Blood in Your Urine After 50: Why It Shouldn't Be Brushed Off as Another UTI
Bladder & Pelvic FloorArticlePink or brown urine, or a urine test that finds blood you can't see, often has a harmless cause such as infection or a stone. But blood in the urine is also how bladder cancer is usually first suspected, and smoking is its biggest risk factor. Here is what the usual workup involves.
In this article
Blood in the urine, called hematuria, comes in two forms: urine that looks pink, red or brown, and blood you can’t see that shows up on a urine test.1 It only takes a small amount of blood to change the color.1 The hidden kind usually causes no symptoms.1
Common, often harmless causes
- Infection or inflammation of the bladder or kidneys1
- Stones in the urinary tract1
- Hard exercise such as long-distance running1
- Medicines, including blood thinners, some antibiotics, and aspirin or other pain relievers1
- Sexual activity or endometriosis1
- Contamination: for women still having periods, menstrual blood can get into the sample, so the test may need repeating.1
Why it still needs follow-up after 50
Blood in the urine is how bladder cancer is usually first suspected.2 About 90% of bladder cancers are diagnosed at 55 or older.2 It’s four times more common in men, but women get it too,2 and in women blood in the urine can easily be blamed on a urinary infection. Smoking is the strongest risk factor, and past exposure to some workplace chemicals adds risk even decades later.2 Up to 7 in 10 bladder cancers are found early, when they’re easier to treat.2
If blood keeps showing up, or a “UTI” doesn’t have a positive urine culture, ask whether more testing is needed.
What testing may involve
- Repeat urine test to confirm blood is there1
- Urine culture to check for infection
- Blood tests for kidney function1
- Imaging: ultrasound or a CT scan of the kidneys and bladder1
- Cystoscopy: a thin camera passed through the urethra to look inside the bladder1 Our guide to cystoscopy preparation explains the visit.
Treatment depends on the cause, and sometimes no treatment is needed.1
Questions to ask
- Was blood confirmed on a repeat test or under a microscope?
- Did my urine culture show infection?
- Given my age and smoking history, do I need imaging or cystoscopy?
- Could any of my medicines be causing it?
Our articles on UTIs after sex and kidney stone testing cover related issues.
Try: “This is the third time a urine test has shown blood, and the last culture was negative. I smoked for 20 years. Should I see a urologist?”
Laugh, Sneeze, Jump includes an appointment prep sheet. Use it to list dates of each urine test, results and any symptoms.
This article is for general educational purposes only and is not medical advice. It isn't a substitute for diagnosis or treatment from a qualified healthcare professional who knows your health history. Please don't ignore professional advice or delay getting care because of something you read here. Seek prompt care for visible blood in the urine, and urgent care if you pass clots, can't urinate, or have fever, severe pain or dizziness. If you think you may be having a medical emergency, call 911 or your local emergency number right away. This article discusses a common finding and general testing approaches. Girl Playbook does not endorse any specific product, test, or provider.
Girl Playbook sells this book. It provides education and worksheets, not individualized medical care.
Sources
The research behind this article, in the order it’s cited. How we source our articles.
- National Institute of Diabetes and Digestive and Kidney Diseases (NIH)Hematuria (Blood in the Urine) (opens in a new tab)abcdefghijklmn
- Medical Sciences (full text via PubMed Central), 2020Epidemiology of Bladder Cancer (opens in a new tab)abcde
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