Dysuria: 10 Common Causes & How to Treat

Dysuria, or burning with urination, is most often a sign of a urinary tract infection (UTI). This condition is much more common in women but can also occur in men, causing symptoms like a heavy sensation in the bladder, frequent urination, and general discomfort.

However, a burning sensation when urinating may also indicate other urinary or gynecological conditions, such as a yeast infection, sexually transmitted infection (STI), or an allergic reaction to hygiene products.

It is important to see a gynecologist or urologist if the burning persists for more than 2 or 3 days, or if it is accompanied by other symptoms, so that the underlying cause can be identified and the proper treatment started.

Main causes

The main causes of dysuria include:

1. Urinary tract infection

A urinary tract infection (UTI) is the most common and well-known cause of dysuria. It occurs more frequently in women because the urethra is located close to the anus, but it can also affect men, especially due to poor hygiene or unprotected anal sex.

Typical symptoms include a constant urge to urinate, low-grade fever, strong-smelling urine, general malaise, and difficulty holding urine.

How to treat: Treatment involves taking antibiotics prescribed by a gynecologist or urologist for 3 to 7 days, depending on the severity of the infection. People who experience frequent infections may benefit from taking cranberry pills as a preventive supplement.

2. Yeast infection (candidiasis)

A yeast infection occurs when there is an overgrowth of Candida fungus in the genital area, which can cause a burning sensation when urinating. This condition is more common in women due to constant moisture in the area but can also occur after a cold, antibiotic use, or when the immune system is weakened.

Common symptoms include intense itching, redness, thick white discharge, and discomfort during sexual intercourse. In women, vaginal burning may also occur, which can be very uncomfortable.

How to treat: Treatment is usually quick and involves antifungal creams like miconazole or clotrimazole. It’s also important to maintain good hygiene, keep the area dry, and wear breathable cotton underwear.

3. Sexually transmitted infections (STIs)

Although less common, sexually transmitted diseases like chlamydia and trichomoniasis can also cause dysuria. These infections are transmitted through unprotected sex, which is why it’s important to always use condoms, especially when having multiple partners.

Symptoms can include yellowish, foul-smelling discharge, bleeding, pain when urinating, and itching. The only way to determine the specific cause is by consulting a healthcare provider and undergoing lab testing.

How to treat: Treatment usually involves antibiotics such as metronidazole or azithromycin, depending on the infection. It’s important to treat these conditions promptly to prevent complications such as infertility or pelvic inflammatory disease.

4. Small genital sores

Small sores or micro-injuries in the genital area can irritate the tissues, which may worsen during urination and cause burning, pain, or even slight bleeding.

This type of irritation is more common in women due to friction during sexual activity but can also occur in men.

How to treat: The burning usually improves within 2 or 3 days as the tissue heals. During this period, it’s recommended to drink plenty of water to keep urine diluted and to avoid sexual intercourse until the area has healed.

5. Intimate hygiene products

Some intimate hygiene products, such as creams, deodorants, or soaps, can cause allergic reactions or alter the vaginal pH, leading to dysuria.

It’s not advised to use products that change the natural smell of the vagina, as they can disrupt the balance of healthy vaginal flora.

In these cases, the burning is often accompanied by itching and redness that improve after bathing or discontinuing the product.

How to treat: If symptoms appear after starting a new product, wash the area with warm water and a mild, fragrance-free soap. If symptoms improve, avoid using that product again.

6. Prostatitis

Prostatitis is inflammation of the prostate that can cause dysuria, along with difficulty starting urination, weak urine flow, frequent urination, and sometimes erectile dysfunction.

It is usually caused by bacterial infections such as Escherichia coli (E. coli), Klebsiella, or Proteus species, but it can also result from injury or surgery in the area.

How to treat: A urologist should evaluate the condition to determine the cause. Treatment usually involves antibiotics such as ciprofloxacin, levofloxacin, doxycycline, or azithromycin. Pain relievers and anti-inflammatory medications may also be prescribed to relieve discomfort.

7. Genital herpes

Genital herpes is a sexually transmitted infection (STI) that causes blisters on the vagina, vulva, or penis. When these blisters rupture, they form sores that itch, hurt, and can cause burning when urinating, especially when the infection occurs near the urethra.

This STI is caused by the herpes simplex virus (HSV) and is transmitted through contact with infected blisters during unprotected sex.

How to treat: A gynecologist, urologist, or primary care provider should confirm the diagnosis. Treatment typically involves antiviral medications such as acyclovir, valacyclovir, or famciclovir, which help prevent viral replication, promote skin healing, and reduce the risk of new outbreaks.

8. Vaginitis

Vaginitis is inflammation of the vaginal mucosa that can cause burning or pain when urinating, redness or irritation in the genital area, and discharge that may have a strong odor.

This condition can result from an imbalance in vaginal flora, infections, yeast overgrowth, hormonal changes, or allergic reactions.

How to treat: Treatment depends on the cause and may involve antifungal, antibiotic, or hormone replacement therapy prescribed by a gynecologist. Avoid using substances that may be triggering allergic reactions.

9. Urethritis

Urethritis is inflammation of the urethra, most often caused by sexually transmitted infections such as gonorrhea, trichomoniasis, chlamydia, or genital herpes.

This condition can cause pain or burning during urination, redness around the urethra, discharge or pus, and swollen lymph nodes in the groin.

How to treat: Treatment should be guided by a gynecologist or urologist and depends on the cause. It may involve antibiotics or antiviral medications.

10. Kidney stones

Burning or pain when urinating can also occur due to kidney or bladder stones, especially when a stone passes through the urethra or blocks urine flow.

Kidney stones can also trigger urinary infections, fever, chills, and cloudy or foul-smelling urine.

How to treat: Treatment should be managed by a urologist or nephrologist. Depending on the case, a doctor may prescribe pain relievers or medications to help pass the stone. In more severe cases, procedures such as lithotripsy or ureteroscopy may be necessary.

Diagnostic tests

The main test used to identify the cause of dysuria is a urinalysis, which checks for blood, white blood cells, or proteins that may indicate an infection.

If another cause is suspected, additional tests such as a urine culture, ultrasound, or vaginal secretion analysis may also be ordered.