Peeing should never be painful. So if you're wincing when you wee or your urine feels like hot lava erupting from a volcano, something's definitely up down there.
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A burning or stinging pain or discomfort when you pee is known as dysuria and, depending on the origin of the problem, it can occur while you tinkle or even after, according to the Cleveland Clinic. While dysuria is more common in people assigned female at birth (AFAB), anyone can have painful urination.
We spoke with Jodie Horton, MD, a board-certified ob-gyn and chief wellness advisor for Love Wellness, to answer the burning question: Why does it burn when I pee? Here are the most common causes for dysuria and what you can do to manage (and prevent) painful urination.
1. You Have a Urinary Tract Infection
"Burning while you pee is usually the first sign of a urinary tract infection (UTI)," Dr. Horton says.
A UTI happens when any part of your urinary system — kidneys, ureters, bladder, urethra — becomes infected, but infections in the bladder and urethra are most common, according to the Mayo Clinic.
"The urethra is the tube that empties the bladder when you urinate, so if it becomes red, swollen or irritated, it may cause burning when you pee," Dr. Horton says.
People AFAB have a greater risk of developing UTIs than those assigned male at birth (AMAB). That's because people AFAB have shorter urethras, which makes it easier for bacteria to reach the bladder, per the Mayo Clinic.
Other signs of a UTI include:
Fix it: If you suspect you've got a UTI, see your doctor ASAP, who will likely prescribe you an antibiotic to treat the infection. The longer you wait to seek medical help, the worse the infection may become: UTIs can develop into a serious problem if they spread to your kidneys, per the Mayo Clinic.
Also, "it's important to drink lots of water to help flush out the bladder and dilute the urine," Dr. Horton adds. "Concentrated urine can be more acidic and cause that stinging sensation when you urinate."
2. You Have a Yeast Infection
Your painful peeing experience might be the product of a yeast infection. In people AFAB, a yeast infection occurs when the natural balance of microorganisms in the vagina (including yeast and bacteria) are disrupted, leading to an overgrowth of fungus, according to the Mayo Clinic.
"Vaginal infections like yeast can cause the vagina to become swollen and inflamed, making the area very sensitive," Dr. Horton says. In people AFAB, the urethra is located just above the vagina, and when you pee, the urine may encounter the irritated skin of the vagina and cause burning, she explains.
Other symptoms of a vaginal yeast infection involve, per the Mayo Clinic:
- Itching and irritation in the vagina and vulva
- Redness and swelling of the vulva
- Vaginal pain and soreness
- Vaginal rash
- Thick, white, odor-free vaginal discharge with a cottage cheese appearance
- Watery vaginal discharge
People AMAB may also get yeast infections, which can cause the head of the penis to become inflamed, a condition known as balanitis, according to the Mayo Clinic. Redness, scaling and a painful rash may also occur in penile yeast infections, per Johns Hopkins Medicine.
Fix it: Most yeast infections are treatable with antifungal topical creams and gels (many found in your local drugstore), Dr. Horton says. But if over-the-counter options don't relieve your symptoms, you should see your doctor right away.
3. You Have Bacterial Vaginosis
Bacterial vaginosis — a kind of vaginal inflammation caused by an overgrowth of bacteria in the vagina — could be the source of your stinging pee.
In addition to burning during urination, you may also experience itching, a gray, frothy discharge and a foul or fishy odor when you have bacterial vaginosis, Dr. Horton says.
Fix it: See your doctor, who can prescribe oral antibiotics or a vaginal suppository, Dr. Horton says.
If you have recurrent bouts of BV, try taking over-the-counter boric acid capsules and suppositories, which can help restore a normal vaginal pH, Dr. Horton says. "Taking probiotics daily can also prevent vaginal infections like yeast and bacterial vaginosis," she adds.
4. You Have a Sexually Transmitted Infection
A slew of sexually transmitted infections (STIs) can produce painful pee. Herpes, gonorrhea and chlamydia are some of the most common offenders, Dr. Horton says. These infections can cause the urethra — and, in people AFAB, tissue in the vulva and vagina — to become irritated and inflamed, which is why you might tear up on the toilet.
Often, people with an STI confuse the condition with a UTI, as both can cause burning at the tip of the urethra after urinating, so they don't get the proper treatment they need to resolve the issue, Dr. Horton says. In addition to burning pee, keep an eye out for other common STI symptoms such as unusual discharge, abnormal bleeding, pelvic pain or sores, she says.
Fix it: If you notice any of these signs, see your doctor as soon as possible. He or she will be able to properly examine and diagnose you, and prescribe the necessary medication.
5. You Have a Vaginal Tear
Tiny tears down there can cause a burning sensation after peeing even with no infection.
"Vaginal tears can occur after childbirth," Dr. Horton says. (It makes sense if you consider how much the vagina must stretch during delivery!)
But small microtears can even happen during sex, Dr. Horton adds. "A penis, finger or sex toys that are inserted can tear the delicate tissue in the vagina," she explains.
