Why does it hurt when I pee?

There’s nothing subtle about painful urination. The sensation of burning, stinging, or any form of pain or discomfort during urination is an unmistakable signal that something isn't quite right. What’s not always so apparent, however, is why it’s happening.

Most people will encounter dysuria, or painful urination, at least once in their lives. Understanding the causes and symptoms of painful urination can help you get the care you need. 

Urinary tract infections

Urinary tract infections (UTIs) are the most common cause of painful urination, especially in women. “UTIs occur when harmful bacteria enter the urinary tract, leading to irritation of the urethra and bladder,” says Dr. Tova Steinhauser, a family medicine doctor with Sharp Rees-Stealy Medical Group. “This irritation is what causes the pain during urination.”

The infection can also cause an increased urgency to urinate, as well as more frequent urination. “Patients may also notice an abnormal smell or cloudiness to the urine," Dr. Steinhauser says.

Dr. Steinhauser suggests making an appointment with your doctor if you feel any symptoms. Since UTIs are so common, you can often be treated via a video call with your doctor. Most of the time, a UTI will go away quickly when you take a prescription antibiotic. Drinking plenty of water to flush out and dilute the urine can also help to lessen the pain and slow the progression of the infection.

Vaginal infection

Similar to UTIs, vaginal infections can cause a burning sensation while urinating. Vaginal yeast infections and bacterial vaginosis (BV) are common vaginal health concerns, but they arise from different causes. A vaginal yeast infection develops when candida — a naturally occurring yeast in the body — starts to grow out of control. Itchiness and discomfort and thick, white discharge are the main symptoms.

In contrast, BV is caused by an imbalance of vaginal bacteria, leading to a fishy odor and grayish-white discharge. While yeast infections respond to antifungal treatments, BV is typically treated with antibiotics.

Sexually transmitted infections

Certain sexually transmitted infections (STIs), such as chlamydia and gonorrhea, can cause painful urination. If an STI is the culprit of the pain, other symptoms may include unusual discharge from your genitals, blister-like sores or burning.

“Testing the urine for a UTI or STI can help determine which infection is present and how to treat it,” Dr. Steinhauser says.

Without treatment, STIs get worse and can sometimes lead to other serious problems. Additionally, if you’re sexually active, regular STI screenings are an important part of preventive health care. 

Even STIs without symptoms can be passed to partners and cause damage to long-term reproductive health. “Testing and treating for STIs prevents the spread of sexually transmitted infections and reduces the risk of complications, such as pelvic inflammatory disease and infertility,” Dr. Steinhauser says.

Kidney stones

Kidney stones are pretty common — about 1 in 10 Americans will have one in their lifetime. They happen when salt and other minerals collect inside your kidneys and clump together, forming hard deposits called kidney stones.

Typically, the substances don’t accumulate enough to stick together and form a stone, as the kidney processes enough liquid to flush them out. But if a stone does form, it can eventually travel out of your kidneys and into your urinary tract.

Passing a stone can be very unpleasant. The main symptom is sharp pain in your back, side, lower abdomen or groin. The pain may last for a short or long time or may come and go in waves. Other symptoms include abnormal urine color, trouble urinating and cloudy or smelly urine.

Prostatitis

For men, prostatitis is a possible cause of painful urination. Prostatitis is a painful condition in which the prostate is inflamed, swollen and tender. Prostatitis is the most common urinary tract problem for men under age 50 and the third most common urinary tract problem for men older than age 50.

There are a few types of prostatitis that can cause symptoms:

• Acute bacterial prostatitis: Bacterial infection of the prostate, usually with sudden, severe symptoms

• Chronic bacterial prostatitis: Ongoing or recurring bacterial infection, usually with less severe symptoms

• Chronic prostatitis/chronic pelvic pain syndrome (CP/CPPS): Ongoing or recurring pelvic pain and urinary tract symptoms with no evidence of infection

CP/CPPS makes up the majority of cases and the exact cause is unclear. If symptoms come on suddenly and are severe, it may be due to acute bacterial prostatitis.

“You might feel ill, with fever, body aches and chills,” says Dr. Steinhauser. “It can also cause pelvic pain and cloudy urine.”

Talk with your doctor if you experience painful urination. Once the cause is determined, treatment can bring you relief and prevent it from leading to other health concerns.

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