Painful urination, or dysuria, is an unpleasant symptom that can indicate some serious — but easy-to-treat — conditions. A few of these include UTIs, yeast infections and STIs like chlamydia and gonorrhea, as well as irritation from soap or hygienic sprays.
Other potential causes of burning pee include a fungal infection called bacterial vaginosis (which can cause fishy-smelling discharge) and hormonal changes caused by menopause.
Urinary Tract Infection
Painful peeing (or dysuria, as doctors call it) isn’t normal and is usually a sign of a problem that needs to be addressed. The discomfort or burning sensation may be felt in the bladder, urethra, or perineum (the area between the anus and genitals). Knowing what kind of pain you’re feeling is key to finding the right treatment.
A urinary tract infection (UTI) is the biggest culprit for burning when you pee. It occurs when bacteria, usually E. coli, gets into the bladder or urethra, says Sarah Yamaguchi, MD, an ob-gyn at Good Samaritan Hospital in Los Angeles. She says women are more likely to get a UTI because of the way their urethras and vaginas connect. They also tend to have shorter urethras, she adds.
Bacterial vaginosis is another common cause of painful peeing. This is when the balance of “good” and “bad” bacteria in the vulva is thrown out of whack, she says. It can be caused by sex, birth control pills, douches, scented soaps, and other products you use on your genitals. The most common symptom of bacterial vaginosis is a foul-smelling discharge (think cottage cheese) and it can be treated with antibiotics, she adds.
Other reasons for painful peeing include little abrasions from sex, childbirth or vaginal tears (which isn’t uncommon during delivery), and certain medications or allergies. Getting regular STD tests is the best way to ensure you haven’t contracted an infection, because many don’t show any symptoms at all, she adds.
Yeast Infection
A yeast infection can also cause a burning sensation when you pee. Candida is a naturally-occurring microorganism in the vagina, and lactobacillus bacteria normally keep it under control. However, when the balance of bacteria shifts (for example, due to a UTI or antibiotics), yeast can overgrow. Yeast infections typically result in itching and a burning sensation when you pee. They’re not an STD, but they can be spread through sexual contact. Yeast infections can also lead to a white or yellow, cottage cheese-like discharge.
Any time you have a yeast infection, it’s important to see your ob-gyn or primary care doctor right away. They can give you a pelvic exam and take a sample of your discharge to check it under a microscope.
Yeast infections can be cured with antifungal medications, like creams and suppositories that you can buy over-the-counter without a prescription. But if you’re struggling with yeast infections often, your health care provider might need to prescribe a longer treatment plan.
You can help prevent yeast infections by avoiding douching (even though it feels good) and using a mild soap in the genital area. Douching removes healthy bacteria and allows yeast to grow. You should also avoid wearing tight-fitting clothing around your vulva, because it can increase sweating and make you more likely to develop a yeast infection. You can also try eating probiotic yogurt and taking lactobacillus acidophilus tablets during your period or after a UTI.
Sexually Transmitted Infections
Most people know that a burning sensation when peeing isn’t good, but they may not realize that it could be a sign of something much more serious. If you experience a burning sensation in your vagina or vulva, it’s important to see a health care professional immediately. A nurse, doctor or gynecologist will be able to diagnose the cause of your symptoms and prescribe antibiotics or other medicines that will help.
Infections like yeast infections and bacterial vaginosis can cause burning during urination along with itching, painful or heavy vaginal discharge, and a fishy smell. Itching and burning can also be a symptom of sexually transmitted diseases (STIs) such as trichomoniasis, chlamydia or herpes. A health care provider will be able to diagnose an STI by asking personal questions and taking a sample of fluid from your sores or body, or a blood test.
If you have a herpes infection, the health care professional will most likely prescribe antiviral medicine such as acyclovir or valacyclovir to treat your herpes. They will probably also recommend that you tell your sexual partners of your diagnosis so they can get tested as well. Other treatments for herpes include lubricants and antifungal creams or pills. For chlamydia or gonorrhea, they will prescribe antibiotics to treat the disease. The health care provider will most likely also recommend that you use condoms during sex with your partner until the infection clears up.
Menopause
When it comes to the vagina, burning can be a sign of an infection like a UTI or yeast. But pain and burning in the vulva can also be related to menopause, a natural part of aging that happens when your reproductive hormones decrease, says Dr. Ruggiero.
A urinary tract infection (UTI) is the most common cause of a painful burning sensation when you pee. A UTI can happen when bacteria infect the lining of your bladder, ureters, or urethra. You can get a UTI from things like using a scented tampon, pad, or soap, sex with someone who has a yeast infection, or by drinking too much alcohol or caffeine.
Yeast infections and bacterial vaginosis are other causes of painful burning when you pee. Bacterial vaginosis can make you have fish-smelling discharge and it often gets worse when you use perfumed products or douches. You can prevent this by wiping from front to back, not using scented tampons or pads, and taking a cranberry supplement.
When you go to see your doctor, they will review your medical history and ask about your symptoms. They’ll also likely do some tests, such as a blood test or urine test to determine if there is an infection or other underlying cause. They may also recommend STI screening if you’re still sexually active.
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