10 Common Symptoms of Blood in Urine (Hematuria) You Should Know

Blood in urine, medically known as hematuria, is a condition where red blood cells are present in your urine. This can be alarming when you notice it, but it’s a relatively common occurrence that can affect both men and women of all ages. Hematuria can appear in two forms: gross hematuria, where the blood is visible to the naked eye, making the urine pink, red, or cola-colored; and microscopic hematuria, where blood cells are only detectable under a microscope during a urine test.

While seeing blood in your urine can be frightening, it doesn’t always indicate a serious medical condition. However, it should never be ignored, as it can be a sign of underlying health issues ranging from urinary tract infections to more serious conditions. Understanding the symptoms associated with hematuria is crucial for early detection and proper medical evaluation. This comprehensive guide will walk you through the most common symptoms, causes, and preventive measures related to blood in urine.

1. Visible Blood in Urine (Gross Hematuria)

The most obvious symptom of hematuria is when you can actually see blood in your urine with the naked eye. This condition, called gross hematuria, causes your urine to change color dramatically. The color can range from pink or light red to deep red or even brown, resembling tea or cola. The intensity of the color doesn’t necessarily correlate with the severity of the underlying condition.

When experiencing gross hematuria, you might notice:

• Pink-tinged urine indicating small amounts of blood
• Bright red urine suggesting fresh bleeding
• Dark red or brown urine which may indicate older blood
• Urine with a smoky or cola-like appearance

It’s important to note that even a small amount of blood can significantly change the color of your urine. Sometimes, only a few drops of blood can turn the entire toilet bowl water pink. This symptom can appear suddenly and may come and go, or it might persist continuously. Regardless of how much blood you see or how long it lasts, visible blood in urine always warrants medical attention.

2. Blood Clots in Urine

One of the more alarming symptoms associated with hematuria is the presence of blood clots in your urine. These clots can vary significantly in size, from tiny specks to larger, more substantial masses. Blood clots in urine typically indicate more significant bleeding within the urinary tract system.

Characteristics of blood clots in urine include:

• Small, thread-like clots that may resemble strings or worms
• Larger, jelly-like clots that can be quite noticeable
• Dark red or brownish clots indicating older blood
• Clots that may cause temporary blockage sensations

The presence of blood clots is more common in cases of significant bleeding from the bladder, kidneys, or other parts of the urinary system. In females, it’s particularly important to distinguish between blood clots from the urinary tract and menstrual bleeding. Blood clots in urine may be accompanied by other symptoms such as difficulty urinating or a feeling of incomplete bladder emptying. If you notice blood clots in your urine, seek immediate medical attention, especially if accompanied by pain or difficulty urinating.

3. Painful Urination (Dysuria)

Painful urination, medically termed dysuria, is a common symptom that often accompanies blood in urine, particularly in cases related to infections or inflammation. This symptom can manifest as a burning, stinging, or sharp pain during urination, making the act of going to the bathroom extremely uncomfortable.

When experiencing dysuria with hematuria, you may feel:

• A burning sensation throughout the urination process
• Sharp, stabbing pains at the start or end of urination
• Intense discomfort that makes you hesitant to urinate
• A stinging feeling in the urethra

This combination of symptoms is particularly common in urinary tract infections (UTI), where bacteria inflame the lining of the urinary tract. In females, blood in urine with pain is frequently associated with UTIs or bladder infections. In males, this symptom combination might indicate prostate problems, urinary tract infections, or urethral inflammation. The pain may be mild or severe and can significantly impact your quality of life and daily activities.

4. Blood in Urine Without Pain

Interestingly, many cases of hematuria occur without any accompanying pain or discomfort. Blood in urine with no pain, known as painless hematuria, can actually be more concerning than painful hematuria because it may indicate certain serious conditions that don’t cause immediate discomfort.

Painless hematuria characteristics include:

• Visible blood in urine without any burning or discomfort
• No urgency or frequency issues
• Normal urination patterns despite blood presence
• Intermittent bleeding that comes and goes without warning

In males, blood in urine with no pain might be associated with prostate enlargement, kidney stones that aren’t currently moving, or more serious conditions. In females, painless blood in urine could indicate various conditions affecting the kidneys or bladder. While the absence of pain might seem reassuring, painless hematuria should never be dismissed. It requires thorough medical investigation to rule out potentially serious underlying conditions. Many healthcare providers consider painless hematuria a red flag that necessitates comprehensive urological evaluation.

