoms that don’t mimic the signs of ovarian cysts include:

  • A burning feeling while urinating
  • Cloudy, white, dark, pink, or red tinged urine
  • Less productive urination — feeling like you have not completely emptied your bladder even when you cannot pee any more
  • Incontinence
  • Urinary retention
  • Mental changes
  • Fever and chills

The confusion may grow if the pressure from large ovarian cysts causes an actual urinary tract infection. A woman will have all the expected symptoms of a urinary tract infection and chances are she will be treated for only the UTI, since the urinalysis and culture done by the doctor show an infection and bacteria present in her urine, and doctors will first look for more common conditions.

If the pain and other related symptoms subside after treatment and do not return, then the condition the female was suffering from was most likely only a UTI. But, if the symptoms continue or return, further evaluation and tests may be required, and they may determine that the woman also had an ovarian cyst.

How does my doctor make a diagnosis to differentiate between a UTI and ovarian cysts?

Distinguishing between a urinary tract infection and ovarian cysts can be a long and often frustrating experience for a woman. It involves a process of elimination. The first, and most obvious tests will be a urinalysis and culture to check for a UTI. If these tests are positive, a woman will probably be prescribed a round of antibiotics to relieve the symptoms and cure the urinary tract infection.

Once she is retested and it is proven that the UTI has been cleared, then the remaining symptoms, if any, will be discussed between the woman and her physician.

The next step could be a kidney and bladder scan, or a cystoscopy (a hollow tube with a camera lens is inserted into the urethra and advanced into the bladder). These tests are meant to rule out such issues as kidney stones or unidentified infections.

When no complications are discovered in the urinary tract, then more advanced testing is needed. The doctor may order an ultrasound, and/or an MRI scan. In these cases, the doctor will be searching for ovarian cysts or ovarian cancer.

Treatments for UTIs and ovarian cysts

The common treatment for a urinary tract infection is antibiotics. A simple infection, one that encompasses the urethra and bladder only, will be treated with three to seven days of antibiotics such as amoxicillin. For a more complex UTI, one that involves the kidneys, patients will receive seven to fourteen days of antibiotics to ensure that the infection is cleared out completely. If the patient is too ill to take medication by mouth, too dehydrated, or the infection has spread to the blood and become sepsis, then hospitalization with intravenous antibiotics and fluids will be absolutely necessary.

Ovarian cysts are likely to resolve themselves with no treatment or intervention necessary. The ovarian cyst will simply dissolve or rupture. Even if an ovarian cyst does rupture, there may be no noticeable symptoms.

However, if the cysts rupture and there is intense or rising pain, and dizziness, then the patient must seek medical aid. Either immediately go to a doctor or an emergency room, especially if there is bleeding involved.

Most normal symptoms of an ovarian cyst are treated conservatively. Usually, only over the counter or prescription pain medication is necessary until the cysts are gone. Surgery is only used if the cyst turns out to be a tumor, there is excessive bleeding, or another life-threatening event occurs because of the ovarian cysts.


The chances of a woman’s pain being a UTI are far greater than having an ovarian cyst. Fifty percent of females will have one or more UTIs in their lifetime. They are painful, inconvenient, and frustrating. But, if they are caught in the early stages, easily resolved.

To prevent urinary tract infections:

  • Drink plenty of water – six to eight glasses a day
  • Wipe from front to back after using the bathroom
  • Wear cotton underwear
  • Urinate immediately after sex
  • Empty the bladder often and completely
  • Follow good hygiene

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