As Liz Lemon would say, burning pee is the worst. That’s why we asked Alyssa Dweck, M.D., ob-gyn, co-author of The Complete A-Z Guide for Your V, and Keith Baar, Ph.D., to break down some of the nitty-gritty reasons behind this annoying feeling, and gave us some tips to help you chill out when you’re feeling all hot and bothered (but not in the good way).
“Think about how sensitive and delicate the skin and tissue around and inside the vagina and urethra are, and you can imagine how any vigorous attention can result in inflammation which may cause that painful burning sensation,” Dweck says. Microabrasions also often occur during sex. These are teeny, tiny cuts that are microscopic, and are likely to hurt because you basically have salty urine touching multiple little open wounds, which is going to cause the same ouch! reaction as any salt touching any open wound. “That can be pretty typical, especially if there wasn’t a lot of lubrication or if it was a long or repeated session,” she says.
Spermicide, lube, and condoms can also cause irritation if you have a sensitivity or allergy. So, if you think you might be having a reaction to spermicide, for example, you can buy the condoms without spermicide. Switch out latex condoms for polyurethane, if you think you might be allergic to latex. Or try a natural lube instead of a synthetic one to see if you notice a difference, Dweck says. (We recommend NaturaLove organic lubricant, available from the Women’s Health Boutique.)
“Urinary tract infections are much more common in women than men because the distance from the urethra to the vaginal and anal area where there is a lot of bacteria is much shorter, making it easier for bacteria to travel to the urethra and then up to the bladder,” says Dweck. The telltale signs of a UTI are burning with urination but also an urgency and a frequency of feeling like you have to pee.
UTIs are straightforward to treat with antibiotics, once your doctor does a urine culture to confirm what it is, Dweck says. Drinking plenty of water to flush out and dilute the urine can also help to lessen the pain and slow the progression of the infection.
You know, sometimes we look for the most obvious thing, such as a UTI, when it’s another obvious thing that’s actually staring us in the face,” Dweck says. “Sexually-transmitted infections also often have burning during urination as their presenting symptom.” So it’s important not to diagnose yourself and to actually go in for the proper test. Gonorrhea and chlamydia both can cause it to hurt when you pee, although they can also sometimes cause no symptoms at all. “But the one that comes to mind that people don’t usually recognize is herpes,” Dweck says, “as one of the indications is a small blister or site of irritation that it is very painful and can feel like it is burning.”
If you do think you might have an STI, see your doc to get the right medication. She might even prescribe a soothing cream with an active, numbing ingredient like lidocaine, which you can apply topically to quell that fiery feeling while you are waiting for the symptoms to clear.
“The symptoms of BV (Bacterial Vaginosis) and yeast are usually distinguishable from a UTI because yeast will typically have a thick white discharge and a whole lot of itching, and with BV, the clue is usually a liquid with a fishy odor,” Dweck says. “However, because of all of the inflammation that both infections bring, burning with urination or a sensation of pressure, like feeling the need to pee a lot, is normal,” says Dweck.
Yeast infections are traditionally treated with fluconazole (an antifungal prescription medication) or an over-the-counter drugstore product that is inserted vaginally.