5. Frequent and Urgent Need to Urinate

When blood appears in your urine, it’s often accompanied by changes in your urination patterns, particularly an increased frequency and urgency to urinate. This symptom can be quite disruptive to daily life, causing you to make frequent trips to the bathroom, often with minimal urine output.

This symptom manifests as:

• Needing to urinate much more often than usual, sometimes every few minutes
• Sudden, intense urges to urinate that are difficult to postpone
• Feeling like you need to rush to the bathroom immediately
• Producing only small amounts of urine despite the strong urge
• Waking up multiple times during the night to urinate (nocturia)

This combination of symptoms is especially common with urinary tract infections (UTI blood in urine) and bladder inflammation. The frequent urge occurs because the bladder becomes irritated and sends signals to your brain that it needs to be emptied, even when it contains very little urine. This can be particularly frustrating and exhausting, especially when it interferes with sleep or work. The urgency can be so intense that some people experience anxiety about being far from a bathroom.

6. Lower Abdominal or Back Pain

Pain in the lower abdomen or back is another significant symptom that can accompany blood in urine. The location and type of pain can provide important clues about the underlying cause of the hematuria. This pain can range from a dull ache to sharp, severe discomfort.

Pain patterns associated with hematuria include:

• Lower abdominal pain or pressure, particularly above the pubic bone
• Flank pain on one or both sides of the lower back
• Sharp, cramping pains that come in waves (common with kidney stones)
• Constant, dull aching in the pelvic region
• Pain that radiates from the back to the groin area

In males, blood in urine with pain, especially in the lower abdomen or back, might indicate kidney stones, urinary tract infections, or prostate issues. The pain may be accompanied by tenderness when the area is touched. Severe, wave-like pain that comes and goes, known as renal colic, is particularly characteristic of kidney stones moving through the urinary tract. Some people describe this as one of the most intense pains they’ve ever experienced. Persistent or severe pain accompanying blood in urine requires prompt medical evaluation.

7. Difficulty Starting or Maintaining Urination Stream

Difficulty with urination, including trouble starting the urine stream or maintaining a steady flow, is another symptom that can occur alongside hematuria. This symptom suggests possible obstruction or irritation within the urinary tract system.

This difficulty may present as:

• Hesitancy or delay in starting urination despite feeling the urge
• A weak or interrupted urine stream that starts and stops
• Straining or pushing required to initiate or maintain flow
• Dribbling at the end of urination
• Feeling that the bladder hasn’t completely emptied

In males, particularly those over 50, this symptom combined with blood in urine often relates to prostate enlargement or inflammation. The prostate gland surrounds the urethra, and when enlarged, it can compress the urinary passage, making urination difficult. In both males and females, this symptom might also indicate a blockage from blood clots, kidney stones, or swelling within the urinary tract. Some people find they need to wait several seconds before urination begins, or they may need to visit the bathroom multiple times to fully empty their bladder.

8. Fever and Chills

When blood in urine is accompanied by fever and chills, it often signals an infection in the urinary system. These systemic symptoms indicate that your body is mounting an immune response, and they should be taken seriously as they may suggest a more severe infection that has potentially spread to the kidneys.

Fever and chills with hematuria may include:

• Body temperature above 100.4°F (38°C)
• Sudden onset of shaking chills or rigors
• Alternating sensations of feeling very cold then very hot
• Night sweats or excessive sweating
• General feeling of being unwell or fatigued

This combination of symptoms is particularly concerning for kidney infections (pyelonephritis), which can develop when a lower urinary tract infection spreads upward to the kidneys. Fever with blood in urine requires urgent medical attention, especially if accompanied by back pain, nausea, or vomiting. In severe cases, untreated kidney infections can lead to serious complications. If you experience fever above 101°F (38.3°C) along with blood in your urine, seek immediate medical care, as this may indicate a serious infection requiring prompt treatment.

9. Nausea and Vomiting

Nausea and vomiting are systemic symptoms that sometimes accompany hematuria, particularly when the underlying cause involves the kidneys or represents a more serious condition. These symptoms indicate that the problem extends beyond just the urinary tract and is affecting your overall physical state.