Fix it: During the postpartum period, patients are often given a small bottle to spray the vagina when urinating to decrease the burning or stinging sensation, Dr. Horton says. "New moms can also sit in shallow water called a sitz bath" to relieve pain and inflammation, she says.
And while preventing vaginal tears during birth isn't always possible, you can avert abrasions during sex. To decrease friction and your risk of tearing, Dr. Horton recommends using a silicone-based or pH-balanced, water-based lubricant like Sex Stuff Personal Lubricant ($9.99, LoveWellness.com).
And always make time for foreplay and arousal. "This allows the vaginal walls to relax and your body to make its own natural lubricant," Dr. Horton says.
6. You Have Atrophic Vaginitis
The stinging sensation when you pee may be related to atrophic vaginitis, a condition that occurs when the lining of the vagina becomes thin, dry and inflamed due to a decrease in estrogen, Dr. Horton says.
While a drop in estrogen and vaginal dryness is most common in menopausal people, those who are perimenopausal, breastfeeding or taking certain types of birth control can also experience atrophic vaginitis, Dr. Horton says.
In addition to vaginal dryness and burning with urination, atrophic vaginitis can also cause symptoms such as the following, per the Mayo Clinic:
- Unusual vaginal discharge
- Genital itching
- Urgency with urination
- Frequent urination
- Recurrent urinary tract infections
- Urinary incontinence
- Light bleeding after intercourse
- Discomfort with intercourse
- Decreased vaginal lubrication during sexual activity
- Shortening and tightening of the vaginal canal
Fix it: While many postmenopausal people experience these symptoms, few seek help, as they're too embarrassed to discuss their situation with their doctor, per the Mayo Clinic.
But you don't have to suffer silently with this condition —there are effective treatments available. "Hormone therapy or vaginal estrogen cream can help reduce the dryness, restore a normal vaginal pH and alleviate vaginal burning and painful urination," Dr. Horton says.
7. You’re Using Irritating Hygiene Products
The culprit causing your wee woes might be in your medicine cabinet. Yep, the wrong feminine hygiene products can alter the pH balance of the vagina and cause vaginal infections, redness and irritation, Dr. Horton says. A swollen, sensitive vagina is a telltale sign that you're using an irritating product, she adds.
Fix it: Dr. Horton recommends keeping your hygiene routine simple. "The vagina can be cleaned with plain water," she says. "And if you choose to use soap to clean the vulva, make sure you use a pH-balanced cleanser and avoid soaps with dyes and perfumes,"
Also, ditch the douching, deodorants and feminine sprays for good, Dr. Horton says. All of them can contain ingredients that act as irritants to your vagina.
8. You Ate Something That’s Causing the Burning
Believe it or not, what you eat or drink can potentially produce painful urination, Dr. Horton says.
Spicy or acidic foods, including citrus fruit like oranges, lemons, limes and grapefruit, as well as caffeine and alcohol can irritate the bladder and trigger burning when you pee, she says.
Fix it: Because not all people are affected by the same food or drinks, it is helpful to keep a food diary to track which things caused you a twinge on the toilet, Dr. Horton says.
Another smart strategy: Drink lots of water to dilute your urine. "Very concentrated urine can also cause discomfort and burning," Dr. Horton says.
9. You Have Prostatitis
In people AMAB, pain during or after urination could indicate a prostate-related problem such as prostatitis, according to the Cleveland Clinic. The prostate is the walnut-sized gland located below the bladder in people AMAB that produces semen, and when it becomes swollen or inflamed, you might feel like flames are shooting out of your urine.
Often triggered by a bacterial infection, prostatitis can also occur as a result of nerve damage in the lower urinary tract brought about by surgery or trauma to the area, per the Mayo Clinic.
The signs and symptoms of prostatitis can vary depending on the root cause. In addition to dysuria, they can include, per the Mayo Clinic:
- Difficulty urinating, such as dribbling or hesitant urination
- Frequent urination, particularly at night (nocturia)
- Urgent need to urinate
- Cloudy urine
- Blood in the urine
- Pain in the abdomen, groin or lower back
- Pain in the area between the scrotum and rectum (perineum)
- Pain or discomfort of the penis or testicles
- Painful ejaculation
- Flu-like signs and symptoms (with bacterial prostatitis)
Fix it: If you have any of these symptoms, seek medical help immediately. Your doctor will be able to prescribe antibiotics (if a bacterial infection is causing the issue) or alpha blockers, a type of medication that relaxes the bladder neck and surrounding muscles, which will help relieve painful urination, per the Mayo Clinic.
In addition, nonsteroidal anti-inflammatory drugs may also decrease the discomfort of dysuria related to prostatitis.
- Cleveland Clinic: “Dysuria (Painful Urination)”
- Mayo Clinic: “Urinary tract infection (UTI)”
- Mayo Clinic: “Yeast infection (vaginal)”
- Mayo Clinic: “Yeast infection in men: How can I tell if I have one?”
- Johns Hopkins Medicine: “Yeast Infection”
- Mayo Clinic: “Vaginal atrophy”
- Mayo Clinic: “Prostatitis”