Causes of Painful Urination

On This Page: Causes | Non-Sexual Causes | Sexual Causes | Diagnosis | Treatment

Dysuria aka Painful Urination

Painful urination, also known as dysuria, refers to pain, discomfort, or burning that can be felt when urinating (peeing). This pain may be felt anywhere in the urinary tract, like in the kidneys, ureters, bladder, or urethra, and is often felt when urine comes into contact with internal lesions or sores. It can be a constant irritation or can occur intermittently when irritants are introduced to the external urethral opening (such as during intercourse or when clothing or other objects come in contact with the area). Burning can begin suddenly or gradually grow in intensity over a period of time.¹

Non-sexual Causes for Burning or Painful Urination

The following are non-sexual causes for painful or burning urination:²

• Allergic reaction to soaps, detergents, clothing, or anything that makes contact with your genitals.
• Bladder stones – Small masses of minerals that can develop in your bladder.
• Bladder cancer – When malignant (cancer) cells form in the bladder, it commonly causes symptoms such as blood in the urine and painful urination.³ You should always contact your healthcare provider if you find blood in your urine.
• Cystitis – Inflammation of the bladder, which is typically caused by a UTI.⁴
• Urinary tract infection (UTI) – UTIs occur when harmful bacteria enters the urinary tract and multiplies. Sometimes this bacteria is sexually transmitted, but not always, thus not considered an STD. While less common in men than women, painful urination is a main symptom of UTIs.⁵
• Medication – Some medications can cause cystitis.
• Irritation from condoms or lubricants.
• Kidney infection – Also known as pyelonephritis, kidney infections are a type of urinary tract infection. Kidney infections need to be treated quickly to prevent permanent damage.
• Kidney stones – Similar to bladder stones, but in the kidneys, kidney stones are hard deposits of minerals and salts that form in the kidneys. Kidney stones can be very painful and is a cause of dysuria.
• Prostatitis – Inflammation of the prostate. Chronic and acute prostatitis can occur in men of all ages and cause very painful burning urination.⁶
• Urethral stricture – The narrowing of the urethra, often caused by prolonged inflammation or a penis injury.
• Urethritis – Inflammation of the urethra.

Painful Urination Caused by STDs

The common bacterial STDs gonorrhea and chlamydia are both infamously associated with painful urination. Chlamydia often occurs simultaneously with gonorrhea in what is called a co-infection. Both infections can be cured when treated with antibiotics, often in a single dose.

Genital herpes, ureaplasma, and trichomoniasis are STDs which also can cause dysuria. While the bacteria that cause UTIs may be acquired through sex, urinary tract infections are generally not considered STDs.

Causes of burning or painful urination that can be passed sexually:⁸

• Chlamydia – A sexually transmitted disease that can result in similar symptoms to a urinary tract infection: painful urination and discharge from the penis.
• Gonorrhea – An STD that can cause discharge to leak from the penis.
• Mycoplasma genitalium – A sexually transmitted infection caused by bacteria that affects the epithelial cells of the urinary tract. It can lead to urethritis (swelling and inflammation of the urethra) and result in penile discharge.
• Genital herpes – Genital herpes can be accompanied by lesions or sores. If urine comes in contact with an ulcer or sore, it can burn.
• Ureaplasma – An STI that is similar to mycoplasma genitalium, ureaplasma can cause symptoms like penile discharge, frequent urge to urinate, and painful or burning urination.
• Trichomoniasis – Trich is an STD that can cause an irritated or itching sensation inside the penis, burning during urination, and/or discharge from the penis.

Differences in Dysuria for Men vs Women

Anatomical differences between males and females can cause differences in the likelihood of certain conditions and how they affect you.⁷ For example, because females have shorter urethras (the opening where urine exits the body), it’s easier for bacteria to enter the bladder, making UTIs in women more common than in men. Common STD symptoms like discharge can also be more difficult for women to notice.

What Causes Painful Urination in Men?

For men, painful urination can be caused by a variety of factors, but some of the most common causes are prostatitis (inflammation of the prostate), sexually transmitted diseases (STDs), and UTIs (urinary tract infection).

What Causes Painful Urination in Women?

If you notice pain when you pee, this could be a sign something’s not right. Some women find they have changes in their vaginal discharge or smell too. This might mean an infection is at play. Sexually transmitted infections often lead to discomfort while urinating. Genital herpes, chlamydia, and gonorrhea are some of the usual suspects here. Along with the sting of urine passing by inflamed areas, these can bring on itching or burning sensations down there.But it isn’t always about infections; other culprits stir up trouble as well. Tiny stones might form in your tract; rough times like long bike rides hurt too sometimes! And don’t overlook how big life changes such as menopause tweak things inside your body making peeing painful. Using scented products near intimate parts? These irritants cause more harm than good, they just make matters worse for sensitive zones!

Diagnosing Dysuria

To determine the cause of painful urination, a doctor may ask questions about your symptoms and potentially your sexual history. If they suspect an infection, they may also order certain tests to aid in the diagnosis, such as urinalysis or STD tests. If you believe your painful urination is caused by an STD, you can skip the time and cost of a doctor visit and quickly take our full 10 test STD panel. If tested positive, we have doctors available who can provide consultation and even write prescriptions for certain STDs.

Treating Painful Urination

The method of treatment for painful urination depends on the cause. Because dysuria is so often caused by bacterial infections, a doctor may prescribe antibiotics for treatment. STDs that cause painful urination (like chlamydia and gonorrhea) can also be treated, but only if they are identified. Getting tested for STDs is the best way to narrow down the cause of irritation. Frequent STD testing is the only way to be sexually active and be completely sure of your STD status.

Medically Reviewed by Kaci Durbin, MD, MBA, FACOG on June 1, 2023