Blood in Urine (Hematuria) Explained

Blood in your urine (pee), also known as Hematuria, can occur due to many causes, including an injury, vigorous physical activity, or it could be a clear sign of kidney stones, enlarged prostate gland, UTI, or other health conditions. 

That’s why you shouldn’t ignore the problem. Can blood in urine go away on its own? When to see a doctor when you observed there’s a blood in your urine?

Here, you can take a closer look at what blood in the urine means for both men and women.

What could be causing it, and how soon can you expect it to go away? 

What is hematuria?

Hematuria means having blood in the urine. It often results in red or pink discoloration. There are different types of this problem.

Gross hematuria refers to the visible blood in urine, or hematuria with the naked eye.

Microscopic hematuria could only be seen under a microscope. To patients with microscopic hematuria, their urine can look normal.

Data shows that hematuria is prevalent, affecting 2% – 30% of adults. Older adults and smokers are more likely to experience this color change. (1)

Hematuria could be symptomatic or asymptomatic. The pattern of hematuria and its symptoms are associated with painful vs painless, intermittent vs constant, and microscopic (when a person can’t see the blood) vs gross (when a person can see the blood in the urine). Hematuria may also be linked with other urinary tract abnormalities. (2)

What does blood in the urine (hematuria) look like?

Gross hematuria produces pink, brown, or red colors. Some people have cola-colored urine. Just a little bit of blood can create red urine. 

But, how the clotted blood in urine looks can vary based on the amount of blood and how acidic the urine is. If the presence of blood is too small, then there won’t be a visible color change (microscopic hematuria). Only microscopic exams or chemical tests can find this. 

Is hematuria serious?

While in many cases, seeing trace of blood in the urine of female and male patients can be harmless, it could also be a sign of a serious ailment. 

Blood in urine after exercise

Harmless hematuria can occur from vigorous physical activity like endurance running, heavy workouts, which may simply be a sign of you pushed your body to its limit.

Microhematuria

But is microscopic hematuria serious? Microscopic hematuria could only be seen under a microscope. Even if you can’t see it, microscopic blood in the urine could result from a urinary tract infection, ureteral stones, kidney disease, or other causes. (3)

Harmless hematuria

Harmless hematuria can happen from infection, heavy workouts, and trauma to the urinary tract, such as damaging the penis or vagina during sex. Menstruation can also be one of the reasons to pee blood.

Serious reasons for hematuria

Serious reasons for hematuria include bladder cancer or kidney cancer. It could also be due to inflammation of the prostate, bladder, urethra, and kidney. People prone to serious hematuria are those with a history of BPH, kidney disease, bladder tumor, or other ailments. 

Causes of blood in urine (Hematuria)

There are many possible causes for hematuria, and in some cases, the blood may be from a different source.

Reasons for blood in the urine vary, but some of the most common causes for men include:

Urinary tract infection

A urinary tract infection is a common cause of hematuria, and although UTIs occur more frequently in women, men can also develop them.

A UTI is an infection of any part of your urinary system — kidneys, ureters, bladder, and urethra. The bacteria, usually Escherichia coli, are mostly responsible for the UTIs and can gain entry via urethra or reach the urinary system via blood.

Enlarged prostate (BPH)

Benign prostatic hyperplasia, also referred to as an enlarged prostate is a common problem as men reach their fifties.

As men grow older, the prostate naturally enlarges, pressing down on the urethra. This causes obstruction, making urination difficult. As a result, the bladder may work harder to release urine, which could lead to damage and bleeding

Prostatitis

Prostatitis is when the prostate becomes inflamed, resulting in symptoms including painful/ frequent urination, painful ejaculation, pelvic pain, and hematuria.

Kidney or bladder stones

Kidney or bladder stones occur when your urine contains more crystal-forming substances than the fluid in your urine can dilute. Side effects include painful urination, abdominal pain, hematuria, nausea, and vomiting.

Prostate cancer

Blood in the urine usually occurs in advanced stages of prostate cancer and should not be ignored. Here’s more on prostate cancer risk assessment.

Bladder cancer

Blood in the urine can be an early sign of bladder cancer. In some cases, blood may be present one day and absent the next, but if a person has bladder cancer, at some point, the blood reappears.

