Q. I am frequently urinating at night and having pain. Please suggest me what to do.

Answered by
Dr. Samer Samer Juma Ali Altawil
and medically reviewed by Dr.Meera Premanand
This is a premium question & answer published on Feb 02, 2022

Hi doctor,

I have had difficulty urinating at night for one year and had orgasm pain for one month. I am currently on Levothyroxine and Lansoprazole. I am getting up 4 to 5 times a night for urination. The urine flow is good during the day, but the flow is slow at night. I am also getting pain during orgasm. Please help.

Thank you.



Welcome to

This is prostatic hyperplasia. Enlargement of the prostate is physiological after 50 years, and according to the shape, it causes blockage. Now you are symptomatic, and further evaluation is indicated. Some tests are required here, such as urine analysis and culture, serum PSA (prostate-specific antigen), uroflowmetry, serum ADH (arginine vasopressin) level, and fasting blood sugar. I suggest tablet Tamsulosin 0.4 mg once at night. More frequency at night could be due to prostate enlargement. It can also be due to inappropriate ADH hormone secretion, leading to increased frequency at night. I prefer to have the above tests done to be a complete workup, but if you could not do it, then you can start the treatment for prostate enlargement at the moment and then follow up later with the requested investigations. Please make your last drink two hours before bed and pass urine immediately before sleep. I hope this helps.

Thank you.

Thank you doctor,

I will try to get my doctor to do these tests. Do you think the additional tiredness and pain at orgasm are part of the same problem? Please help.



Welcome back to

No doubt, as your sleep is affected, tiredness is there. Painful orgasm can be due to prostate enlargement or inflammation of the prostate. Stepwise treatment is better, in my view. You go ahead with the first treatment. If there is still painful ejaculation, then we will do a semen culture to rule out bacterial prostatitis. I hope this is clear.

Thank you.

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