George Krucik, MD, MBA
An estimated 20 million new sexually transmitted infections occur annually in the US, according to the Centers for Disease Control and Prevention. Although there many different STDs, a limited number are known to potentially cause urinary frequency. This symptom usually occurs due to infection and inflammation of the urethra, the tube through which urine flows as it passes from the body. Painful urination, or dysuria, often accompanies urinary frequency associated with an STD. Men are more likely than women to experience urinary symptoms caused by an STD.
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In 2016, nearly 1.6 million cases of chlamydia were reported to CDC -- a record high number. Most people with chlamydia initially experience no symptoms, which contributes to ongoing spread of this STD. Among men, the urethra is the primary site of genital infection. Those men who experience chlamydia symptoms typically report a watery penile discharge, burning with urination and urinary frequency. The cervix is the primary site of genital chylamydia in women. When symptoms occur, they may include a change in vaginal discharge and spotting between periods or after intercourse. Chlamydia sometimes also infects the urethra in women causing dysuria and frequency, but this is relatively uncommon.
CDC estimates 820,000 new cases of gonorrhea occur each year in the US. While most women with gonorrhea experience no symptoms until complications develop, the overwhelming majority of men with infection of the urethra, or urethritis, experience symptoms. Initial symptoms typically include painful urination and a pus-like penile discharge. Urinary frequency often follows if the infection remains untreated. Some men experience a drop or two of bloody discharge after urination.
Mycoplasma genitalium Infection
While most people are familiar with chlamydia and gonorrhea, you might not have heard of Mycoplasma genitalium (M. genitalium). This sexually transmitted bacterial infection, which was first identified in 1980, is a significant cause of urethritis in men. As with other STDs that cause urethritis in men, symptoms may include penile discharge, dysuria and urinary frequency. The possible role of M. genitalium as a sexually transmitted cause of urethritis in women is uncertain; additional research is needed.
Trichomoniasis, commonly known as trich, is an STD caused by a microscopic parasite. CDC estimates that 3.7 million people in the US have trich, 70 to 85 percent of whom have minimal or no symptoms. The urethra is the primary site of infection in men, which can potentially lead to dysuria, a small amount of mucus-like penile discharge and urinary frequency. Left untreated, trich can lead to scrotal pain and swelling due to spread of the infection to the epididymis, a network of tubes that carry sperm from the testicle. Women with trich who develop symptoms might experience increased vaginal discharge and odor, and vaginal and vulvar itchiness. Burning pain with urination might occur due to vulvar irritation but urinary frequency is not a commonly reported symptom of trich in women.
CDC estimates that at least 50 million Americans have genital herpes. Most people with this STD have no symptoms or very mild symptoms that aren't recognized to be caused by genital herpes. Genital herpes can cause urethritis with painful urination and urethral discomfort between urination that might lead to urinary frequency. However, genital herpes is a relatively uncommon cause of urethritis compared to the other STDs discussed.
Other Considerations and Next Steps
Many conditions unrelated to a sexually transmitted infection can cause urinary frequency, including urinary tract infections; prostate enlargement or inflammation; a prolapsed bladder; and certain medications. See your healthcare provider if you experience urinary frequency to determine the cause and best treatment. If you suspect your urinary symptoms might be due to an STD, it's best to abstain from sexual contact with others or use condoms to reduce the risk of transmitting such an infection to your partner(s).
Reviewed and revised by: Tina M. St. John, M.D.