Painful urination for men and women may be the result of a sexually transmitted infections (STIs) or the side effect of medications. Chemotherapy cancer drugs or radiation treatments to the pelvic area may inflame the bladder and cause painful urination.
Dysuria (Painful Urination)
Dysuria means you feel pain or a burning sensation when you pee (urinate). Men and women of any age can experience dysuria, but it’s more common in women. Urinary tract infections are commonly associated with dysuria. Treatment depends on the cause and ranges from antibiotics, to avoiding irritants to treating the underlying medical problem.
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Overview
What is dysuria (painful urination)?
Dysuria is pain or discomfort when you urinate (pee). It burns! Dysuria isn’t about how often you go (urinary frequency), though urinary frequency often happens together with dysuria. Dysuria is not a diagnosis. It’s a sign or symptom of an underlying health problem.
Who gets dysuria (painful urination)?
Men and women of any age can experience painful urination. It’s more common in women. Urinary tract infections (UTIs) are commonly associated with dysuria. UTIs occur in more women than men.
Other people at a higher risk of dysuria include:
- Pregnant women.
- Men and women with diabetes.
- Men and women with any type of disease of the bladder.
What are the symptoms of dysuria (painful urination)?
Symptoms of painful urination can vary between men and women, but both genders usually describe it as a burning, stinging or itching. Burning is the most commonly reported symptom.
Pain can occur at the start of urination or after urination. Pain at the start of your urination is often a symptom of a urinary tract infection. Pain after your urination can be a sign of a problem with the bladder or prostate. In men, pain can remain in your penis before and after urination too.
Symptoms in women can be internal or external. Pain outside your vaginal area may be caused by inflammation or irritation of this sensitive skin. Internal pain can be a symptom of a urinary tract infection.
How is dysuria (painful urination) diagnosed?
See your healthcare provider if you feel pain or burning when you pee. Dysuria can be a symptom of medical condition that may need to be treated. To diagnose your pain, first your healthcare provider will review your complete medical history, including asking you questions about your current and past medical conditions, such as diabetes mellitus or immunodeficiency disorders. He or she may also ask about your sexual history to determine if an STI could be the cause of the pain. Tests to screen for STIs may also be needed, especially if men have a discharge from their penis or women have discharge from their vagina. If you are a woman of childbearing age, a pregnancy test may be done.
Your provider will also ask about your current prescriptions and over-the-counter medication use and any tried “home remedies” to manage the dysuria.
Your healthcare provider will also ask you about your current symptoms and obtain a clean catch sample of your urine. Your urine sample will be analyzed for white blood cells, red blood cells or foreign chemicals. The presence of white blood cells tells your provider you have inflammation in your urinary tract. A urine culture reveals if you have a urinary tract infection and if so, the bacteria that are causing it. This information allows your provider to select the antibiotic that will work best in treating the bacteria.
If no sign of infection is found in your urine sample, your healthcare providers may suggest additional tests to look at your bladder or prostate (in men). Your provider may also take a swab sample of the lining of your vagina or the urethra to check for signs of infection (in women).
Possible Causes
What are the causes of dysuria (painful urination)?
There are many causes of dysuria. Also know that doctors can’t always identify the cause.
WOMEN: Painful urination for women can be the result of:
- Bladder infection (cystitis).
- Vaginal infection.
- Urinary tract infection.
- Endometritis and other causes outside the urinary tract, including diverticulosis and diverticulitis.
- Inflammation of the bladder or urethra (urethritis) (Your urethra is the tube that begins at the lower opening of your bladder and exits out of your body). Inflammation is usually caused by an infection.
The inflammation may also be caused by sexual intercourse, douches, soaps, scented toilet paper, contraceptive sponges or spermicides.
Normal female anatomy
MEN: Painful urination for men may be the result of:
- Urinary tract infection and other infections outside the urinary tract, including diverticulosis and diverticulitis.
- Prostate disease.
- Cancer.
Normal male anatomy
Painful urination for men and women may be the result of a sexually transmitted infections (STIs) or the side effect of medications. Chemotherapy cancer drugs or radiation treatments to the pelvic area may inflame the bladder and cause painful urination.
Care and Treatment
How is dysuria (painful urination) treated?
Treatment for dysuria depends on the cause of your pain/burning sensation. The first step in your treatment is to determine if your painful urination is caused by infection, inflammation, dietary factors, or a problem with your bladder or prostate.
- Urinary tract infections are most commonly treated with antibiotics. If your pain is severe, you may be prescribed phenazopyridine. Note: this medication turns you urine red-orange and stains undergarments.