Blood in the urine for people over the age of 35 should be taken even more seriously, with the most common cause being bladder cancer.

Sickle cell disease

Sickle cell disease is a form of anemia. This is a condition in which there aren’t enough healthy red blood cells to carry oxygen throughout the body. Gross hematuria is often a symptom of the disease.

Glomerular disease

Glomerular disease is when tiny filters in the kidneys, known as glomeruli, are damaged. As a result, the large-sized blood cells are passed into urine which is otherwise filtered.

This is a type of kidney disease, and symptoms can include blood in the urine, protein in the urine, high blood pressure, and anemia.

Medication

Certain medications can also cause hematuria. These include blood thinners, such as warfarin (Coumadin) penicillins, and sulfa-containing drugs.

Strenuous exercise

In some cases, vigorous exercise can result in hematuria. This is usually harmless and is more common in men than in women.

It could be something else

• Food can turn the pee pink. Especially if you recently ate beetroot. Rhubarb, blackberries, and beets can also turn the urine pink or red.
• You started using a new medication. Drugs that numb the urinary tract discomfort, treat tuberculosis, or laxatives with senna can turn the urine reddish-orange.
• Menstruation can turn the urine red.
• There is bleeding from the bottom instead.

Can blood in urine go away on its own? 

Absolutely. Hematuria can self-resolve if it is triggered by strenuous physical activity, medication, or rough sex. 

Strenuous exercise and work, such as weightlifting, increase intra-abdominal pressure. This is why it is a possible risk factor for developing pelvic floor dysfunction. Urine problems can happen, but these can be temporary. (4)

Many of those affected are runners. Running is an intense workout, which makes it easy to get visible urinary bleeding. 

As soon as the body heals, the blood in the urine should go away on its own. In the meantime, try to rest. Give your body enough time to recuperate, especially if you’ve been running long distances.

In women, a classic cause of blood particles in urine is vaginal bleeding and menstruation. These rarely cause any problems, and the blood in the pee does go away on its own. So keep tabs on your menstrual period to feel at ease. 

Different medications can result in urinary bleeding, especially anti-cancer meds like cyclophosphamide and penicillin. 

You can see blood in the pee at times if you are taking anticoagulants and even when using heparin or aspirin-type medications. 

But, there is a classic misconception. Even if the blood in your urine goes away on its own, it doesn’t mean you are in the clear. 

Not all hematuria can be seen with the naked eye. So, get a urine test and some blood testing if necessary to rule out any serious health problems. 

How long does it take for blood in the urine to go away?

It depends on what’s causing the problem. For example, if you trace blood in urine after a strenuous workout, then you can expect it to go away in roughly 24 – 48 hours. 

If there has been some mild trauma or damage to the tissues, you would need to wait for it to heal. 

This is the case with having rough sex. Occasionally, intercourse can cause bleeding from the vulva or vagina, particularly in women who have a condition known as atrophic vaginitis. 

The lining of their vagina is thinner, making it prone to damage. The pain from pressure and friction should end in a couple of hours. 

If the visible blood in urine comes from a UTI, then you will need to treat the infection for it to go away. 

If peeing blood causes burning pain when urinating, cloudy or smelly pee, pain in the sides, lower back pain, and frequent need to pee, then this could be from a urinary tract infection. 

With kidney stones, groin pain and lower back pain can come and go. The presence of blood should dissipate after you solve kidney problems. 

For example, if the hematuria is from a kidney stone, then you would need for it to pass or get it removed for the blood in the urine to go away. 

The temporary effects of treatment also have their impact, like having a prostate biopsy with ultrasound. You can see blood in urine hematuria for 7 – 14 days after the procedure. This kind of bleeding can come and go. 

You could also experience rust-colored semen for about 12 weeks. This is due to the small amounts of blood present in it. While the change in urine color from food and drugs should dissipate in a couple of days. 

You should still see a specialist if you have red urine and no pain. There could be something wrong with the urinary system. The hematuria urine color can be an important sign that you might be dealing with a particular health problem. 

Does drinking water help with blood in urine?

