If you’re noticing that your urine smells a little different than usual, you might be wondering if it’s cause for concern. Things like the frequency, color, and yes, the smell of your urine can actually tell you a lot about your health. Doctors explain the most common causes of smelly urine and symptoms that mean it’s time to see a doctor.
“Urine gives us clues about our hydration status, filtration processes, renal (kidney), cardiac, hormonal, and even sleep health,” says Tanaka Dune, M.D., a board-certified urogynecologist and pelvic health expert.
Meet the Experts: Tanaka Dune, M.D., a board-certified urogynecologist and pelvic health expert; Michael Ingber, M.D., a urogynecologist with the Center for Specialized Women’s Health at Garden State Urology; and Michael O’Leary, M.D., senior urologic surgeon at Brigham and Women’s Hospital in Massachusetts and professor of surgery at Harvard Medical School.
The good news is that in many cases, you don’t need to worry too much about your urine smelling strange. “If odor is present with no symptoms, this is typically benign and no treatment or evaluation is needed,” says Michael Ingber, M.D., a urogynecologist with the Center for Specialized Women’s Health at Garden State Urology. “However, if odor is present with symptoms, urinary urgency, peeing frequently, pain, burning, this can be a sign of an infection, and you should consult with a medical professional,” he explains.
Below, doctors explain the most common causes of smelly urine and how you can remedy the situation.
1. You’re simply dehydrated.
No surprise here, folks: Failing to drink enough water concentrates your urine, which can give it a stronger ammonia-like smell than usual, says Dr. Dune. (Basically, the waste products created in your kidneys don’t have enough fluid available to dilute them as you excrete them.)
The harsh smell is also typically accompanied by a darker-than-usual color (along with these other signs of dehydration), which should tip you off that it’s time to grab a giant glass of water, pronto, Michael O’Leary, M.D., senior urologic surgeon at Brigham and Women’s Hospital in Massachusetts and professor of surgery at Harvard Medical School, explains.
2. A UTI or bladder infection could be to blame.
Bladder and urinary tract infections are common causes of smelly urine, particularly in women, who have shorter urethras than men (and thus less distance for bacteria to travel to impact the bladder), says Dr. O’Leary. Unfortunately, this is pretty common. Anywhere from 40 to 60 percent of women will have at least one UTI in their lifetime—and 1 in 4 will experience multiple, according to the National Institute of Diabetes and Digestive and Kidney Diseases.
“Urine should theoretically be a sterile fluid, and the presence of bacteria can affect its odor,” Dr. O’Leary explains. (The bacteria in our digestive tracts contribute to the smell of our stool, too.)
3. You have a yeast infection.
Yeast infections, which occur as a result of fungal overgrowth in the vagina and vulva, will affect most women at some point in their lives.
Though yeast infections themselves don’t directly cause smelly urine, they can indirectly have an impact on what you smell when you go.
According to Dr. Dune, infection-related bacteria in the vagina can come into contact with your urine while you pee—and the chemical reaction between the two can create a foul smell. Plus, many women might mistake the unusual vaginal odor created by the infection for smelly urine itself.
4. You just drank lots of coffee.
Coffee has a light diuretic effect, meaning it can cause your body to release water, ultimately dehydrating you and contributing to ammonia-like urine, says Dr. Dune.
Plus, the metabolites (aka by-products) produced as your body breaks down coffee may also influence the smell of your urine, Dr. Dune adds. Nothing to be concerned about—as long as you make the effort to hydrate post latte.
5. Garlic and onions were the stars of your meal.
Yep, those pesky (but normal!) metabolites are back again—and messing with the smell of your pee. “Different foods produce different metabolites as we break them down,” says Dr. Dune. Depending on how much of these foods—garlic and onions are two common culprits—you ate, you might notice changes in the smell of your urine.
6. You lack a certain enzyme—and ate some asparagus.
This nutritious vegetable can also affect the smell of some people’s urine (which is often described as rotting cabbage.) “Some people have an enzyme that breaks down compounds in asparagus that can cause smelly urine,” Dr. O’Leary says. People who can break down the smell-inducing compounds in asparagus are called asparagus anosmic.
If you don’t have that enzyme, though, you end up with smelly urine after eating asparagus. According to research published in the British Medical Journal, roughly 40 percent of people notice changes in how their pee smells after eating this veggie.
