Blood in urine, known as hematuria or hemoglobinuria, can appear as pink, red, or tea-colored urine depending on the amount of blood present. It may occur with symptoms like burning during urination or may be completely painless.

This symptom is often related to kidney or urinary tract problems, but it can also result from conditions like UTIs, kidney stones, vigorous exercise, or the use of certain medications. In women, blood in urine can also be linked to menstruation and is not usually a cause for concern.

Although many causes are mild and temporary, others may require medical care, such as infections, prostate problems, or kidney diseases. Diagnosis typically involves urine testing and imaging exams, which help determine the cause and guide the most appropriate treatment.

What causes blood in urine?

The main causes of blood in the urine include:

1. Menstruation

It is common to see blood in urine during your period, especially in the first few days. As your cycle progresses, urine should return to its normal color, although a urine test may still reveal some blood cells in the urine. This is why urine testing during a period is not recommended, as it can interfere with the results.

What to do: Blood in the urine is normal during your period, and therefore it does not require treatment. If you notice bloody urine for several days, or if it occurs on other days of your cycle, you should see your doctor for assessment to investigate the cause and initiate treatment as necessary.

2. UTI

A UTI, or urinary tract infection, is most common in women. It can cause symptoms like urgency, pain with urination and lower abdominal pressure. Learn more about common UTI symptoms.

The presence of blood in this case is more common when an infection is in its most advanced stage. In addition to blood cells, a urine test will also reveal high quantities of bacteria, leukocytes and epithelial cells.

What to do: It is important to follow-up with your doctor to confirm a UTI, as it requires treatment with antibiotics depending on the bacteria causing infection. Read more about UTI treatment and how it can be treated with medication and natural options.

3. Kidney stones

The presence of kidney stones is most common in adults, but can occur at any age. It causes symptoms like burning with urination, intense lower back pain and nausea. See what can cause kidney stones and what other symptoms that can emerge.

Urine testing will reveal the presence of blood cells as well as crystals or particles depending on the type of kidney stone.

What to do: Kidney stones are a medical emergency due to the intense pain they can cause. You should proceed to the emergency room immediately to confirm a diagnosis, especially if you are unable to urinate.

In some cases, medication to help with elimination of the stone can be prescribed. However, if the stone does not pass or if it is too big, a procedure may be needed to destroy or remove the stone.

4. Medications

Some anticoagulant medication, like warfarin or aspirin, can cause blood in the urine, especially in older adults.

What to do: In these cases, you should inform the prescriber, as a dose change or medication change may be necessary.

5. Renal, bladder or prostate cancer

Blood in the urine can be a sign of kidney, bladder or prostate cancer. It is one of the most common symptoms of these cancers in men. These cancers can also cause symptoms like urinary incontinence, pain with urination and weight loss for no apparent cause.

What to do: You should consult your doctor if you experience these symptoms or if bloody urine emerges with no apparent cause. The quicker a diagnosis is confirmed, the faster treatment can be initiated, which can improve chance of cure.

6. Vigorous or prolonged exercise

Very intense exercise such as long-distance running, cycling, or high-impact sports can irritate the bladder and lead to temporary blood in the urine. Some people may also notice pelvic discomfort or darker-colored urine after strenuous activity.

What to do: Rest and hydration usually resolve the bleeding within 24 to 72 hours. If the blood persists beyond this timeframe or occurs repeatedly after exercise, you should follow up with your doctor to rule out other urinary or kidney problems.

7. Enlarged prostate (BPH)

In men, an enlarged prostate can press against the urethra and weaken nearby blood vessels, which may cause visible or microscopic blood in the urine. Other symptoms can include difficulty starting urination, a weak stream, or frequent nighttime urination.

What to do: A doctor may confirm BPH with urine tests, a physical exam, or imaging, and recommend medications to relax or shrink the prostate. If symptoms are severe or do not improve, other treatments or procedures may be necessary. Check-out some natural remedies for an enlarged prostate that you can use to complement your medical treatment.

8. Glomerulonephritis

Glomerulonephritis is inflammation of the kidney’s filtering structures and can cause dark, tea-colored urine due to blood and protein loss. People may also experience swelling in the legs or face, high blood pressure, or fatigue.

What to do: It is important to see a doctor promptly, as this condition requires blood and urine testing to confirm the cause of the inflammation. Treatment varies depending on the type but may include medication to control blood pressure or inflammation.

9. Polycystic kidney disease

Polycystic kidney disease causes multiple cysts to form in the kidneys, and these cysts can rupture and lead to blood in the urine. Some people also experience flank pain, frequent kidney infections, or high blood pressure.

What to do: A doctor may recommend imaging to confirm the presence of cysts and monitor kidney function regularly. Treatment focuses on managing symptoms, controlling blood pressure, and preventing complications.

10. Sexually transmitted infections (STIs)

Infections like chlamydia or gonorrhea can irritate the urethra and cause blood in the urine, especially in younger adults. Additional symptoms may include burning with urination, genital discharge, pelvic pain, or pain during sex.

What to do: A doctor can confirm an STI with urine or swab testing and start antibiotic treatment to relieve symptoms and prevent complications. It is also important to notify recent partners so they can be tested and treated.

11. Catheter use or recent urological procedures

Using a urinary catheter or undergoing procedures like cystoscopy, lithotripsy, or bladder surgery can temporarily cause minor bleeding in the urine. Some people also notice mild discomfort or increased urinary frequency.

What to do: This type of bleeding usually resolves on its own within a short period, especially with adequate hydration. If bleeding becomes heavy, lasts longer than expected, or is accompanied by fever or severe pain, you should contact your doctor.

12. Bleeding disorders

Conditions such as thrombocytopenia, hemophilia, or von Willebrand disease can make bleeding more likely, including in the urinary tract. People with these disorders may also experience easy bruising, frequent nosebleeds, or prolonged bleeding from minor injuries.

What to do: A doctor may order blood tests to evaluate clotting ability and adjust medications or recommend treatment to help control bleeding. If hematuria is new or worsening, prompt evaluation is especially important to prevent complications.

Blood in urine during pregnancy

Blood in the urine during pregnancy is usually caused by a UTI. However, the blood can come from the vagina and mix with the urine. Vaginal bleeding can indicate more serious problems, like placental abruption, which require immediate assessment to ensure maternal and fetal health.

Learn more about what can cause vaginal bleeding during pregnancy.

Newborns with blood in urine

Newborns who have blood in urine is not a serious concern, as it can be caused by the presence of crystals in the urinary tract. These crystals can give urine a red or pinkish color, which looks like blood.

Increasing fluid intake in newborns is essential for diluting the urine to bring it to a more normal color. If the dark color does not resolve with increasing fluids, the newborn should be assessed immediately.

When to go to the doctor

You should see your doctor if the bloody urine persists for over 48 hours, if you have difficulty urinating, or if you have other symptoms like fever over 38ºC (or 100.4ºF), intense pain with urination, or vomiting.

To identify the cause of urine in the blood, the doctor may order testing like an ultrasound, CT scan or cystoscopy.

Blood in Urine: 12 Possible Causes (& What to Do)