Key takeaways:
Blood in your urine can look bright red, light pink, or brown. Sometimes, it can be invisible to the naked eye.
Common causes of blood in your urine include infections, kidney stones, and some medications. Less often, certain cancers and kidney conditions can also cause it.
The causes of blood in your urine can range from mild to serious. Anytime you have bloody urine, you should see a healthcare professional for testing.
It can be quite alarming to look in the toilet bowl after you urinate and see red or pink. Blood in your urine — also called hematuria — can be caused by many different things. Even though many of these causes aren’t dangerous, bloody urine is never normal. That’s why it’s important to identify the underlying cause. Below, we explain what blood in the urine looks like, common causes, and when to see a healthcare professional.
What causes blood in the urine?
The following section goes through the common causes of blood in urine, medications that can cause it, and things that can look like blood in urine but are something different.
Common causes
The most common causes of blood in your urine include:
UTI (urinary tract infection): This includes infections anywhere along the urinary tract, including your urethra, bladder, or kidneys.
Kidney stones: When a kidney stone travels down the urinary tract, it can cause some bleeding. This is usually accompanied by episodes of intense pain.
Enlarged prostate: Benign prostatic hyperplasia (BPH) can sometimes cause bleeding. More often, it causes difficulty peeing or a weak urine stream.
Cancer: Prostate, bladder, and kidney cancers can all cause blood in your urine. But cancer is a rarer cause of blood in the urine.
Injury or trauma: This can range from mild trauma — like the insertion of a urinary catheter — to a serious fall or crash that injures your kidneys. Minor bumps or falls aren’t likely to injure your kidneys or urinary tract.
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Medications that can cause blood in urine
Certain medications may also cause blood in your urine. More commonly, these include:
Penicillin: An antibiotic that can sometimes irritate your kidneys and cause bleeding
Aspirin: This is a pain medication that changes how your blood clots, which can make urinary bleeding more likely.
Cyclophosphamide: This is a cancer treatment medication that can damage your kidneys and lead to blood in your urine.
Blood thinners: Examples of blood thinners include warfarin, Xarelto, and aspirin. They’re more likely to cause bleeding from your nose or intestines than your urinary tract. But they can increase the risk of bleeding anywhere in your body.
Situations that may mimic blood in urine
There are certain things that can look like blood in your urine, but are actually something different. It’s easy to be fooled by:
Menstruation: A person who has their period may have urine that appears brown if menstrual blood mixes in. This commonly happens at the start or end of menstruation, when the blood looks more brown than red.
Certain foods: Foods with a red color — like rhubarb, beets, and berries — can make urine (and sometimes poop) appear red, especially if you eat a lot of them. When beets cause this, it’s sometimes called “beeturia.”
Certain medications: Some laxatives, like senna, can make urine look red. Once the medication is stopped, this should go away.
Rhabdomyolysis: This is a serious condition caused by rapid muscle breakdown. It can be caused by things like medications, drug use, intense exercise, or injury. When muscles break down, they release a substance called myoglobin into your urine. And this leads to dark red or tea-colored urine.
What does blood in the urine look like?
Blood in your urine can have many different appearances. It can look:
Light pink
Bright red
Dark red
Brown or brownish-red
But blood in the urine isn’t always noticeable. If only a small amount of blood is present, your urine can still look yellow. Some conditions that cause bleeding, like UTIs and kidney stones, often do this. Fortunately, these conditions usually come with other symptoms that alert you when something is wrong.
What are the symptoms of blood in urine?
Many causes of blood in your urine also cause other symptoms. This is especially true for infections, kidney stones, and an enlarged prostate. Other symptoms can include:
Burning with urination
Increased urinary frequency or urgency
Difficulty passing urine
Pain in your lower abdomen or flank
Fever
It’s important to note that not all causes of bloody urine cause other symptoms. For example, kidney cancer doesn’t always cause abdominal pain or pain with peeing. And medications that cause bleeding usually don’t cause other symptoms either.
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That’s why it’s important to see a healthcare professional for blood in your urine — no matter what symptoms you have.
When to see a healthcare professional
If you see blood — or what looks like blood — in your urine, you should see a healthcare professional as soon as possible to figure out the cause.
Most of the time, your primary care provider is a good place to start. But some symptoms mean you need a more urgent appointment or a visit to your local ER. If you’re experiencing any of the below symptoms, seek medical attention as soon as possible:
Large amounts of bright red blood in your urine, especially if you take blood thinners
Muscle aches or pain
Persistent vomiting or diarrhea
Abdominal or flank pain
Disorientation
Peeing a lot more or a lot less than usual
Inability to pee
A significant decrease in urine production
These symptoms could be a sign of a more serious problem and shouldn’t be ignored.
Testing for causes of blood in the urine
When you see a healthcare professional, there are several different tests that can help figure out the potential cause of blood in your urine. These include:
Urine tests: These tests can help confirm the presence of blood. They can also check for things like infection.
Blood tests: These can include a complete blood count and an electrolyte panel, which tests things like kidney function.
Imaging: Tests like an ultrasound or CT scan can take a closer look at your urinary tract and kidneys. But these tests aren’t always needed to determine the cause of blood in the urine.
In some cases, your healthcare team may suggest you see a medical specialist called a urologist. They can run even more tests if the cause is still unclear. This often includes a cystoscopy, which is when they use a tiny camera to look inside your bladder.
Frequently asked questions
When a man urinates blood, it can mean many different things:
Urinary tract infection
Kidney stone
Enlarged prostate
Cancer of the prostate, kidney, or bladder (less common)
Certain medications or foods
It may also be easy to confuse blood in the urine with blood in semen, which has a different list of potential causes.
Any amount of blood in your urine should be evaluated by a healthcare professional. But this doesn’t mean you need to worry. Many causes — like urinary tract infections or medications — are temporary and treatable. If you see large amounts of bright red blood in your urine, you should go to the ER instead of waiting for an appointment with your primary care provider.
The treatment for blood in your urine focuses on treating the underlying cause, not just the blood. For example, blood in the urine from a UTI is treated with antibiotics. A kidney stone may be treated with medications or procedures to help pass the stone. In rare cases, the bleeding itself may need treatment. This is more common if there has been a significant trauma to the kidney or urinary tract.
When a man urinates blood, it can mean many different things:
Urinary tract infection
Kidney stone
Enlarged prostate
Cancer of the prostate, kidney, or bladder (less common)
Certain medications or foods
It may also be easy to confuse blood in the urine with blood in semen, which has a different list of potential causes.
Any amount of blood in your urine should be evaluated by a healthcare professional. But this doesn’t mean you need to worry. Many causes — like urinary tract infections or medications — are temporary and treatable. If you see large amounts of bright red blood in your urine, you should go to the ER instead of waiting for an appointment with your primary care provider.
The treatment for blood in your urine focuses on treating the underlying cause, not just the blood. For example, blood in the urine from a UTI is treated with antibiotics. A kidney stone may be treated with medications or procedures to help pass the stone. In rare cases, the bleeding itself may need treatment. This is more common if there has been a significant trauma to the kidney or urinary tract.
The bottom line
Seeing blood in your urine can be alarming. The good news is that many causes of blood in the urine are temporary and easy to treat. Schedule an appointment with your healthcare team. Some quick and simple tests can usually find the cause. In rare cases, there may be a more serious problem. If your symptoms feel severe and you can’t schedule an appointment quickly, go to your nearest ER.
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References
Bolenz, C., et al. (2018). The investigation of hematuria. Deutsches Ärzteblatt International.
National Institute of Diabetes and Digestive and Kidney Diseases. (2022). Hematuria (blood in the urine).
