Blood in the urine can be a very concerning symptom to experience. But this symptom is surprisingly common. Around one in five people examined by a urologist will be diagnosed with bloody urine.
What can this symptom mean, and should you be concerned?
Bloody urine can be a sign of various health conditions, from fairly benign conditions to some that are very serious.
Keep reading to find out more.
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Hematuria, or blood in the urine, is a condition where blood cells are found in the urine, which can sometimes be seen with the naked eye (gross hematuria) or only detected under a microscope (microscopic hematuria).
While it can be unsettling, it’s important to remember that hematuria is a symptom, not a disease in itself, and it can be caused by a variety of conditions.
UTIs occur when certain bacteria enter the urinary tract, causing inflammation. UTI symptoms include:
A urinary tract infection can also cause blood in the urine. The inflammation caused by the UTI can cause bleeding, which is then expelled from the body through the urine. These bacteria are not sexually transmitted.
If you think you may have a UTI, order your Urine for Microscopy and Culture Home Test Kit.
These occur when bacteria enter the kidneys, often resulting in back pain, fever, nausea, and hematuria.
Hard deposits of minerals and salts can form in your kidneys, sometimes causing significant pain. These stones can cause bleeding, resulting in hematuria.
Infections in the bladder or kidneys can cause inflammation and result in blood in the urine.
A very common cause of blood in the urine is because of a prostate problem. This could be due to inflammation, infection (even STIs that have reached the prostate), benign enlargement, or cancer. The typical symptoms of prostate trouble is difficulty urinating. (For example: it takes longer to start urinating, the stream of urine is weak, and there is more dribbling at the end than normal.)
Chlamydia, Gonorrhoea, and Mycoplasma can cause prostate infections and therefore blood in the urine, but usually prostatitis is an infection caused by other bacteria.
Some drugs, including certain antibiotics, analgesics, and anticoagulants, can cause hematuria.
Surprisingly, intense physical activity can sometimes cause hematuria. The reasons aren’t entirely understood but may be linked to dehydration, bladder trauma, or the breakdown of red blood cells that occurs during sustained aerobic exercise.
Some STIs can indeed cause hematuria. Here are a few examples.
Gonorrhoea is a sexually transmitted infection caused by Neisseria gonorrhoeae or gonococcus bacteria. This infection can be passed on through unprotected sexual activity, like vaginal, anal, and oral sex, and by sharing sex toys.
During a Gonorrhoea infection, bacteria infect the urinary tract. The body’s immune response to the bacteria causes inflammation, which primarily causes symptoms like pain during urination and unusual discharge from the penis and vagina.
In some cases, the inflammation can cause bleeding, which may result in hematuria. It’s extremely rare and is generally minor and not repeated. If it doesn’t resolve after testing and treatment, other causes should be investigated.
Chlamydia is another bacterial infection that can potentially cause hematuria. This sexually transmitted infection is caused by the Chlamydia trachomatis bacterium. Chlamydia is the most common bacterial STI in the world, and thousands of people are diagnosed with the infection every year in the UK.
Similar to a Gonorrhoea infection, during a Chlamydia infection, bacteria infect the urinary tract, causing inflammation. This inflammation can, in some cases, cause hematuria. Once again this is an extremely unlikely scenario, but is definitely more common if the Chlyamida infection has reached the prostate. If there is blood in the urine and prostatic symptoms (difficulty peeing), Chlamydia is definitely an infection to look for.
Other Chlamydia symptoms include pain during sex, unusual discharge from the vagina and penis, and painful urination.
You can get Chlamydia the same way you get Gonorrhoea: through unprotected sexual activity and by sharing sex toys.
Trichomonas differs from the two infections above in that it is not caused by bacteria, but by a parasite.
The parasitic protozoan Trichomonas vaginalis lives in semen and vaginal fluids. In women, Trichomonas infects the vagina and urethra (the tube that transports urine to the outside). In men, it infects the urethra, the head of the penis, and the prostate gland.
This parasitic infection can cause irritation and inflammation in the urinary tract, which can lead to hematuria in some extremely rare cases.
You can get this infection from sexual activity. However, there is some evidence to suggest that Trichomonas can, in very rare cases, be contracted by other means, like sharing bath water.
The Human Papillomavirus (HPV) is the most common sexually transmitted infection on earth. Most people who are sexually active will get some strain of HPV in their lifetime.
For most people, these infections are cleared by the immune system without incident. However, some higher risk strains of HPV have been linked to cancer.
HPV causes around 99% of cervical cancers in women. When cervical cancer gets to an advanced stage, it can cause bloody urine, along with other symptoms like difficulty urinating and swelling in the legs.
An infection with Herpes around the urethra can also cause blood to spill into the urine during an attack, which would usually be accompanied by very painful urinating.
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This article has been medically reviewed by Dr. Steve Chapman, 30/10/2024.