Why Does It Hurt When I Pee? Doctors Explain the Causes for Painful Urination

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.

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 It Hurt When I Pee? Doctors Explain the Causes for Painful Urination

Painful urination can usually be traced back to an issue with your bladder, vagina, prostate, or skin.

By Lauren Krouse Published: May 24, 2020

KittisakJirasittichai // Getty Images

Painful urination, also known as dysuria, can be one of the most annoying and embarrassing symptoms, especially if it’s become a persistent problem. Whether it burns when you pee, your skin down there is itchy and irritated, or you need to go multiple times a day due to pelvic pain, you’re likely wondering Why does it hurt when I pee?

The good news is, usually there’s a common culprit at the root of painful urination. And even if you’re dealing with a less-common reason for dysuria, answering a few questions and, if need be, peeing in a cup can help your doctor figure out what’s going on and set you up with the right treatment.

So, if you’re wondering why peeing has suddenly become painful, read on for eight possible reasons, with expert insight from doctors.

1. You should rule out a UTI.

If you have to pee frequently (but don’t want to because it burns yet hardly any urine comes out), you might have a urinary tract infection (UTI). “The first thing we typically want to rule out is a urinary tract infection—it’s one of the most common types of infection overall, and 50 to 60 % of women get one in their lifetime,” says Michael Ingber, M.D., a board-certified urogynecologist at the Center for Specialized Women’s Health, a division of the Garden State Urology & Atlantic Medical Group in New Jersey.

Up to 60% of women will deal with a UTI in their lifetime.

That doesn’t mean that men can’t have a UTI, but women are about 30 times more likely than men to get one. Why? A woman’s urethra, the tube that carries urine out of the body, is shorter than a man’s urethra, so bacteria don’t have to travel as far to cause trouble, explains David Samadi, M.D., a board-certified urologic oncologist and director of Men’s Health and Urologic Oncology at St. Francis Hospital in Roslyn, NY.

While UTIs can be really painful and may even cause you to feel pressure in your lower abdomen or result in foul-smelling, cloudy, or bloody urine, treatment typically only requires a urine test and a prescription antibiotic (and you can up your chances of preventing one, too, with a few lifestyle changes).

2. Or it may be a yeast infection.

Like UTIs, yeast infections can cause pain when you pee because the area around your urethra is tender, though the primary symptom tends to be really itchy skin down there.

Again, your chances of getting a yeast infection are higher if you’re a woman (up to 75% of women end up with one at least once), but men could be at risk if they’re uncircumcised or have taken antibiotics for a long time, says Dr. Samadi. In this case, the head of your penis becomes inflamed and irritated.

For treatment, over-the-counter antifungal creams like Monistat (for women) or Lotrimin AF (for men) will usually do the trick, though you may need a prescription oral medication like Diflucan (fluconazole) to completely clear it up, says Dr. Samadi.

3. An out of whack bladder could be causing issues.

If you’re always looking for the bathroom because you have to pee upwards of eight times a day and it’s not just uncomfortable but hurts when you have to go, you could have interstitial cystitis, a.k.a. painful bladder syndrome.

Often, all you need to do is watch your intake of triggering spicy and acidic foods, but you might also need medication or additional procedures like botox injections, acupuncture, or a bladder “pacemaker” known as a sacral nerve stimulator to ease your symptoms, says Dr. Ingber.

4. Fellas, your prostate could be acting up.

When it’s painful to pee and ejaculate and it’s hard to get out or dribbles down, doctors may suspect something’s going on with your prostate gland—especially if you’re 50 and up. Prostatitis, or an inflamed prostate gland, can happen when bacteria reaches your prostate through your urinary tract, says Jennifer Linehan, M.D., a board-certified urologist and associate professor of urologic oncology at the John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA.