- Inflammation caused by irritation to the skin is usually treated by avoiding the cause of the irritant.
- Dysuria caused by an underlying bladder or prostate condition is treated by addressing the underlying condition.
There are several steps you can take to reduce the discomfort of painful urination, including drinking more water or taking an over-the-counter aid (such as Uristat® or AZO®) to treat painful urination. Other treatments need prescription medications.
If you have frequent urinary tract infections, your provider can help find the cause.
Can anything be done to prevent dysuria?
- Drink more water. Drink two to three liters of water a day.
- If you wear a urinary incontinence pad, change it as soon as it gets soiled.
- After you (a woman) urinates, take some additional new tissue and wipe away any urine from the inside of your vaginal lips.
When to Call the Doctor
When should I call my healthcare provider?
Dysuria is a symptom. It causes a burning sensation, pain and/or discomfort. You will likely choose to contact your healthcare provider because this symptom is uncomfortable. It’s important to see your provider to determine if your symptom is related to a urinary tract infection or another medical cause. In any case, the sooner you see your provider, the sooner a diagnosis can be made and treatment can be started.
Last reviewed by a Cleveland Clinic medical professional on 12/08/2020.
References
- Merck Manual. Dysuria. (http://www.merckmanuals.com/home/kidney-and-urinary-tract-disorders/symptoms-of-kidney-and-urinary-tract-disorders/urination,-pain-or-burning-with) Accessed 12/1/2020.
- American Academy of Family Physicians. Painful Urination. (https://familydoctor.org/urinary-tract-infections-causes-painful-urination/) Accessed 12/1/2020.
- Wrenn K. Dysuria, Frequency, and Urgency. In: Walker HK, Hall WD, Hurst JW, eds. Clinical Methods: The History, Physical, and Laboratory Examinations. 3rd ed. Boston: Butterworths; 1990. Chapter 181. ncbi.nlm.nih.gov. (http://www.ncbi.nlm.nih.gov/books/NBK291/) Accessed 12/1/2020.
- Kurowski K. The women with dysuria. Am Fam Physician. 1998 May 1;57(9):2155-64, 2169-70. Accessed 12/1/2020.
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Why Does My Pee Burn? 11 Possible Reasons for Painful Urination
Ever sit on the toilet and find yourself worrying, Ummm… why does my pee burn? You are certainly not alone. Most people will encounter the unsettling experience of painful urination at least once in their lifetime.
Urination, as you know, shouldn’t be uncomfortable. So, if you are experiencing a burning sensation when peeing, that’s usually a sign that your body is trying to tell you something. Medically known as dysuria, a catch-all term for painful peeing, the unpleasant symptom can be an indication of several issues—both severe and less so.
Either way, you’ll need to head to your doctor to get an accurate diagnosis, which is important because, if left untreated, “many of the causes of painful urination can get worse and have a great implication for your long-term health, such as a kidney infection or pelvic inflammatory disease (PID),” Lauren Ruggiero, MD, clinical assistant professor in the Department of Obstetrics & Gynecology at NYU Langone Health tells SELF. “If you are not noticing resolution or improvement of your symptoms a day or two after your symptoms start, then definitely see your doctor so they can help figure out what is going on.”
Ahead, experts explain what might be causing your burning pee, as well as ways to potentially ease the sting.
What is dysuria?
“Painful urination, also known as dysuria, happens when urine comes into contact with inflamed or irritated tissue,” 1 Dr. Ruggiero says. “When this occurs, your local nerves send a pain signal to your brain telling you something is wrong.”
This pain is usually felt in your urethra, i.e. the tube that carries urine out of your bladder, or in your perineum, the area between your anus and genitals. For the record: Dysuria doesn’t refer to how often you pee, but sometimes people can also have a health condition that makes them pee more than usual when they have dysuria, the Cleveland Clinic says.
What are some common dysuria symptoms?
You get the whole “burns when I pee” thing. But the Cleveland Clinic says dysuria can present with other signs as well. Here is a range of symptoms that characterize painful urination as a whole:
- Stinging when you pee
- An itching feeling
- Pain when you start to pee
- Pain after you pee
What causes painful urination?
There are a bunch of different things that could be behind your painful urination. Here are the most common causes:
Urinary tract infection (UTI)
This is the biggest culprit behind a burning sensation when peeing, Sarah Yamaguchi, MD, an ob-gyn at Good Samaritan Hospital in Los Angeles, tells SELF. As the name implies, a UTI develops when any part of your urinary tract (think kidneys, ureters, bladder, and urethra) gets infected, according to the Mayo Clinic. That said, it’s usually the bladder and urethra that get infected. Due to having shorter urethras, people with vaginas tend to get more UTIs than people with penises.
