Why Vulvar Dysfunction Is Often Mistaken for a UTI—and What You Can Do About It

Is It Really a UTI? Here’s the Problem No One Talks About.

For people with vulvas, the answer to painful urination, irritation, or pressure is almost always: “It’s a UTI.” But what happens when it isn’t?

Many people cycle through antibiotics, negative tests, and ongoing discomfort—only to find out later the root cause wasn’t an infection at all. It was vulvar dysfunction.

What Is Vulvar Dysfunction, Exactly?

“Vulvar dysfunction” is an umbrella term for conditions that affect the skin, nerves, or structure of the vulva. Common examples include:

• Vulvodynia or vestibulodynia (nerve-related pain)

• Hormonal atrophy (due to menopause, birth control, or postpartum changes)

• Skin irritation or allergic reactions

• Tight or spasming pelvic floor muscles

These issues can create UTI-like symptoms—including burning, pressure, and pain—without an actual bacterial infection.

The Overlap: Why Vulvar Dysfunction Feels Like a UTI

Vulvar pain or inflammation can easily be mistaken for a urinary tract infection, especially when the discomfort is near the urethra or during urination. Some people even feel internal “pressure” that mimics bladder pain.

What many people don’t know is that the skin and tissue around the vaginal opening (called the vestibule) are very similar to the tissue inside the bladder. So when that area gets irritated or inflamed, it can cause the same symptoms as a UTI—like burning, needing to pee a lot, or feeling like you can’t wait to go.

In fact, studies show that 60% of people with vulvar pain conditions report lower urinary tract symptoms that mimic UTIs.

According to urologist Dr. Maria Uloko, founder of VULVAi :

“You can have pain from inflammation, trauma, or nerve sensitivity that mimics a UTI. And it’s often dismissed or overlooked—especially if your urine culture comes back negative.”

Why It Gets Misdiagnosed (A Lot)

Unfortunately, vulvar dysfunction is frequently missed in medical settings. Here’s why:

• Many clinicians don’t know how to  perform full vulvar exams

• Negative UTI tests lead to dismissal

• Insurance often doesn’t cover specialized exams

• Patients may feel too embarrassed or unsure how to advocate

Bottom line: Many people are repeatedly treated for infections they don’t have—while the actual issue goes unaddressed.

How Vulvar Health Can Lead to Real UTIs

• → Hormonal changes (birth control, postpartum, menopause)
    → Disrupt the vaginal microbiome
    → Lower vaginal pH
    → Increase susceptibility to infections

• → Thinning of vulvar tissue due to low estrogen/testosterone
    → Weakens the tissue’s natural barrier
    → Makes it easier for bacteria to enter

• → Skin irritation or microtears near the urethra
    → Can occur from dryness, itching, or inflammation
    → Create access points for bacteria

• → Painful sex and friction
    → Leads to inflammation and breakdown of tissue defenses

• → Pelvic floor tension or dysfunction
    → May cause incomplete bladder emptying
    → Promotes urine retention and bacterial growth

So even when you do get a UTI, treating only the infection without addressing the underlying issue sets you up for the next one. Understanding this connection is key to getting the right treatment—not just for pain, but for recurrent or treatment-resistant UTIs.

What You Can Do Today

✅ 1. Rethink Testing

• Use PCR testing (like the MyUTI Complete Test) to confirm whether there’s actually an infection before starting antibiotics.

✅ 2. Know the Clues It Might Be Vulvar Dysfunction

• Pain that comes and goes or flares associated with  sex

• Burning or discomfort without urinary urgency

• Symptoms that don’t improve with antibiotics

✅ 3. Check In With Your Anatomy

• Use a mirror to look for redness, dryness, or irritation. 

Talk to a Specialist

Finding a vulvar specialist is important—but so is educating yourself. Unfortunately, most doctors are not trained in vulvar anatomy, pelvic floor dysfunction, or hormonally mediated pain. That’s why it’s critical to advocate for a comprehensive evaluation.

Ask your provider for:
→ A pelvic floor muscle exam
→ A vulvar skin assessment
→ A hormone evaluation (especially if you're postpartum, on birth control, or in perimenopause)

Not sure where to start?

➡️ Sign up for the VULVAi waitlist at VULVAi.co to get tools, guidance, and insights that help you understand your vulvar health—and advocate for the care you deserve.

“Your symptoms are real—even if your test results are negative. Vulvar dysfunction deserves the same attention and respect as any other medical condition.” —Dr. Maria Uloko

You’re not alone—and you’re not broken. At MyUTI, we’re working to transform UTI care by helping you rule out infection and understand the full picture behind your symptoms, including overlooked vulvar conditions.