Written by Elizabeth Millard
There’s nothing subtle about painful urination (medically known as dysuria)—that uncomfortable burning sensation  that can make every bathroom visit feel like an exercise in courage. What’s not always so apparent, however, is why it’s happening.
Painful urination can occur for many reasons, for example as a result of a urinary tract infection (UTI), or in some cases as a result of a sexually transmitted disease. Although there can be several reasons at play for the pain, the good news is that it’s possible to test for some of the most likely causes, often in the comfort of your home - and start treatment - so you can start feeling better fast.
Here’s a look at why you might be experiencing dysuria, and when to see your doctor.
Reason #1: Sexually Transmitted Diseases
Although many sexually transmitted diseases (STDs) have no symptoms, they may begin with mild symptoms that are similar to a UTI.  Chlamydia, for example, has such similar symptoms to a UTI that one study about emergency care noted that a chlamydia infection is often mistaken for a urinary tract issue. 
Another STD that might be causing pain with urination? Gonorrhea, which can come with symptoms that mimic a UTI, such as the urge to urinate more frequently, pain in the abdomen, and vaginal discharge. [2; 4] For men, there might also be a pus-like discharge, as well as swelling in one testicle. 
Your best bet, if you’re experiencing painful urination and suspect an STD may be the cause, is to get tested, which you can do at home. If left unchecked, many STDs can lead to serious health complications, including cancer, arthritis, pelvic inflammatory disease, infertility, and heart disease, according to the Mayo Clinic. [2; 4]
Reason #2: You Have a Urinary Tract Infection (UTI)
Your urinary tract has a number of components that work together to produce urine. This includes your bladder, kidneys, urethra—the tube that carries the urine out of the body—and the ureters, which take urine from the kidneys to the bladder.  An infection anywhere along the system is a UTI and is most often caused by bacteria, according to the Mayo Clinic. 
So, what causes the infection? For starters, you’re more likely to get a UTI if you’re a woman, you’re pregnant, you have diabetes, you’re experiencing kidney stones, or you are older. [1; 6; 7] Although there are several reasons why an infection can happen, a change in the vaginal climate is a common cause of infections in women.  In the case of older women, for example, lower estrogen levels in the body cause an imbalance in the vagina and make her more prone to infections.  It’s worth noting that a recurring UTI could signal a chronic condition, such as diabetes or another condition that impairs the immune system. If you’re experiencing repeated UTIs, it makes sense to test at home for diabetes or another underlying condition.
Although UTIs are more common in women, prostate problems such as an enlargement of the prostate (also called benign prostatic hyperplasia, or BPH) or an overactive bladder could lead to men experiencing the condition as well. [1; 6; 7] Other symptoms of this infection, Mayo Clinic adds, can include a cloudy or foul-smelling urine and an increased urgency to urinate. 
The main problem with untreated UTIs is that the infection may spread to other parts of the body such as the kidneys. In some cases, this can result in a serious infection.
It is important to talk to your doctor if you are experiencing symptoms of a UTI as treatment with antibiotics may be required. [6; 7]
Reason #3: You Have a Yeast Infection
An infection called vaginal candidiasis — or more commonly, a yeast infection — can cause pain when urinating as well, especially when paired with irritation and itchiness of the skin. [7; 9; 10; 11]
According to Mayo Clinic, it’s a fairly common infection, affecting up to 75 percent of women at some point in their lifetimes.  Many women will have more than one infection; some may even have recurring episodes. [7; 9; 10; 11] The condition can cause inflammation in the genital area, leading to dysuria, Mayo Clinic notes. [6/9] Other symptoms associated with yeast infections include redness and swelling, soreness, and a thick, white vaginal discharge. [7; 9; 10; 11]
Every woman has a balanced blend of yeast, bacteria, and a fungus called candida. When the balance is thrown off, that means not enough of the bacteria is present to stop an overgrowth of the candida yeast. It’s not always easy to know why this happens, but some typical causes include an overuse of antibiotics, a compromised immune system, uncontrolled diabetes, or the use of oral contraceptives or estrogen hormones. [7; 9; 10; 11]
Once a yeast infection is confirmed, your doctor will likely prescribe an antifungal medication, according to the Cleveland Clinic.  If you have recurring yeast infections, your doctor may suggest an over-the-counter treatment rather than a prescription. [7; 10; 11]
Less-Common Reasons for Painful Urination, and When to See Your Doctor
Although those are the top three culprits when it comes to dysuria, they’re not the only ones. According to Dr. Eilber, inflammation or infection in other parts of the genital region, such as around the anus, could be at play, as these areas often share the same sensory nerves. Pain with urination could even be related to passing a kidney stone, she adds, since that causes inflammation throughout the urinary tract. 
She’s also seen patients who have autoimmune disorders like lupus struggle with dysuria, as well as inflammation in other parts of the body, including arthritis. 
No matter what the cause, there are some home remedies that may ease symptoms associated with dysuria. However, it’s important to keep in mind that, although these remedies can sometimes make symptoms more tolerable, they aren’t considered a treatment in the way that antibiotics would be. [4/7]
When it comes to UTIs or yeast infections, for example, in addition to visiting a healthcare provider, Dr. Eilber suggests increasing fluids, taking a cranberry supplement to help with the infection, and using anti-inflammatory medications like ibuprofen. [1; 6; 7]
While those strategies can often help ease discomfort, and home tests can help pinpoint possible reasons for your dysuria, it is very important to see a doctor to get additional tests. For most infections, antibiotics will be prescribed, and the type you are prescribed will depend on what those tests indicate, says Dr. Eilber. [1; 6; 7]
Also, if you have more serious symptoms, like higher levels of pain or a fever, and definitely if you’re seeing blood in your urine, make an appointment with your doctor, she suggests. 
Harvard Medical School
Harvard Health Publishing
American College of Obstetricians and Gynecologists
Chlamydia, Gonorrhea, and Syphilis
Wilbanks MD, Galbraith JW, Geisler WM.
Dysuria in the emergency department: missed diagnosis of Chlamydia trachomatis.
Western Journal of Emergency Medicine 2014 Mar;15(2):227-30
Centers for Disease Control and Prevention
Gonorrhea - CDC Fact Sheet
Johns Hopkins Medicine
Anatomy of the Urinary System
Urinary Tract Infection (UTI)
Symptoms and Causes
U.S. Department of Health and Human Services
Office on Women’s Health
Vaginal Yeast Infections