A UTI happens when bacteria, often E. coli, get into your bladder or urethra. The bacteria can travel upward from there and possibly even cause a kidney infection. The result: unpleasant symptoms like the persistent urge to hit up the bathroom and burning pee. “If you’re having burning pee, particularly at the end of the urinary stream, it might be a sign of a urinary tract infection,” Alyssa Dweck, MD, FACOG, board-certified gynecologist in New York at Northwell Health and sexual and reproductive health expert for INTIMINA, tells SELF.
Yeast infection
An uncomfortable burning sensation when peeing is also a common symptom of a yeast infection, which happens due to an overgrowth of yeast in the vagina, Dr. Yamaguchi explains. Yeast infections are pretty common—they happen to three out of four people with vaginas at some point in their lifetime, and many will experience them at least twice in their life, according to the Mayo Clinic. The possible causes? Anything from using antibiotics 2 to douching, both of which can mess with your vagina’s natural pH balance and create an environment where yeast more easily overgrows, according to the U.S. Department of Health & Human Services. Besides burning pee, per the Mayo Clinic, yeast infections often come along with other symptoms such as:
- An itchy or irritated vulva and vagina
- A reddened or swollen vulva
- A sore vulva or vagina
- A rash in or around your vagina
- Watery discharge, or discharge that looks like cottage cheese and doesn’t smell
Bacterial vaginosis
Oh, bacterial vaginosis, you foul-smelling condition. Yup, this can lead to fish-scented discharge in addition to burning when you pee, Dr. Dweck says. Bacterial vaginosis arises when the “good” and “bad” bacteria in your vagina get thrown out of whack via sex, products you use, and the like, according to the Centers for Disease Control and Prevention. You may have never heard of it, but it’s actually the most common vaginal condition for people between the ages of 15 and 44, the CDC says. The symptoms are very similar to those of a yeast infection, so it’s easy to confuse the two, Renita F. White, MD, FACOG, a board-certified ob-gyn at Georgia Obstetrics & Gynecology who is affiliated with Northside Hospital in Atlanta, tells SELF. This is why it’s important to get checked out by a physician, who can help determine the cause of your symptoms to ensure you’re treated properly.
Sexually transmitted infections
Plenty of sexually transmitted infections (STIs) can cause painful urination as just one of their annoying symptoms (when symptoms show up, that is—in many cases, STIs exhibit no symptoms at all). Herpes, an extremely common viral infection known for causing sores on the mouth and genitals, is one possibility, Dr. Yamaguchi says. But other STIs can cause discomfort when urinating, too. The reason: “The urethra and vulva and vaginal tissue become inflamed and extra sensitive, so when you pass urine, it may burn,” explains Dr. Dweck.
Chlamydia, a bacterial infection prevalent in young people under 25 that’s known as a “silent” infection because most people are asymptomatic, 3 and gonorrhea, another bacterial infection that shows up a lot in that age range, are other common causes, Dr. Dweck says. Both chlamydia and gonorrhea can also lead to abnormal vaginal discharge colors, like some that are yellow or green, so be on the lookout for that as well.
Trichomoniasis, a common STI that’s caused by a parasite, can also present with terrible-smelling discharge and pain when peeing.
Sex-related vaginal tears
Getting busy in the bedroom can and should be amazing—but if you feel burning pee after sex, don’t ignore it. That sharp, sudden pain may be a sign of vaginal irritation if you have penetrative intercourse. “Little abrasions from sex can cause some burning and irritation when peeing,” Dr. Yamaguchi says.
You might have noticed that sex was uncomfortable during the act, or maybe it felt great at the moment but you realize you’re a little sore afterward. “Usually, this is short-lived and heals on its own within a day or so,” Dr. White says. (FYI: Try to make it a point to pee after sex. Doing so can help flush out bacteria that can potentially cause a UTI, according to the Cleveland Clinic.)
Non-sex-related vaginal tears
Many people find themselves asking, “Seriously, why does it burn when I pee?” after they give birth vaginally. Since all the tissue down below stretches impressively to make room for the baby, vaginal and perineal tears can occur. This, unsurprisingly, can cause some serious post-birth pain and soreness, along with painful urination.
Vaginal hygiene products
“We’ve been led to believe that the vaginal area is super dirty, and we should be cleaning with deodorizers and perfumes—that’s not the case,” Dr. Dweck says. “The vagina has a good self-cleaning protocol, if you will, to keep its pH in balance and keep things in order.” Keeping your vagina clean is actually the whole point of discharge. So when you use unnecessary products like douches or hygiene washes (or even put soap into your vagina), you might wind up with irritation that leads to burning pee. If your skin is super sensitive, this can even happen from fragrant bubble baths, Dr. Dweck explains.
