Blood in Urine? Why Hematuria Happens and Your Medical Next Steps

Seeing blood in your urine can be alarming. The medical term for this is hematuria. While hematuria is sometimes caused by minor or temporary issues, it can also be a sign of something more serious. The key is not to panic — but not to ignore it either.

This guide explains what hematuria is, why it happens, and what medical steps you should take next.

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What Is Hematuria?

Hematuria means there is blood in the urine. It can appear in two main forms:

• Gross hematuria: You can see the blood. The urine may look pink, red, or cola-colored.
• Microscopic hematuria: The blood is not visible to the eye but is found during a urine test under a microscope.

Both types matter. Even microscopic hematuria can signal an underlying health issue.

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What Causes Hematuria?

Hematuria can come from anywhere along the urinary tract, which includes:

• Kidneys
• Ureters (tubes connecting kidneys to bladder)
• Bladder
• Urethra

Here are the most common causes.

1. Urinary Tract Infections (UTIs)

UTIs are one of the most frequent causes of hematuria, especially in women. Symptoms may include:

• Burning during urination
• Frequent urge to urinate
• Cloudy or strong-smelling urine
• Pelvic discomfort

UTIs are usually treated successfully with antibiotics.

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2. Kidney Infections

A kidney infection is more serious than a bladder infection. It may cause:

• Fever and chills
• Back or side pain
• Nausea or vomiting
• Blood in urine

Kidney infections require prompt medical treatment.

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3. Kidney Stones

Kidney stones can cause bleeding as they move through the urinary tract. Symptoms often include:

• Severe pain in the back or side
• Pain that radiates to the lower abdomen
• Nausea
• Blood in urine

Even small stones can cause noticeable hematuria.

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4. Enlarged Prostate (in Men)

In older men, an enlarged prostate (benign prostatic hyperplasia, or BPH) can cause hematuria. Other symptoms may include:

• Difficulty starting urination
• Weak urine stream
• Frequent urination at night

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5. Vigorous Exercise

Intense exercise — especially long-distance running — can lead to temporary hematuria. This usually resolves within 24–72 hours. If it does not, medical evaluation is necessary.

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6. Medications

Certain medications can cause blood in urine, including:

• Blood thinners (like warfarin)
• Aspirin
• Some antibiotics
• Chemotherapy drugs

Never stop a medication without consulting your doctor.

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7. Kidney Disease

Some kidney conditions affect the filtering system of the kidneys and cause microscopic hematuria. These conditions may not cause pain, which is why testing is important.

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8. Cancer of the Urinary Tract

Although less common, hematuria can be a sign of:

• Bladder cancer
• Kidney cancer
• Ureter cancer

Bladder cancer, in particular, often presents as painless gross hematuria. Risk factors include:

• Smoking
• Age over 50
• Occupational chemical exposure

This is why any unexplained blood in urine — especially without pain — should be evaluated promptly.

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When Should You See a Doctor?

You should always contact a doctor if you notice blood in your urine.

Seek urgent medical care if hematuria is accompanied by:

• Severe pain
• Fever
• Inability to urinate
• Large blood clots in urine
• Weakness or dizziness

Even if you feel fine, visible blood in urine should never be ignored.

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What to Expect at the Doctor's Office

Your doctor will likely begin with:

1. Medical History

They will ask about:

• Recent infections
• Exercise habits
• Medications
• Smoking history
• Family history of kidney disease

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2. Urine Tests

A urinalysis checks for:

• Red blood cells
• Signs of infection
• Protein levels

Sometimes a urine culture is done to identify bacteria.

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3. Blood Tests

These evaluate kidney function and look for signs of systemic illness.

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4. Imaging Tests

Depending on your age and risk factors, your doctor may order:

• Ultrasound
• CT scan
• MRI

These tests look for stones, tumors, or structural abnormalities.

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5. Cystoscopy

If bladder cancer or structural issues are suspected, a urologist may perform a cystoscopy. This involves inserting a small camera into the bladder to examine it directly.

While that may sound uncomfortable, it is typically a brief outpatient procedure.

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Is Hematuria Always Serious?

Not always — but it is always important.

Common benign causes include:

• Minor infections
• Temporary exercise-related bleeding
• Menstruation contamination
• Mild trauma

However, because hematuria can be an early sign of serious conditions, proper medical evaluation is essential.

Early detection makes a significant difference — especially for cancers or kidney disease.

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Risk Factors That Increase Concern

Certain factors increase the likelihood that hematuria may signal something serious:

• Age over 50
• Smoking history
• Occupational chemical exposure
• Family history of kidney disease
• Recurrent urinary infections
• Persistent microscopic hematuria

If any of these apply to you, medical evaluation is especially important.

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What Should You Do Right Now?

If you notice blood in your urine:

1. Do not ignore it
2. Avoid self-diagnosing
3. Schedule an appointment with a healthcare provider
4. Seek urgent care if severe symptoms occur

Before your appointment, you can use a free AI-powered blood in urine symptom checker to help identify possible causes and prepare the right questions to ask your doctor about your specific symptoms.

However, online tools are not a substitute for medical care. If something feels serious or life-threatening, seek immediate medical attention.

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How Is Hematuria Treated?

Treatment depends entirely on the cause.

Examples include:

• Antibiotics for infections
• Medications or procedures for kidney stones
• Prostate treatments for enlargement
• Specialized care for kidney disease
• Surgery, chemotherapy, or immunotherapy for cancers

In some cases, no cause is found. Even then, doctors may recommend periodic monitoring to ensure nothing develops later.

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Can Hematuria Be Prevented?

Not always — but you can reduce risk by:

• Staying well hydrated
• Not smoking
• Managing blood pressure
• Controlling diabetes
• Practicing safe hygiene to prevent UTIs
• Wearing protective gear during high-impact sports

These steps help protect overall urinary and kidney health.

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The Bottom Line

Hematuria is a symptom — not a diagnosis. It tells you that something is happening somewhere in the urinary tract.

Many causes are treatable and not life-threatening. However, some causes — including bladder or kidney cancer — require prompt diagnosis and treatment.

The safest approach is simple:

• Take it seriously
• Get evaluated
• Follow through with recommended testing

If you notice blood in your urine, speak to a doctor. If symptoms are severe, worsening, or accompanied by fever, pain, or weakness, seek urgent medical care immediately.

Addressing hematuria early gives you the best chance for effective treatment — and peace of mind.