Seeing blood in your urine can be alarming, but it could be happening for many reasons. It could be caused by having your period, an infection, problems with your kidneys or cancer.
Find out what blood in your urine could mean in women and people assigned female at birth (AFAB), and what you should do if it happens to you.
The word
hematuria is a medical term for blood in your urine, or pee. Sometimes you can see blood in your urine, and it can look red, pink or brown. But sometimes you can’t see the blood, and it can only be detected under a microscope or in a urine sample. That’s called microscopic hematuria. When you can actually see blood in your urine, it’s known as gross hematuria.
Having blood in your urine doesn’t always mean there’s something wrong — but sometimes it does. It’s important to let your healthcare provider (HCP) know so they can figure out the cause.
Here are 10 reasons you might have blood in your urine:
1. Having your period
Blood during your period leaves the body through the vagina, so it’s common to see blood when you use the bathroom, and it isn’t a cause for alarm. But hematuria that happens outside of your menstrual cycle, or after you’re no longer having periods, should be evaluated by your HCP.
2. Infection
Blood in your urine can be a sign that you have a bladder infection, also called a urinary tract infection (UTI), or a kidney infection. These infections usually cause other symptoms as well, such as the frequent or urgent need to pee, pelvic or low back pain, and cloudy urine with an odor. Kidney infections can also cause fever, chills and pain in your back, sides or groin.
3. Urinary stones
Kidney stones, bladder stones or ureteral stones are made of hard deposits or crystals of substances in your urinary tract. In addition to blood in your urine, urinary stones can cause urine that smells bad or is cloudy, intense pain in your back or side, vomiting, and fever. Most urinary stones will pass on their own, but they may be quite painful coming out, especially if they are on the larger size.
4. Kidney problems
Your kidneys filter waste and fluid from your blood and make urine. When the kidneys get damaged, they can allow blood to leak into the urine. A type of kidney disease called glomerulonephritis can cause microscopic hematuria. The only way to know if you have blood in your urine that you can’t see is to get a urine test from your HCP. If you have symptoms of glomerulonephritis, such as swelling in your hands, face or feet or a decrease in how much you're peeing, talk to your HCP to see about getting a urine test
You could also have blood in your urine if you’ve had an injury to your kidney, like from an accident or playing contact sports.
5. Cancer
Seeing blood in your urine could be a sign of certain types of cancer, such as kidney or bladder cancer. Blood in the urine is often the first sign of bladder cancer, and trace amounts might be discovered during a urine test. You might also see blood in your urine as a pink or orange color.
6. Prostate issues
If you are a trans woman or assigned male at birth (AMAB), blood in your urine could be a sign of a prostate concern. A prostate infection and enlarged prostate can also cause blood to be present in the urine.
7. Endometriosis
In endometriosis, tissue that normally lines the uterus grows where it shouldn’t. In some cases, endometrial tissue can grow in the bladder, kidney or ureters. This can cause blood in the urine along with other symptoms, such as painful periods, pain during sex and infertility.
8. Inherited illnesses
Hematuria can be a symptom of sickle cell anemia or Alport syndrome, both inherited illnesses. If you know you have one of these conditions, you should still get any blood in your pee checked out to make sure there is no other cause.
9. Hard exercise
Sometimes hard exercise, contact sports and long-distance running can result in blood in the urine. For contact sports, this can be related to bladder or kidney damage from getting hit. But for hard exercise or long-distance sports, it isn’t clear why bleeding happens. Hematuria related to exercise usually goes away on its own in about seven days, but if you notice blood in your urine after exercise, it’s still a good idea to see your healthcare provider.
10. Medicine usage
Certain types of medicine, like penicillin, an anti-cancer drug called cyclophosphamide and those that prevent blood clots or thin the blood can cause blood in your urine. Hematuria from medicine usage usually goes away on its own once you stop the medicine that triggered it. However, you should let your healthcare provider know so they can determine the cause of the blood in your urine.
What are the risk factors for hematuria?
Factors that can increase your risk for hematuria include:
- A current or past smoking history
- Being above age 60
- Having glomerulonephritis
- A recent bacterial or viral infection
- Being on certain medications, such as blood thinners, aspirin or antibiotics
- Exposure to chemicals or dyes, like benzene or aromatic amines, from your job
- Running long distances, such as marathons, or participating in intense sports or exercise
How is hematuria treated?
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Treatment for blood in your pee will depend on the cause. This is why it’s important to let your HCP know if you’re having symptoms. Sometimes, no treatment is necessary.
If you have a UTI or kidney infection, you may be given antibiotics to treat the infection, along with pain medication. Other medications may be prescribed to treat the underlying cause.
Cancer can be treated with chemotherapy, radiation, immunotherapy, surgery or a combination of treatments.
You may have medical treatments to help break up bladder or kidney stones — known as a lithotripsy — or you might need surgery.
What to do if you have blood in your urine
If you have blood in your urine and you’re not on your period, it’s important to see your HCP. They may do a physical exam and ask you questions about your medical and family history. They will ask if you’re having any other symptoms, such as difficulty peeing, back pain, nausea or vomiting, or fevers.
Your HCP may ask for a urine sample so they can run a test to determine if there is blood in your urine, especially blood you can’t see with the naked eye. Urine tests can also help diagnose a bladder infection or kidney stones.
Other tests can help your HCP make a diagnosis. In addition to checking your urine, your HCP might order additional tests, such as:
- A cystoscopy: A procedure that uses a tube with a camera attached (called a cystoscope) to view the inside of your urethra — the tube that empties urine from the bladder outside of the body — and your bladder to check for infection or cancer.
- Imaging tests: Ultrasound, CT scan and MRI can be used to look at the urinary system and organs to determine the cause of the bleeding.
No matter what the cause, your HCP might recommend follow-up appointments to make sure the treatment worked and you no longer have blood in your urine.
Some causes of hematuria are more serious than others, so always let your HCP know if you see blood in your urine. And report any other symptoms you’re experiencing so you can get an accurate diagnosis, and treatment can start right away.
This educational resource was created with support from Daiichi Sankyo andMerck.