Vaginal changes
Hormonal changes during menopause (mainly the loss of estrogen) can result in a phenomenon known as atrophic vaginitis, or vaginal atrophy, Dr. Yamaguchi says. The skin of the vulva and vagina thin out, which can lead to painful urination as well as burning and irritation during sex and while just going about your daily life. The vaginal tissue is also more fragile during the postpartum period, which can make you susceptible to irritation, Dr. White adds.
Kidney stones
Kidney stones can lead to intense pain in many different regions—such as your side, back, and groin—in addition to painful urination, according to the Mayo Clinic. Ouch.
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Kidney stones develop when salts and minerals commonly found in your pee pile up, crystalize, and stick together in your kidneys. Generally, this happens when your urine becomes concentrated for various reasons, including dehydration. For many people, drinking plenty of water throughout the day can help lower their chances of developing kidney stones. 4 But there are some medical conditions like gout (which causes joint swelling), that can increase your chances of developing these painful, pebble-like deposits, according to the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). Taking certain medications can also cause kidney stones.
Interstitial cystitis
Informally called “painful bladder syndrome,” this condition lives up to its name, as it can cause abdominal, bladder, and pelvic pain. (And yes, pain when peeing.) Generally, your pain starts when your bladder gets full and escalates until you let it all out. Then, you will have some relief until your bladder fills up again, according to the NIDDK. Aside from this, you may have the urge to use the bathroom very suddenly and more often than you normally do. Experts don’t know the exact cause of interstitial cystitis, but people who have the chronic condition may notice that dehydration, sex, and holding their pee makes their symptoms worse.
Obstructive uropathy
With obstructive uropathy, your urine doesn’t drain through the urinary tract properly and backs up into your kidneys, causing a blockage. This typically happens as a complication of another health issue, such as kidney stones or a more serious condition like ovarian cancer, according to the National Library of Medicine (NLM). Other signs of a blockage include pain in your sides (near your kidneys), getting the urge to pee often, decreased urine flow, and feeling like your bladder is never truly empty. If you think you have obstructive uropathy, it’s important to see a doctor as soon as you can because the blockage can cause bladder and kidney damage without treatment.
How do I stop my pee from burning?
Treatments and remedies for dysuria largely depend on what’s causing that painful urination in the first place. In general, though, Dr. White says that “if the symptoms are persistent after two to three days, getting worse, associated with other bothersome symptoms like fever or ulcers on the vagina, these are all reasons to be seen by your doctor.”
If it’s a UTI:
If you suspect you have a UTI, it’s crucial to see a doctor who can order a urine culture to confirm your diagnosis. If you do have a UTI, then a round of antibiotics can kick the infection (and burning pee) to the curb. Otherwise, your doctor can work with you to determine the real cause of your discomfort when urinating.
As we mentioned, if left untreated, a UTI can spread and turn into a kidney infection, which can be potentially life-threatening. In addition to being more likely to get a UTI if you have a vagina, you’re also more likely to get a UTI if you’re sexually active, have a suppressed immune system, are in menopause, or have kidney stones or other complications blocking your urinary tract (among other risk factors), according to the Mayo Clinic. Over-the-counter urinary pain relief meds, like Azo, can ease your symptoms, but do not treat the infection, Dr. White says.
If UTIs regularly besiege your poor body, make sure to take preventive measures, like staying hydrated, wiping from front to back, and trying to pee after you have sex if that seems to set off symptoms for you. And if you specifically get two or more UTIs in six months or four or more within a year, your doctor may be able to offer you preventive treatment like a single-dose antibiotic you take after sex, the Mayo Clinic says. People who have gone through menopause may take topical vaginal estrogen to help with recurrent UTIs.
If it’s a yeast infection:
Antifungal medications can clear up the infection (and symptoms like painful urination). Some of these are available over-the-counter, and some are prescribed. With that said, it can be smart to talk to a doctor before grabbing an OTC medication, especially since some other vaginal issues, including STIs or UTIs, can seem a lot like yeast infections. (Here’s a more in-depth explanation of treating a yeast infection at home.) Beyond that, if you have four or more yeast infections a year, you can talk to your doctor about preventative strategies, who will likely prescribe a longer course of antifungals. To avoid recurrent yeast infections, Dr. Yamaguchi recommends wearing cotton underwear for breathability (or at least underwear that has a cotton crotch) and changing ASAP after you work out instead of staying in sweaty gear because yeast can thrive in moist and warm environments. 5
If it’s bacterial vaginosis:
Your doctor can do a few simple tests to determine what type of infection you have, and if they find bacterial vaginosis is behind your dysuria symptoms, they’ll prescribe antibiotics for you to take either orally or vaginally, the Mayo Clinic says.
