Dear Alice,

About six months ago, I experienced pain when urinating after having intercourse. Typically, I have pain/burning the first time I urinate after sex, but then the pain tends to go away or diminish. I am a 38 year old male. I have no pain otherwise.

— Burning

Dear Burning,

While the symptoms you're experiencing are uncomfortable, they're quite common and may be attributed to several different causes (more on those later). Whether it’s an allergy, infection, or irritation, speaking with your health care provider may provide some clarity about your dysuria, or painful urination, and what you need to do to extinguish it.

Although it’s not totally uncommon for men to experience some discomfort after intercourse due to rubbing and friction from time to time, some pain may be indicative of a more serious issue. Having pain when you pee is typically attributed to an infection in the reproductive or urinary tract. Urethritis, or inflammation of the urethra, is one of the most common causes of discomfort seen in sexually active men. Your pain may also be a result of bacterial sexually transmitted infection (STI) such as chlamydia, trichomonas, and gonorrhea, or a viral STI such as herpes simplex virus. The best way to know if an STI is the source of your pain is to get tested. Doing that in short order is a good idea, too, because a bacterial infection left untreated can spread and evolve into prostatitis — inflammation of the prostate gland — or a urinary tract infection, both of which might lead to painful urination. Other symptoms of a more serious infection include:

  • Drainage or discharge from penis
  • Painful urination that lasts longer than one day
  • Blood in urine or cloudy urine
  • Other pelvic pain, perineal discomfort, or testicular pain
  • Fever, chills, malaise, and vomiting
  • Pain radiating to the back or flank
  • Discomfort during ejaculation
  • Itching and tingling in the genital area

Burning, you mentioned that this sensation usually follows intercourse — it may also be possible that the type of sex you're has contributed to the source of your pain. For example, some studies show that there’s a link between men who have anal sex and symptoms such as pelvic pain, overactive bladder, and discomfort while urinating. Other non-infectious causes of dysuria may result from changing the condoms, lubricant, spermicide, or soap you use, or it may also be an allergic reaction or sensitivity to the ingredients in these products. Perhaps trying a new type of lube or condom (e.g., trying non-latex instead of the latex variety) might help rule out some possibilities.

If and when you experience this pain again, or if it persists over time, your best bet is to seek out medical attention. During your visit with a health care provider, it'll be good to relay your repeated experience with this pain. And, though it may be uncomfortable, it's also a good idea to let your health care provider know the type of sex you're having and what kinds of sexual health tools (i.e., condoms and lubricant) you're using. That way, s/he will have all the information they need to give an appropriate diagnosis, so you can get any treatment you need to be pain-free ASAPee.

Here's hoping "urine" luck when it comes to pain relief in the future!

Alice!

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