Blood in your urine may indicate various medical conditions, particularly those affecting the kidneys, bladder, urinary tract, and prostate.
You may naturally feel concern if you notice blood in your urine. Visible blood in your urine is known as gross hematuria. Blood in your urine that can’t be seen and is detectable only with a microscope is known as microscopic hematuria.
Causes of Hematuria
When you experience hematuria, red blood cells leak from your kidneys or your urinary tract into your urine. Blood in your urine is not always a sign of a serious medical condition, but it should be taken as a warning that something could be wrong. Hematuria can be a sign of many medical conditions:
If you notice blood at the following points during urination, it can have different implications:
Blood at the beginning of urination may mean the bleeding originates in the urethra.
Blood in the urine stream may be due to your bladder, kidneys, or ureters.
Blood at the end of urination may suggest that the cause involves the bladder or prostate.
If you’re over age 35 and are a smoker, blood in your urine may be a sign of bladder cancer.
Certain medications can also cause urinary bleeding:
cyclophosphamide (Cytoxan)
penicillin
aspirin
heparin
anticoagulants such as warfarin (Coumadin), rivaroxaban (Xarelto), dabigatran (Pradaxa), or apixaban (Eliquis)
Extremely strenuous exercise can also cause hematuria, possibly because it can lead to bladder trauma, dehydration, or the breakdown of red blood cells. If you’re a runner or have exercised strenuously and notice blood in your urine, contact your doctor.
Blood may also come from these other sources:
The vagina during menstruation
Ejaculation in men (often because of a prostate problem)
A bowel movement due to hemorrhoids or other issues
What Causes Small Blood Clots in Urine?
Urinary tract infections, kidney stones, and prostate problems are common causes of small blood clots, which can sometimes look like coffee grounds. If you notice blood clots in your urine — even small ones — you should contact your doctor. Larger blood clots can block the flow of urine and cause discomfort, and they’re often a sign of a medical emergency.
If you notice different shapes of blood clots in your urine, such as a wormlike appearance, it may be a sign that you are bleeding from the urethra or prostate. Painful clots may come from the tubes that connect your kidneys to your bladder, known as ureters.
Can Dehydration Cause Blood in Urine?
While dehydration is less likely to be a direct cause of hematuria, it can lead to related conditions.
For example, low urine volume due to consistent dehydration can lead to kidney stones that can cause blood in the urine. Dehydration may also contribute to blood in the urine during extreme exercise.
Causes of Hematuria in Children
Visible and microscopic blood in children's urine can indicate a medical condition or a risk of developing one.
If red, pink, or brown discoloration is visible, the change is likely due to medication or certain foods. Regardless, parents should consult a doctor if they notice any abnormal color changes in their child’s urine.
Roughly 4 percent of children will experience microscopic blood in their urine, according to a paper from 2020. Because microscopic blood isn’t visible, parents should also look for these symptoms of possible conditions that might be causing it:
Urinating more often than usual
Painful urination
Fever
Abdominal pain or masses
Pain in the sides
Cola-colored urine
High blood pressure
Swelling
Hearing loss
Eye abnormalities
Skin rashes
Joint inflammation
Fatigue
Easy bruising
Hemarthrosis
Bleeding gums
Bleeding joints, causing pain, reduced movement, warmth, and swelling
Hematuria in children can be a sign of the following:
Polycystic kidney disease
Kidney stones
Hereditary nephritis
Alport syndrome
Sickle cell disease
Kidney cysts
It’s also possible that your child has thin basement membrane disease. In many children, no symptoms other than blood in the urine are present. However, in some children, high blood pressure, swelling, and reduced urine output might occur.
Symptoms That Accompany Blood in Your Urine
If your urine is pink, red, or brown, you may be experiencing hematuria. A small amount of blood can change urine's color, but you may also notice that you’re passing larger blood clots.
Discolored urine, however, does not mean that you have blood in your urine. Foods such as blackberries, rhubarb, and beets, as well as some medications and vitamins, can change the color of your urine.
Regardless, consulting your doctor anytime your urine is discolored can help you determine whether the change is harmless or more serious.
Additional symptoms that might accompany blood in urine can include the following:
Discomfort or pain while urinating
Urgent need to urinate
Frequent need to urinate
Unexpected or unexplained weight loss
Inability to urinate
Fever
Nausea or vomiting
Abdominal pain
Chills
Diagnosing the Cause of Blood in Urine
To determine the cause of blood in urine, your doctor will usually begin by discussing your medical history with you. They may ask if you’ve had any recent infections or have a family history of hematuria.