When experiencing these symptoms with blood in urine, you might notice:

• Persistent queasy feeling or upset stomach
• Loss of appetite or aversion to food
• Actual vomiting episodes
• Dry mouth and dehydration from inability to keep fluids down
• General weakness and fatigue

Nausea and vomiting associated with hematuria are particularly common with kidney stones, as the severe pain from stones moving through the urinary tract can trigger these symptoms. They may also occur with kidney infections or other serious urinary tract conditions. The combination of blood in urine with nausea and vomiting should never be ignored, as it may indicate a severe infection or significant kidney problem. These symptoms can lead to dehydration, which can worsen the underlying condition, making it crucial to seek medical attention promptly.

10. Swelling in the Body (Edema)

Swelling or edema, particularly in the legs, ankles, feet, or around the eyes, when combined with blood in urine, can indicate kidney-related problems. The kidneys play a crucial role in regulating fluid balance in the body, and when they’re not functioning properly, fluid can accumulate in tissues.

Edema associated with hematuria may appear as:

• Puffiness around the eyes, especially noticeable in the morning
• Swelling in the ankles and feet that worsens throughout the day
• Legs that feel heavy or tight
• Indentations that remain when you press on swollen areas (pitting edema)
• Sudden weight gain from fluid retention
• Swelling in the hands or face

This symptom is less common than others on this list but can be significant when present. It may indicate glomerulonephritis (inflammation of the kidney’s filtering units) or other kidney conditions affecting the organ’s ability to regulate fluids and remove waste products. The swelling typically develops gradually and may be accompanied by reduced urine output or darker, more concentrated urine. If you notice swelling along with blood in your urine, particularly if accompanied by high blood pressure or changes in urination patterns, seek medical evaluation promptly as this could indicate significant kidney involvement.

Common Causes of Blood in Urine

Understanding what causes blood in urine is essential for proper evaluation and management. Hematuria can result from various conditions affecting different parts of the urinary system:

Urinary Tract Infections (UTIs)

One of the most common causes of blood in urine, especially in women. UTIs occur when bacteria enter the urinary tract, causing inflammation and irritation that can lead to bleeding. UTI blood in urine is typically accompanied by burning during urination, urgency, and frequency.

Kidney Stones

Hard deposits of minerals and salts that form in the kidneys can cause blood in urine as they move through the urinary tract. They often cause severe pain and may produce blood clots in urine along with visible bleeding.

Bladder or Kidney Infections

Infections that specifically affect the bladder (cystitis) or kidneys (pyelonephritis) commonly cause hematuria along with pain, fever, and urinary symptoms.

Enlarged Prostate

In males, particularly those over 50, an enlarged prostate gland can compress the urethra and cause blood in urine, often without pain. This is a frequent cause of blood in urine in males.

Kidney Disease

Various kidney conditions, including glomerulonephritis, can cause microscopic or gross hematuria along with other symptoms like swelling and high blood pressure.

Medications

Certain medications, particularly blood thinners like aspirin, warfarin, and other anticoagulants, can increase the risk of bleeding in the urinary tract.

Strenuous Exercise

Intense physical activity can sometimes cause temporary hematuria, often called “runner’s bladder.” This is usually harmless but should still be evaluated.

Trauma or Injury

Injury to the kidneys, bladder, or other parts of the urinary tract from accidents, falls, or contact sports can result in blood in urine.

Cancer

While less common, bladder, kidney, or prostate cancer can cause painless hematuria. This is why blood in urine with no pain requires thorough investigation.

Inherited Disorders

Conditions like sickle cell anemia or Alport syndrome can cause blood in urine as part of their disease process.

Prevention and Risk Reduction

While not all causes of blood in urine can be prevented, there are several steps you can take to reduce your risk of developing hematuria:

Stay Properly Hydrated

Drinking adequate water throughout the day helps flush bacteria from your urinary system and prevents the formation of kidney stones. Aim for 8-10 glasses of water daily, or more if you exercise heavily or live in a hot climate.

Practice Good Hygiene

Proper hygiene, especially for women, is crucial in preventing urinary tract infections. Wipe from front to back after using the bathroom, urinate after sexual activity, and keep the genital area clean.

Avoid Tobacco Products

Smoking significantly increases the risk of bladder and kidney cancer, which can cause blood in urine. Quitting smoking is one of the best things you can do for your urinary tract health.

