8 Possible Reasons It Really, Really Hurts to Pee, According to Doctors
Painful urination, also known as dysuria, can be one of the most annoying and embarrassing symptoms, especially if it’s become a persistent problem. Whether it burns when you pee, your skin down there is itchy and irritated, or you need to go multiple times a day due to pelvic pain, you’re likely wondering Why does it hurt when I pee?
The good news is, usually there’s a common culprit at the root of painful urination. And even if you’re dealing with a less-common reason for dysuria, answering a few questions and, if need be, peeing in a cup can help your doctor figure out what’s going on and set you up with the right treatment.
So, if you’re wondering why peeing has suddenly become painful, read on for eight possible reasons, with expert insight from doctors.
1. You should rule out a UTI.
If you have to pee frequently (but don’t want to because it burns yet hardly any urine comes out), you might have a urinary tract infection (UTI). “The first thing we typically want to rule out is a urinary tract infection—it’s one of the most common types of infection overall, and 50 to 60 % of women get one in their lifetime,” says Michael Ingber, M.D., a board-certified urogynecologist at the Center for Specialized Women’s Health, a division of the Garden State Urology & Atlantic Medical Group in New Jersey.
That doesn’t mean that men can’t have a UTI, but women are about 30 times more likely than men to get one. Why? A woman’s urethra, the tube that carries urine out of the body, is shorter than a man’s urethra, so bacteria don’t have to travel as far to cause trouble, explains David Samadi, M.D., a board-certified urologic oncologist and director of Men’s Health and Urologic Oncology at St. Francis Hospital in Roslyn, NY.
While UTIs can be really painful and may even cause you to feel pressure in your lower abdomen or result in foul-smelling, cloudy, or bloody urine, treatment typically only requires a urine test and a prescription antibiotic (and you can up your chances of preventing one, too, with a few lifestyle changes).
2. Or it may be a yeast infection.
Like UTIs, yeast infections can cause pain when you pee because the area around your urethra is tender, though the primary symptom tends to be really itchy skin down there.
Again, your chances of getting a yeast infection are higher if you’re a woman (up to 75% of women end up with one at least once), but men could be at risk if they’re uncircumcised or have taken antibiotics for a long time, says Dr. Samadi. In this case, the head of your penis becomes inflamed and irritated.
For treatment, over-the-counter antifungal creams like Monistat (for women) or Lotrimin AF (for men) will usually do the trick, though you may need a prescription oral medication like Diflucan (fluconazole) to completely clear it up, says Dr. Samadi.
3. An out of whack bladder could be causing issues.
If you’re always looking for the bathroom because you have to pee upwards of eight times a day and it’s not just uncomfortable but hurts when you have to go, you could have interstitial cystitis, a.k.a. painful bladder syndrome.
Often, all you need to do is watch your intake of triggering spicy and acidic foods, but you might also need medication or additional procedures like botox injections, acupuncture, or a bladder “pacemaker” known as a sacral nerve stimulator to ease your symptoms, says Dr. Ingber.
4. Fellas, your prostate could be acting up.
When it’s painful to pee and ejaculate and it’s hard to get out or dribbles down, doctors may suspect something’s going on with your prostate gland—especially if you’re 50 and up. Prostatitis, or an inflamed prostate gland, can happen when bacteria reaches your prostate through your urinary tract, says Jennifer Linehan, M.D., a board-certified urologist and associate professor of urologic oncology at the John Wayne Cancer Institute at Providence Saint John’s Health Center in Santa Monica, CA.
Depending on the reason—and sometimes, there is no clear cause—you may need to take antibiotics or additional medications like alpha blockers (which help relax the area where your prostate and bladder meet) and nonsteroidal anti-inflammatory drugs to ease your pain. Lifestyle changes like avoiding trigger foods can help, too, per the Mayo Clinic.
5. You may have an STI.
Some sexually-transmitted infections like gonorrhea and chlamydia can cause painful urination, as well as discharge from your urethra or pelvic pain, says Dr. Ingber. While having an STI can be stressful, treatment is pretty straightforward: Get tested to know what’s going on for sure, contact any partners to let them know, hold off on sex for a while, and zap it with antibiotics, per Planned Parenthood.
If you have genital herpes, the first outbreak (which appears as small, red bumps that develop into blisters and oozing or bleeding ulcers) is often the worst episode, says Tsippora Shainhouse, M.D., F.A.A.D., a board-certified dermatologist in private practice at SkinSafe Dermatology and Skin Care in Beverly Hills.
It can be extremely painful to walk, sit, and pee, and you may even have flu-like symptoms like a fever and body aches. While there’s no cure for herpes, antiviral medications like acyclovir (Zovirax) and valacyclovir (Valtrex) can help dial down your symptoms during flare-ups, as can pain medications like ibuprofen (Advil) and acetaminophen (Tylenol) and self-care strategies like sitz baths—so start treatment ASAP, says Dr. Shainhouse.
6. You could have a skin condition.
Believe it or not, plenty of skin conditions can develop only down there, triggering seriously painful urination and sex alike, says Sharleen St. Surin-Lord, M.D., F.A.A.D., a board-certified dermatologist and medical director of Visage Dermatology and Aesthetics Center in Largo, MD.
For one, eczema can cause red, sore skin that’s incessantly itchy and painful in your genital area. Similarly, lichen sclerosus causes severely itchy and painful white and shiny skin down there that may even lead to tearing and scarring if left untreated. Lichen planus can cause a painful burning sensation when you pee, but it appears as purplish flat bumps surrounded by a white, net-like pattern on your skin (and often affects the inside of your mouth, too), says Dr. St. Surin-Lord.
The good news: All of these conditions are manageable with topical steroids. If you do get a diagnosis of lichen sclerosus or lichen planus, know that this may increase your risk of developing squamous cell cancer by about 5%, research shows. For this reason, it’s important to talk to a dermatologist about scheduling regular screenings just in case, suggests Dr. St. Surin-Lord.
7. Perhaps you bought the wrong bath bomb.
If you’ve just taken a wonderfully relaxing bubble bath but now you’re super itchy and it hurts when you pee, you’re probably having an allergic reaction, a.k.a. contact dermatitis. Your vagina is sensitive and more easily irritated by products like soaps, laundry detergents, wipes, shaving creams, lubes, and even some topical medicines, says Dr. Shainhouse.
The fix: Get rid of whatever’s irritating your skin. Opt for gentle, fragrance-free products and switch out scented wipes for plain-old soap and water, suggests Dr. Shainhouse. If the itchiness is relentless, call your doctor—you may need medication like a topical steroid cream or oral antihistamines to stop the itch-scratch cycle for good.
8. Blame bladder stones.
When your bladder isn’t completely emptied out, concentrated urine can crystallize and turn into stones—which can irritate your bladder or block your flow, resulting in painful urination, says Dr. Linehan. Often, this happens more often in men over 50 than women, thanks to an enlarged prostate, a.k.a. benign prostate hyperplasia (BPH).
For small bladder stones you may need to just drink plenty of water to pass them through, but if they’re larger, your doctor may need to help break them up with a laser, ultrasound, or surgery.
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