Depending on the reason—and sometimes, there is no clear cause—you may need to take antibiotics or additional medications like alpha blockers (which help relax the area where your prostate and bladder meet) and nonsteroidal anti-inflammatory drugs to ease your pain. Lifestyle changes like avoiding trigger foods can help, too, per the Mayo Clinic.

5. You may have an STI.

Some sexually-transmitted infections like gonorrhea and chlamydia can cause painful urination, as well as discharge from your urethra or pelvic pain, says Dr. Ingber. While having an STI can be stressful, treatment is pretty straightforward: Get tested to know what’s going on for sure, contact any partners to let them know, hold off on sex for a while, and zap it with antibiotics, per Planned Parenthood.

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If you have genital herpes, the first outbreak (which appears as small, red bumps that develop into blisters and oozing or bleeding ulcers) is often the worst episode, says Tsippora Shainhouse, M.D., F.A.A.D., a board-certified dermatologist in private practice at SkinSafe Dermatology and Skin Care in Beverly Hills.

It can be extremely painful to walk, sit, and pee, and you may even have flu-like symptoms like a fever and body aches. While there’s no cure for herpes, antiviral medications like acyclovir (Zovirax) and valacyclovir (Valtrex) can help dial down your symptoms during flare-ups, as can pain medications like ibuprofen (Advil) and acetaminophen (Tylenol) and self-care strategies like sitz baths—so start treatment ASAP, says Dr. Shainhouse.

6. You could have a skin condition.

Believe it or not, plenty of skin conditions can develop only down there, triggering seriously painful urination and sex alike, says Sharleen St. Surin-Lord, M.D., F.A.A.D., a board-certified dermatologist and medical director of Visage Dermatology and Aesthetics Center in Largo, MD.

For one, eczema can cause red, sore skin that’s incessantly itchy and painful in your genital area. Similarly, lichen sclerosus causes severely itchy and painful white and shiny skin down there that may even lead to tearing and scarring if left untreated. Lichen planus can cause a painful burning sensation when you pee, but it appears as purplish flat bumps surrounded by a white, net-like pattern on your skin (and often affects the inside of your mouth, too), says Dr. St. Surin-Lord.

The good news: All of these conditions are manageable with topical steroids. If you do get a diagnosis of lichen sclerosus or lichen planus, know that this may increase your risk of developing squamous cell cancer by about 5%, research shows. For this reason, it’s important to talk to a dermatologist about scheduling regular screenings just in case, suggests Dr. St. Surin-Lord.

7. Perhaps you bought the wrong bath bomb.

If you’ve just taken a wonderfully relaxing bubble bath but now you’re super itchy and it hurts when you pee, you’re probably having an allergic reaction, a.k.a. contact dermatitis. Your vagina is sensitive and more easily irritated by products like soaps, laundry detergents, wipes, shaving creams, lubes, and even some topical medicines, says Dr. Shainhouse.

The fix: Get rid of whatever’s irritating your skin. Opt for gentle, fragrance-free products and switch out scented wipes for plain-old soap and water, suggests Dr. Shainhouse. If the itchiness is relentless, call your doctor—you may need medication like a topical steroid cream or oral antihistamines to stop the itch-scratch cycle for good.

8. Blame bladder stones.

When your bladder isn’t completely emptied out, concentrated urine can crystallize and turn into stones—which can irritate your bladder or block your flow, resulting in painful urination, says Dr. Linehan. Often, this happens more often in men over 50 than women, thanks to an enlarged prostate, a.k.a. benign prostate hyperplasia (BPH).

For small bladder stones you may need to just drink plenty of water to pass them through, but if they’re larger, your doctor may need to help break them up with a laser, ultrasound, or surgery.

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Lauren Krouse is a freelance writer who covers health, domestic violence, and self-advocacy. Her work appears in _Women’s Health, Men’s Health, Prevention, Self, HuffPost, and elsewhere. When she’s not writing, you can find her trying to meditate more, weightlifting, or walking in the woods with her partner and black lab.