You can prepare for your appointment by making a few notes on your urine color and odor, how often you urinate, and whether you experience any pain during urination. You can take a photo of your discolored urine on your phone and show it to your doctor at your appointment.
Your doctor may also perform several tests. Urinalysis can detect microscopic hematuria and test for a urinary tract infection or kidney stones. If urinalysis does not identify the cause, your doctor may also order a CT scan, MRI, or ultrasound. They may also want to examine the bladder and urethra using a cystoscopy, in which a healthcare professional inserts a tube with a camera into the bladder.
Additional tests may include the following:
Antinuclear antibody test
Blood creatinine level
Kidney biopsy
Complete blood count
Strep test
Blood disorder tests
Coagulation tests
Blood chemistry tests
24-hour urine collection
“Many doctors and patients underestimate the importance of searching for a cause for blood in the urine,” says Anne Schuckman, MD, an associate professor of urology and urologic oncology at the Keck School of Medicine at the University of Southern California in Los Angeles. She recommends that a urologist evaluate any patients with hematuria.
“Infection can cause blood, but unfortunately, many patients who have blood in the urine may also have some white cells in the urine and receive treatment for a presumed urinary tract infection,” Dr. Schuckman says. “The antibiotics may help for a while. However, a serious underlying cause of the blood may be missed without a full investigation.”
Schuckman notes that new guidelines support less intense workups for patients who are younger and do not have a smoking history, allowing many patients to forgo a cystoscopy and get a molecular urine test instead. “Others may need imaging studies such as an ultrasound or a CT scan,” says Schuckman. “If people have a significant smoking history, it remains very important to undergo a direct look into the bladder using a cystoscopy to rule out serious issues such as bladder cancer.”
Treating the Causes of Hematuria
Treatment for blood in the urine depends on the underlying medical condition causing hematuria. For example, if you have a urinary tract infection, your doctor may prescribe antibiotics. If you have an enlarged prostate, your doctor may prescribe medication to shrink it.
For bladder or kidney stones, your doctor may use shock wave treatment, known as extracorporeal shock wave lithotripsy. They may remove the stone by inserting a scope through the urethra, or they may recommend surgery.
The Takeaway
True hematuria (blood in your urine) may be a sign of an underlying medical condition, such as a urinary tract infection, kidney or bladder stones, endometriosis, an enlarged prostate, or cancer of the kidneys, bladder, or urethra.
Some blood in your urine is normal during the menstrual cycle, as it does not originate from the urinary tract, and certain foods can change the color of urine.
Hematuria can occur due to certain medications and strenuous exercise.
If you have blood in your urine and symptoms like painful or frequent urination, fever, weight loss, or abdominal pain, speak with a healthcare professional.
Everyday Health follows strict sourcing guidelines to ensure the accuracy of its content, outlined in our editorial policy. We use only trustworthy sources, including peer-reviewed studies, board-certified medical experts, patients with lived experience, and information from top institutions.
Resources
Blood in urine (hematuria) causes and treatment. American Kidney Fund. July 17, 2025.
Blood in urine (hematuria): Symptoms & causes. Mayo Clinic. December 24, 2025.
Christopher Wolter, MD, is an assistant professor in urology at Mayo Clinic in Phoenix, Arizona. He has been in practice since 2008, specializing in the areas of urinary incontinence, pelvic organ prolapse, urologic reconstruction, urologic prosthetics, post prostate cancer survivorship, erectile dysfunction, neurourology and neuromodulation, and overall functional considerations of urogenital health.
Dr. Wolter has been heavily involved in urologic education. He spent the last 12 years heavily involved in resident education and leadership for his department, including the last eight years as urology residency program director. He currently serves as the director of urologic education for the preclinical and clinical rotations for the Mayo Clinic Alix School of Medicine Phoenix, Arizona, campus.
Wolter completed his undergraduate and medical education at the University of Illinois. He then completed his urology residency at Tulane University in New Orleans, followed by a fellowship in female pelvic medicine and reconstructive urology at Vanderbilt University in Nashville, Tennessee.
Kathleen Smith, PhD, is a licensed professional counselor with a private therapy practice in Washington, DC, and a freelance writer. Her writing on mental health has appeared in New York magazine and on Slate, Salon, Bustle, and Lifehacker, as well as in many psychology publications. Dr. Smith received her PhD in counseling from George Washington University. She is the author of the book Everything Isn't Terrible: Conquer Your Insecurities, Interrupt Your Anxiety, and Finally Calm Down.