Limit Exposure to Chemicals

Certain chemicals and industrial substances can increase bladder cancer risk. If you work with chemicals, follow all safety guidelines and use appropriate protective equipment.

Maintain a Healthy Diet

A balanced diet low in salt and animal protein can help prevent kidney stones. Limiting foods high in oxalates (like spinach, nuts, and chocolate) may also reduce stone formation in susceptible individuals.

Exercise Regularly but Safely

Regular physical activity promotes overall health, but avoid overexertion that might cause exercise-induced hematuria. Gradually increase exercise intensity and stay hydrated during workouts.

Manage Chronic Conditions

If you have diabetes, high blood pressure, or other chronic conditions, work with your healthcare provider to manage them effectively, as these can affect kidney function.

Use Medications Carefully

If you take medications that can affect bleeding, such as blood thinners, follow your doctor’s instructions carefully and report any signs of blood in urine immediately.

Frequently Asked Questions

What does blood in urine look like?

Blood in urine can range from pink or light red to dark red or brown. Sometimes it may look like tea or cola. The amount of blood doesn’t necessarily indicate the seriousness of the condition – even a small amount can significantly change urine color. In microscopic hematuria, the urine appears normal but blood cells are detected under a microscope.

Should I go to the doctor if I see blood in my urine once?

Yes, you should always consult a healthcare provider if you notice blood in your urine, even if it only happens once. While it might be something minor, blood in urine can indicate serious conditions that require medical evaluation. Don’t wait to see if it happens again – early detection is important for proper treatment.

Why is my pee red if I’m not on my period?

Red urine can be caused by actual blood in the urine (hematuria) from various conditions like UTIs, kidney stones, or infections. However, it can also be caused by certain foods (like beets, berries, or rhubarb), medications, or dyes. If you haven’t eaten anything that could change urine color, red urine likely indicates blood and should be evaluated by a doctor.

Is blood in urine always serious?

While blood in urine isn’t always serious, it should always be taken seriously and evaluated by a healthcare provider. Some causes, like mild UTIs or vigorous exercise, are relatively minor and easily treated. However, hematuria can also indicate more serious conditions like kidney disease or cancer, which is why medical evaluation is crucial.

Can dehydration cause blood in urine?

Dehydration itself doesn’t directly cause blood in urine, but it can contribute to conditions that do, such as kidney stones or concentrated urine that irritates the bladder. Severe dehydration can also make urine appear darker, which might be mistaken for blood. Staying well-hydrated is important for urinary tract health.

Does blood in urine mean I have cancer?

No, blood in urine does not automatically mean you have cancer. While bladder, kidney, or prostate cancer can cause hematuria, these are less common causes. Most cases of blood in urine result from infections, kidney stones, or other benign conditions. However, because cancer is a possibility, any blood in urine should be properly investigated by a healthcare provider.

Can stress cause blood in urine?

Stress itself doesn’t directly cause blood in urine. However, stress can worsen certain conditions that do cause hematuria, such as triggering UTIs or exacerbating existing bladder conditions. Stress can also affect your immune system, potentially making you more susceptible to infections.

Is blood in urine more serious in males or females?

Blood in urine should be taken seriously regardless of gender, though the common causes may differ. In females, UTIs are more common causes, while in males, especially older men, prostate issues are more frequent. Both genders need proper medical evaluation to determine the cause and appropriate management.

How long does blood in urine last with a UTI?

With a UTI, blood in urine typically resolves within 24-48 hours after starting appropriate treatment. However, you should complete the full course of any medication prescribed by your doctor. If blood persists beyond a few days of treatment, contact your healthcare provider for further evaluation.

Can I exercise if I have blood in my urine?

You should avoid strenuous exercise until you’ve been evaluated by a doctor and the cause of blood in your urine has been determined. Exercise can sometimes worsen certain conditions causing hematuria. Once your doctor identifies the cause and provides treatment, they can advise you on when it’s safe to resume physical activity.

References:

• Mayo Clinic – Blood in Urine (Hematuria)
• National Institute of Diabetes and Digestive and Kidney Diseases – Hematuria
• National Kidney Foundation – What Your Urine Says About You
• Urology Care Foundation – Hematuria
• Johns Hopkins Medicine – Hematuria (Blood in the Urine)