7. It could be a sign of diabetes (or prediabetes).
Changes in how often you urinate—and what’s in that urine—are often the first indicators of diabetes, says Dr. O’Leary.
In both type 1 and type 2 diabetes, the body’s inability to properly process sugar means some of the sweet stuff (in the form of glucose) ends up in your urine. “Mellitus, the term that characterizes these types of diabetes, literally means sweet-tasting,” Dr. O’Leary says.
Luckily, a quick urine test at the doctor’s office can confirm the presence of glucose in your pee, so you and your doctor can create a treatment plan to regulate your blood sugar. If you’ve already been diagnosed with diabetes and notice sweet-smelling urine, consider it a sign that your condition is no longer under control—and make an appointment with your physician.
8. You loaded up on vitamins.
We’ve all experienced this one: You take your daily multivitamin (or whatever slew of vitamins and supplements your daily routine involves) and a couple of hours later your urine looks and smells rather terrifying.
Don’t be alarmed: “Multiple vitamins—especially vitamin B6—can affect urine color and odor,” says Dr. Dune. In fact, B vitamins are notorious for turning urine a neon yellow-green color.
9. It’s possible you have an STI.
Certain STIs—particularly chlamydia and trichomoniasis—can lead to painful urination and smelly discharge in both men and women, according to the CDC.
Many women might mistake the abnormal vaginal discharge associated with these sexually transmitted infections with smelly urine, says Dr. Dune.
Because both chlamydia and trichomoniasis (and other STIs) may not present symptoms, but can have a serious lasting impact on the reproductive system, it’s important to get regular screenings and make an appointment with your doctor at the first sign of concern.
10. Or, you’ve got kidney stones.
Often caused (at least partially) by dehydration, kidney stones form when chemicals in your urine crystalize together. While small stones may pass without you even noticing, larger stones can lead to pain and a slew of other symptoms, including cloudy, foul-smelling, and even bloody urine, according to the National Kidney Foundation.
Since having kidney stones increases risk of developing kidney disease (and dealing with more stones in the future), it’s important to stay well hydrated and work with your doctor to make any lifestyle or dietary adjustments that can reduce risk.
11. It’s a side effect of certain medications.
Those metabolites are back! According to Dr. Dune, certain medications affect the metabolites created in the body or contribute to pH changes in our urine, both of which can affect our pee’s smell. Certain diabetes medications—and a drug called Methenamine, which is used to address chronic UTIs—can have this effect.
12. You have a bladder fistula.
Fistulas, openings that form between two organs, often affect the bladder. According to the Urology Care Foundation, fistulas of the bladder often connect the organ to either the bowel or vagina—contributing to a number of issues, including changes in urine odor.
In most cases, bladder fistulas that connect to the bowel are caused by inflammatory bowel diseases, like Crohn’s disease or ulcerative colitis, says Dr. O’Leary. However, gynecological and colon cancers, along with recent surgeries, can also cause fistulas.
Since bladder fistulas can allow bacteria from other organs into the bladder, they often manifest as urinary tract infections, urine that looks or smells like stool, and urine that contains gas.
13. A rare metabolic disorder may be the culprit.
Though very uncommon, metabolic disorders (which affect our body’s ability to convert the food we eat into energy), can impact the smell of our urine.
One of the most common is maple syrup urine disease, in which a deficiency in enzymes needed to break down certain amino acids causes sweet-smelling urine, explains Dr. Dune. Luckily, this condition is usually caught and treated in infancy.
Other metabolic disorders, like phenylketonuria (also known as PKU), though, can also influence urine smell. In PKU, a defective gene prevents the breakdown of the amino acid phenylalanine, which builds up and causes musty-smelling breath and urine, among other symptoms, like rashes and even seizures.
❗When to see your doctor about smelly urine
Though stinky pee alone may not always be cause for alarm, strange-smelling urine that’s accompanied by other symptoms may be.
If you’re also noticing cloudy or bloody urine, experience pain during urination, are peeing a lot more or less than usual, or have lower back or abdominal pain, make an appointment with your doctor, says Dr. Dune.
Just a few days of persistent symptoms warrant a visit, says O’Leary. When in doubt, just get it checked out.
Read the full article here