Red Urine: 11 Common Causes & What to Do

Updated in January 2024

Red urine can be caused by eating red-colored foods (like beets), a period, cystitis, prostatitis, kidney stones or even certain medications, like phenazopyridine-

Red urine caused by a health conditions may be accompanied by other symptoms, such as fever, painful urination, burning when urinating, kidney cramping or bladder heaviness.

It is important to consult a urologist, nephrologist or family doctor if you notice red urine for more than 3 days or if the red urine os accompanied by other symptoms. The doctor will complete a thorough assessment to determine the underlying cause and guide the most appropriate treatment.

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What causes red urine?

The main causes of red urine are:

1. Eating red foods

Consuming red foods, such as beets, blackberries, rhubarb, or foods with red artificial coloring (like cake frosting or red candy), can lead to red urine.

Drinking red wine can also give the urine a red tinge. 

What to do: Red urine from eating red food is not considered to to be clinically significant. You should avoid excessive consumption of these foods if you notice this symptom often, and instead opt for a diverse and balanced diet, as recommended by a registered dietitian.

2. Menstruation

During menstruation, it is very common for urine to become red due to the presence of menstrual blood. This is not considered to be clinically significant.

What to do: Because it is considered to be a normal condition, treatment is not necessary. Be sure to maintain optimal hygiene when on your period by changing your pad frequently, cleaning your menstrual cup or disc as needed, and cleansing the vaginal area with water and mild soap.

3. Cystitis

Cystitis is inflammation in the bladder normally caused by bacteria, such as Escherichia coliIt causes symptoms such as abdominal pain, bladder heaviness, low and persistent fever and pain or burning when urinating.

Additionally, urine may be red, dark, or cloudy and have a foul odor

The main causes of cystitis are poor hygiene, sex without protection, use of spermicides, urinary catheters, pregnancy or even kidney stones.

What to do: Treatment should be carried out as prescribed by a urologist or gynecologist. The doctor may prescribe antibiotics, such as fosfomycin, ciprofloxacin or amoxicillin to eliminate bacteria and relieve symptoms.

4. Urethritis

Urethritis is inflammation of the urethra, which is the hole through which urine is eliminated. Urethra inflammation can cause symptoms such as urinary frequency, pain or burning when urinating, yellow discharge, and the presence of blood in the urine.

Typically, urethritis is caused by sexually transmitted infections (STIs), such as chlamydia, gonorrhea, trichomoniasis or herpes. It can also occur with urethra injuries or irritation.

What to do: Treatment should be oriented by a urologist or gynecologist. It normally involves the use of antibiotics, such as amoxicillin, erythromycin, ceftriaxone, azithromycin or metronidazole. The type of antibiotic use depens on the microorganism causing the infection.

5. Glomerulonephritis

Glomerulonephritis is the inflammation of the glomeruli in the kidneys. These tissues responsible for filtering the blood and removing toxins. When the glomeruli become swollen, they can cause symptoms such as blood in the urine (which can cause red urine), urinary urgency, urinating in small quantities, abdominal pain and fever.

This inflammation can be caused by  bacterial, viral or parasitic infections, as well as autoimmune diseases or chronic diseases, like diabetes and hypertension.

What to do: The treatment is oriented by a nephrologist and is typically conducted in a hospital setting with IV antibiotics. In more severe cases, the patient may experience kidney failure, which will require dialysis.

6. Kidney stones

Kidney stones can also cause red urine due to the small amount of bleeding that occurs when the stone moves from the urinary tract, from the kidneys to the urethra.

The passage of the stone can cause damage to the cells lining the urinary tract, which can lead to scant bleeding and red urine. 

Also recommended: 11 Symptoms of a Kidney Problem (with online quiz)

What to do: Proceed to the emergency room immediately if you suspect you may have kidney stones. The doctor will prescribe IV antibiotics for pain relief, while the stone itself can be treated through removal or by breaking it.

7. Prostatitis

Prostatitis refers to inflammation of the prostate gland. It that can lead to blood in the urine, giving it a red appearance as well as blood in the sperm, pain when urinating, fever or chills.

This inflammation can be caused by bacterial infections or injuries or surgeries in the prostate region, for example.

What to do: Treatment should be oriented by a urologist and will depend on the cause. Infections can be treated with antibiotics, while pain and discomfort can be managed with anti-inflammatories and analgesics..

Also recommended: Blood in Urine: 5 Common Causes & What to Do

8. Benign prostate hyperplasia

Benign prostatic hyperplasia, BPH, refers to enlargement of the prostate. This condition is very common in men over the age of 50, and can cause symptoms such as urinary urgency, difficulty completely emptying the bladder or a weak urine stream.

An enlarged prostate can bleed and lead to the elimination blood through urine, causing red urine.

What to do: Treatment is oriented by a urologist using medicines such as tamsulosin or finasteride. Surgery may be advised in more severe cases.

9. Cancer

Prostate, bladder or kidney cancer can also lead to blood in the urine, which gives urine a red color.

Generally, in its early stages, these cancers do not present with any symptoms. However, as they progress, other symptoms may start to emerge, such as a weak urine stream, pain when urinating, excessive tiredness or weight loss for no apparent reason.

What to do: You should consult a urologist or nephrologist to confirm the type of cancer and undergo treatment as advised. Depending on the type of cancer, its stage and the patient's symptoms, the oncologist may recommend surgery, chemotherapy or radiation therapy.

Also recommended: 12 Potential Signs of Cancer (& What To Do)

10. Physical exercises

Intense physical exercise can also cause red urine. This condition is referred to as exercise-induced hematuria.

This can occur because intense physical exercise can affect the kidneys' filtering process, favoring the elimination of proteins and red blood cells in the urine.

What to do: Red urine caused by intense exercise usually improves and resolves within 72 hours. If it does not improve or is accompanied by other symptoms such as black urine, back pain or fever, you should proceed to the emergency room for assessment. to determine whether the red urine is related to another cause. 

11. Use of medications

Continuous use of some medications can also affect the color of urine, making it redder.

Some of the medications that typically cause this effect are phenazopyridine, rifampicin, phenolphthalein, daunorubicin, doxorubicin or contrast for imaging tests.

Anticoagulant medications, which reduce blood clotting, can also cause bleeding along the urinary tract and red urine. 

What to do: You should your prescriber if you notice red urine after starting a new medication to determine whether you are experiencing a side effect. Do not stop taking a medication without speaking to your doctor first.

When to go to the doctor

You should consult a urologist, nephrologist or family doctor if you notice red urine that persists for more than 3 days, or if your red urine is accompanied by symptoms such as: 

  • Pain or burning when urinating
  • Foul-smelling urine
  • Weak urine stream
  • Back pain or abdominal pain
  • Bladder heaviness
  • Fever or chills.

Therefore, the doctor will order urine tests and bloodwork to identify theunderlying  cause of the red urine, which will help to guide the most appropriate treatment.