If it’s an STI:
If you’ve been sexually active and are now feeling pain after peeing, it’s worth heading to the doctor to be safe, if you can. If you do have an STI, treatment depends on what type you’re diagnosed with. If it’s herpes, your doctor will probably prescribe antiviral medication like acyclovir (Zovirax) or valacyclovir (Valtrex) to use when you have symptoms, the Mayo Clinic says. For chlamydia, you’ll likely be treated with antibiotics, the CDC says. If gonorrhea is the cause of your painful urination, the CDC recommends having a single dose shot of intramuscular ceftriaxone and an oral dose of the antibiotic azithromycin. For trichomoniasis, your doctor will recommend that you take a large dose of either metronidazole (Flagyl) or tinidazole (Tindamax), the Mayo Clinic says. It’s really important to get tested for an STI if you think you have one. Left untreated, some infections (like chlamydia and gonorrhea) can have long-term consequences including infertility.
If it’s a sex-related vaginal tear:
To cut back on that yikes-inducing feeling, Dr. Yamaguchi recommends pouring warm water over your vaginal area while you’re peeing. “The temperature will help interfere with the nerve pathways,” she says. And to avoid the issue altogether, she suggests making sure you’re plenty lubed up whenever your vagina’s getting some attention. If your vaginal tissue is more fragile due to atrophy and lubrication doesn’t help prevent abrasions, you can ask your doctor about other options like estrogen replacement therapy, Dr. White advises.
If it’s a childbirth-related vaginal tear:
Pain related to vaginal and/or perineal tears is an unfortunately common circumstance after vaginal childbirth. There are a few strategies you can try for relief, like using perineal irrigation bottles. These are devices many new moms rely on that make it even easier to squirt warm water on themselves to dull the pain. According to the Mayo Clinic, you may also want to try using ice packs (wrapped in something like a towel to protect your skin), taking sitz baths, or putting chilled witch hazel pads on the affected area (a sanitary pad in your underwear will help keep the witch hazel pads in place). Pain relievers, numbing sprays, and stool softeners may also help—talk to your doctor to figure out what might be right for you.
If it’s due to products like soap or douches:
This is more about prevention. Stop using any products you think are giving you trouble—these commonly include scented soaps, vaginal hygiene products, and douches. Try replacing them with gentle, fragrance-free soap and some water to wash your vulva (your external genitalia). Again, you don’t even need to wash your actual vagina. Let it clean itself in peace, please!
If it’s post-menopause atrophic vaginitis:
Sadly, many people who experience this dysuria cause don’t seek treatment, either because they’ve given up hope on feeling better or they’re too shy to discuss it with their doctor, according to the Mayo Clinic. If you’re dealing with this, chat with your doctor to determine whether hormonal supplementation with estrogen may help your symptoms, and if not, how to find relief. Other options include vaginal moisturizers, lubricants, dilators, and numbing agents, the Mayo Clinic says.
If it’s kidney stones:
Treatment depends on the type of kidney stones you have (yes, there are numerous types based on the substance they’re made of), their size, why you developed them in the first place, and your specific symptoms, according to the NIDDK. A doctor can run multiple tests, such as a urine test to look for high amounts of minerals, or an X-ray to look at the size and location of your kidney stones. Your treatment can be as simple as drinking lots of water to help the stone pass (even though this will likely be painful), or it might involve having a procedure that uses sound waves to break up larger stones.
If it’s interstitial cystitis:
Since there’s no cure for this condition, treatment will aim to help relieve your individual symptoms. For example, you may drink lots of fluids to avoid dehydration or try pelvic floor therapy if you have muscle spasms, according to the NIDDK. Bladder training, 6 which involves holding in your urine for longer than you typically do, may also help. Before you start a bladder training program on your own, though, it’s best to talk to your doctor about how to do this without making your symptoms worse.
If it’s obstructive uropathy:
If your symptoms suggest obstructive uropathy, chat with your doctor about testing, which may include an ultrasound of your abdomen or pelvis, according to NLM. If there is an obstruction, your doctor will talk through options about relieving symptoms and removing the blockage, depending on the root cause of the condition. For example, you may have a stent placed in your ureter to drain urine, in addition to surgery to repair the obstruction, according to NLM.
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