The more water you drink, the easier it is to dilute the urine. Ensure you urinate more often and flush out the bacteria before it triggers an infection. 

Hydration dilutes the pigments in the urine and makes it clearer. Dehydration causes a more concentrated color. And severe dehydration can make the urine amber.

But, the urine can turn other colors that are not normal. This includes dark brown, green, blue, red, and cloudy white. 

While drinking water can help dilute the urine, it can’t always help if you have a particular health problem. So, it’s best to contact a specialist for urinary bleeding in male and female patients. 

What happens if the blood in the urine goes untreated?

Any of the hematuria causes can become worse if you don’t get treatment. They could add additional pressure to the urinary tract. 

An untreated kidney problem can lead to kidney failure. 

If the cause is nothing serious, then the presence of red blood cells quickly self-resolves. But, it is best to get treatment if you are dealing with UTIs, STDs, prostate enlargement, or others.

When to see a doctor for blood in the urine

Book an appointment as soon as you spot blood in the pee. Hematuria diagnosis starts with a digital rectal or pelvic exam and urine testing. 

If the doctor thinks it is serious, they can suggest additional tests. This may include a CT scan, MRI scan, or cystoscopy. It is important to take a closer look inside the bladder and urethra to find the health issue causing the problem.

Do remember that the urine can look brown or red even if there is no blood in it. Using certain drugs, being dehydrated, or having liver issues can all alter the color of the urine. So, call your doctor if the urine looks red.

How is Hematuria diagnosed?

As discusses above, hematuria is caused by many factors. Therefore, to determine the underlying cause, your Doctor/ urologist will perform the following tests.

Physical examination

Physical examination includes a discussion of your medical history. Your doctor may also perform a digital rectal exam (DRE) to determine if your prostate may be causing the hematuria.

Urinalysis

Urine tests can be used to detect a urinary tract infection UTI or the presence of minerals that cause kidney stones.

Urine cytology

Urine cytology is used to look for abnormal cells in your urine.

Imaging test

Imaging tests are usually required to find the cause of hematuria. Your doctor may also recommend a CT scan (Computed tomography) or MRI scan.

Cystoscopy

During a cystoscopic examination, your doctor inserts a thin, flexible device called a cystoscope through the urethra into the bladder. This allows your doctor to view your lower urinary tract and check for any abnormalities.

Treatments and natural remedies for blood in the urine

Only a doctor can suggest the best form of hematuria treatment. Treatment for bloody urine varies based on what’s causing the problem. 

Antibiotics prescriptions

For example, if the cause is a urinary tract infection, a course of antibiotics may be prescribed.

In terms of a diagnosis of bacterial prostatitis, a course of antibiotics will also be prescribed, which may wipe out the specific bacteria causing your prostatitis.

However, it’s also affecting the whole microbiome of probiotics living in your urinary tract. This could reduce the protective bacteria to seriously low numbers, leaving harmful fungi to grow – and potentially cause chronic prostatitis.

Other medications or treatments

For BPH, patients can get alpha-blockers and dihydrotestosterone blockers. Natural remedies like beta-sitosterol, saw palmetto, rye grass pollen, and stinging nettle can also help improve BPH symptoms.

For kidney disease, this might include blood pressure drugs, diuretics, and erythropoietin.

For carcinoma, various treatments are available, such as chemo, radiation, surgery, active surveillance, etc. 

If the underlying cause is an enlarged prostate, you may be recommended medication, such as 5-a reductase inhibitors such as finasteride. However, it is important to be aware that such prostate drugs can have adverse side effects.

Natural Alternatives

Lifestyle changes, including diet, exercise and probiotics, and natural supplements, may also help to alleviate symptoms.

Natural alternatives, such as saw palmetto, beta-sitosterol, pygeum, and stinging nettle, have also been found in clinical trials to relieve urinary symptoms effectively.

Conclusion

In many people, blood in the urine goes away on its own relatively quickly. It can go away if it is caused by a vigorous workout, rough intercourse, or the medications you are taking. 

But, at times, it could also require medical intervention. If the blood in the urine doesn’t go away by itself, it’s important to receive treatment. Talk to your healthcare provider when you start noticing drastic changes in the color of the urine. 

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