Discharge that’s watery, or discharge that looks like cottage cheese and doesn’t smell
3. You have bacterial vaginosis.
Oh, bacterial vaginosis, you foul-smelling condition. Yup, this infection can lead to fish-scented discharge in addition to burning when you pee, Dr. Dweck says. Bacterial vaginosis arises when the “good” and “bad” bacteria in your vagina get thrown out of whack via sex, products you use, and the like, according to the Centers for Disease Control and Prevention (CDC). You may have never heard of it, but it’s actually the most common vaginal condition for people between the ages of 15 and 44, the the CDC says. The symptoms are very similar to those of a yeast infection, which is why it’s important to get checked out by an ob/gyn.
4. You have a sexually transmitted infection.
Plenty of sexually transmitted infections (STIs) can cause painful pee as just one of their annoying symptoms (when symptoms show up, that is—in many cases, STIs exhibit no symptoms at all). Herpes, an extremely common viral infection known for causing sores on the mouth and genitals, is one possibility, Dr. Yamaguchi says. But other STIs can cause painful pee, too. The reason: “The urethra and vulva and vaginal tissue become inflamed and extra sensitive so when you pass urine, it may burn,” explains Dr. Dweck.
Chlamydia, a bacterial infection especially prevalent in people under 25, and gonorrhea, another bacterial infection that shows up a lot in that age range, are other common causes, Dr. Dweck says. Both chlamydia and gonorrhea can also lead to abnormal discharge, like some that’s yellow or green, so be on the lookout for that as well.
And trichomoniasis, a common STI that’s caused by a parasite, can also present with terrible-smelling discharge and pain while peeing.
5. You have some sex-related vaginal tears.
The sharp, sudden pain of burning while peeing might come with a surge of panic that something is really, really wrong, but that’s not always true. “Little abrasions from sex can cause some burning while peeing and irritation,” Dr. Yamaguchi says. You might have noticed that the sex was uncomfortable during the act, or maybe it felt great in the moment but you’re realizing afterward that you’re a little sore.
6. Or you might have some non-sex-related vaginal tears.
Many people find themselves asking Seriously, why does it burn when I pee? after they give birth vaginally. Since all the tissue down below stretches in an impressive way to make room for the baby, vaginal and perineal tears can occur. This, unsurprisingly, can cause some serious post-birth pain and soreness, along with painful urination.
7. You’re using unnecessary hygiene products.
“We’ve been led to believe that the vaginal area is super dirty, and we should be cleaning with deodorizers and perfumes—that’s not the case,” Dr. Dweck says. “The vagina has a good self-cleaning protocol, if you will, to keep its pH in balance and keep things in order.” Keeping your vagina clean is actually the whole point of discharge. So, when you use unnecessary products like douches or hygiene washes (or even put soap into your vagina), you might wind up with irritation that leads to urinary burning. If your skin is super sensitive, this can even happen from fragrant bubble baths, Dr. Dweck explains.
8. You’re dealing with post-menopause atrophic vaginitis.
Hormonal changes during menopause (mainly the loss of estrogen) can result in a phenomenon known as atrophic vaginitis, or vaginal atrophy, Dr. Yamaguchi says. The skin of the vulva and vagina thin out, which can lead to painful urination as well as burning and irritation during sex and while just going about your daily life.
Treatments and Remedies
Treatments and remedies for dysuria largely depend on what’s causing that painful urination in the first place.
1. If it’s a UTI:
If you do, in fact, have a UTI, it’s crucial to see a doctor who can prescribe a round of antibiotics to kick the infection (and dysuria) to the curb. As we mentioned, if left untreated, a UTI can spread and cause a kidney infection, which can be life-threatening. In addition to being more likely to get a UTI if you have a vagina, you’re also more likely to get a UTI if you’re sexually active, you have a suppressed immune system, you’re in menopause, or you have kidney stones or other complications blocking your urinary tract (among other risk factors), according to the Mayo Clinic.
If UTIs regularly besiege your poor body, make sure to take preventive measures, like staying hydrated, wiping from front to back, and peeing after you have sex. And if you specifically get two or more UTIs in six months or four or more within a year, your doctor may be able to offer you preventive treatment like antibiotics you take after sex, the Mayo Clinic says.
2. If it’s a yeast infection:
Antifungal medications can clear up the infection (and symptoms like painful urination). Some of these are available over-the-counter, and some are prescribed. With that said, it can be smart to talk to a doctor just in case before grabbing an OTC medication, especially since some other vaginal issues (like STIs) can seem a lot like yeast infections. Here’s some help figuring out if it makes sense to try to treat your yeast infection on your own. Beyond that, if you have four or more yeast infections a year, you should definitely see your doctor who will likely prescribe a longer treatment plan, according to the Mayo Clinic.
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