Dysuria (Painful Urination): Causes & Treatments

What Is Dysuria?

Dysuria is the medical term for painful urination. It may feel like simple discomfort, a burning sensation, or itching when you pee. Patients feel dysuria either in the urethra or around the urethral opening.

Painful urination is generally not a severe problem; most cases are easily treated. If you’re experiencing symptoms of dysuria, make an appointment to see your healthcare professional to discuss your treatment options.

Who Gets Dysuria?

Painful urination is most common in women and anyone with diabetes or a bladder condition. However, men and women may experience this condition at any age.

Women are more likely to develop urinary tract infections, which are closely associated with pain while peeing. The female urethra is shorter than a male’s, and it’s easier for bacteria to make their way up the female urinary tract into the bladder and cause infections.

Other groups at a higher risk of developing dysuria include:

• Diabetics
• People who get kidney stones
• Anyone with a urinary catheter
• Older people
• Young children who haven’t learned good hygiene habits yet
• Men with enlarged prostates
• Pregnant women
• People with a sexually transmitted infection (STI)
• People with interstitial cystitis

Even if you don’t have these risk factors, you can still experience pain when peeing.

Symptoms

• Pain while urinating
• Burning sensation during or after urination
• Strong-smelling urine
• A strong urge to urinate
• More frequent urination
• Abdominal pain
• Urge incontinence (leaking urine associated with a powerful urge to urinate)
• Altered urinary microbiome

If you have any of these common symptoms of dysuria, seek medical advice. You should be screened for a urinary tract infection, which needs antibiotics.

Diagnosis

Healthcare providers diagnose dysuria by taking your medical history and performing a physical examination. They will perform a urinalysis with a urine culture to look for bacterial infections or do a vaginal exam and swab test for pathogens.

Your doctor will ask you about whether you have or have a family history of diabetes, immunodeficiency disorders, bladder disease, and sexual history. Discharge from the penis or vagina will prompt a test for STIs. Women may be given a pregnancy test.

If you don’t have an infection and your physical exam and urine sample are routine, your family doctor may run additional tests to rule out other causes of dysuria. These tests can include imaging the urinary tract with an MRI, CT scan, or ultrasound imaging. A prostate exam may be required for men with idiopathic (unexplained) dysuria.

Causes

Bacterial infections, typically UTIs, are the most common cause of dysuria, but other medical conditions can also cause painful urination. 

The causes of dysuria include:

• Urinary tract infections (UTIs)
• Bladder infections
• Douches or bubble baths
• Kidney infection (pyelonephritis)
• Interstitial cystitis
• Sexual activity (especially sexual intercourse)
• Sexually transmitted diseases (STDs) like chlamydia (Chlamydia trachomatis infection), genital herpes, or gonorrhea
• Hematuria 
• Urethritis (inflammation of the urethra)
• Endometritis (inflammation of the uterine endometrium)
• Diverticulosis and diverticulitis
• Dysfunction of the body’s microbiome
• Irritants around the urethra, like scented toilet paper or harsh soaps
• Benign prostatic hyperplasia (in rare cases)
• Medications, including those used to treat bladder cancer

There are also conditions specific to either gender that may cause burning urination.

In Women

Vaginitis is the most common cause of dysuria for females. Vaginitis is a vaginal infection and inflammation that can be uncomfortable and painful.

Symptoms of vulvovaginitis include changes in vaginal discharge, itching, and dysuria. It can be caused by a bacterial infection (bacterial vaginosis), a yeast infection or trichomoniasis.

Vaginitis can also be caused by hormonal changes in the body, a condition called atrophic vaginitis. One of the core symptoms of atrophic vaginitis is dysuria. 

It’s challenging to distinguish atrophic vaginitis from infectious vaginitis without a differential diagnosis, although it is most likely to occur in postmenopausal women due to low levels of estrogen and progesterone.

In Men

Common causes of painful urination in men specifically include:

• Prostatitis (inflammation of the prostate gland)
• Obstruction in the ureter
• Epididymitis
• Urethral stricture (narrowing of the urethra)
• Prostate disease
• Cancer

To treat these issues, you may need to see a specialist in urology. Your urologist will run tests to see if any of these conditions are causing your dysuria. Your doctor will also rule out any more serious causes of urinary problems like prostate cancer.

Treatments

To treat dysuria, your medical provider must first learn why you’re experiencing pain when you urinate. There are 3 general root causes that are treated differently:

• If your dysuria is caused by a UTI or other infection, you may be prescribed a course of antibiotics. You may also be given a prescription for phenazopyridine (Azo Urinary Pain Relief) if your dysuria pain is severe.
• If your dysuria is caused by skin irritation, you’ll probably be advised to avoid whatever irritant caused your pain and monitor any changes in your symptoms. You can reduce discomfort by taking over-the-counter medications like Uristat® or AZO®.
• If your dysuria is caused by another condition or disease, your doctor will address the root condition and possibly offer additional pain relief according to the condition and your unique needs. For instance, dysuria caused by yeast infection may be treated with a course of antifungal medication. 

While your urinary pain heals, be sure to:

• Avoid heavily perfumed soaps and personal care products
• Drink a lot of water (64 ounces or more per day)
• Keep your genital area clean, practice good personal hygiene, and change feminine products regularly

Home Remedies

Some home remedies may fight bacterial and fungal infections causing painful urination.

• Clove oil: Studies show that clove oil hinders bacterial growth. Communicate with your doctor about interactions with current prescriptions such as blood thinners. Clove oil should not be taken for more than 2 weeks or by young children.  
• Cardamom: Both extracts and oils from cardamom have been shown to inhibit the growth of several strains of bacteria and even some drug-resistant strains of Candida. 
• Oregano oil: Some studies show oregano essential oils may help protect against common causes of dysuria. 

Prevention

It’s possible to prevent dysuria naturally in many cases. A large factor in prevention is keeping your urinary tract healthy. You should also practice safe sex and use condoms to avoid contracting any STIs that cause painful urination.

In most cases, you can prevent dysuria caused by common triggers by:

• Drinking plenty of water every day (at least 64 ounces).
• Probiotics are a great way to treat and prevent urinary problems, including urinary tract infections. They can also help to prevent vaginosis and vaginal yeast infections that can cause it. 
• Diet is crucial for urinary tract health. Diet has been shown to influence kidney stone formation, and kidney stones are linked to dysuria. Patients with dysuria due to interstitial cystitis should follow an interstitial cystitis diet
• Cranberry supplements are an effective way to promote urinary health and can also directly reduce the symptoms of dysuria. Researchers found tannins and polyphenols in cranberries may fight bacteria in the urinary tract.

FAQs

Concerned About Dysuria? Let’s Talk.

If you’re a Colorado resident experiencing dysuria symptoms or want a plan to maintain your urinary tract health naturally, we can help. Schedule a free phone consultation to learn more!

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