Your Pee Can Smell Weird Even When Nothing Is Technically Wrong
Bathroom breaks are a regular part of your day, and you probably don't think twice about them...unless you notice anything unusual, like a change in color or odor. When that happens, it may send you into a panic spiral as you wonder, Why does my pee smell?
Well, urine doesn't smell all that great to begin with. “It's created when the kidneys filter and remove waste products from the blood," says Stephanie Pannell, MD, MPH, a urologist at UCLA Health. "The strength and type of odor depend on multiple factors, including diet, how hydrated someone is, and medications.”
Urine consists of things like ammonia, creatinine, urochrome, which gives urine its typical yellowish color, urea (from amino acid metabolism), and water. It's a delicate balance between all of these components, but when it's off, say in the case of dehydration, you will notice a stronger smell.
"When dehydrated, urinary waste products, such as ammonia, are more concentrated and result in stronger smelling urine,” explains Daniel Garvey, MD, an assistant professor and the residency program director of the department of urology at the University of Illinois at Chicago.
Smelly urine is not usually a big deal, unless it's accompanied by other symptoms like blood in your urine, burning when you go to the bathroom, or frequent trips to the loo. However, it can sometimes be a sign of a condition like diabetes, liver disease, kidney stones, renal failure, or a urinary tract infection (UTI).
Meet the experts: Stephanie Pannell, MD, MPH, is a urologist at UCLA Health. Daniel Garvey, MD, is an assistant professor and the residency program director of the department of urology at the University of Illinois at Chicago. Sherry Ross, MD, is an ob-gyn at Providence St. John’s Health Center in Santa Monica.
If the odor persists for several days even while you are drinking tons of water or you develop a fever, general malaise, pain in the back or lower abdomen, nausea, and vomiting, you should contact your doctor right away, recommends Dr. Garvey.
What does healthy pee smell and look like?
For the record, urine does have a smell, but it's usually very slight and not super noticeable, according to the Cleveland Clinic. That's because 95 percent of it is water, so the waste products that do carry an odor make up only a small part of urine.
In terms of appearance, healthy urine is pale yellow, says Sarah Adelstein, MD, an assistant professor of urology at Rush University Medical Center. Keep in mind you'll notice a darker color in your very first trip to the bathroom in the morning because you're probably a little dehydrated after a night of sleep. The color should clear up, though, as you start hydrating throughout the day.
13 Common Causes of Smelly Urine
Diet and your level of hydration can affect the appearance and smell of urine, says Dr. Adelstein, but so can food, infection, medications, and medical conditions. Here are the most common reasons your urine may produce a funky smell and how to ditch the stench ASAP.
1. You’re dehydrated.
"When your body is dehydrated, the urine has a strong odor and appears dark in color,” says Sherry Ross, MD, an ob-gyn at Providence St. John’s Health Center in Santa Monica. It’s your body’s way of telling you to rehydrate, stat.
The fix: Don't wait until your toilet water turns a shade of mustard yellow to start downing some extra H2O. Instead, keep a water bottle handy (at your desk, in your bag, wherever), so you can drink as often as you feel like, says Dr. Ross. If you’ve done a good job hydrating, your pee will be the color of pale straw or a more transparent yellow (think: fresh-made lemonade), according to the Cleveland Clinic.
But don’t pat yourself on the back if you look into the toilet and don’t see a bit of yellow—totally clear urine means you’ve over-hydrated (yep, that’s a thing). The optimal amount of water each day, BTW: eight glasses.
2. You ate something with a strong smell.
Quick Q: Have you ever eaten asparagus and noticed that your urine smelled...off afterward? You're not alone: About 40 percent of people can actually smell a difference in their pee after eating this veggie, according to a 2016 study in the British Medical Journal (it's actually called asparagus anosmia, and it's due to genetic variations in our senses of smell, not the pee itself. Go figure!).
But these stalks are not the only food that can change the scent of your urine. "Certain foods like Brussels sprouts, onions, some spices, garlic, curry, salmon, and alcohol can change the smell," says Dr. Ross.
A high-salt diet can also make your urine more concentrated, giving it a stronger scent than what you may be used to. An excess of salt can also keep you dehydrated because sodium draws water out of your cells and into your blood (in an effort to dilute the salt in your blood), per Harvard T.H. Chan School of Public Health.
The fix: General medical advice says it’s best to slash the salt. Your body will feel better, and your urine won’t smell so foul. As far as eating those other foods goes, expect some slightly stinky pee afterward and don't worry too much (it'll go away in a day or so when you've digested and passed the food).
3. You just drank some coffee.
Some people "may notice an interesting odor when they've consumed coffee," says Adam Ramin, MD, a urologist and the medical director of Urology Cancer Specialists in Los Angeles. That smelly urine odor is due to coffee metabolites (a.k.a. byproducts from coffee after it gets broken down in your body).
The fix: Really, coffee-smelling pee is NBD, but the fact that coffee is a diuretic means you could have dehydrated pee, and that could be an issue. Try sipping a glass of water before or after your morning (and afternoon, and maybe even night—hey, we don’t judge) cup of coffee, just to avoid dehydration.
4. You have a urinary tract infection.
The most common medically concerning reason for smelly pee is a urinary tract infection (UTI), according to Dr. Ross. UTIs tend to be more prevalent in people with vulvas, according to the Office on Women's Health (OWH), because their urethras tend to be shorter, inviting more bacteria to enter the bladder. In fact, pee that has a strong ammonia smell, or foul or slightly sweet-smelling urine is often the first indication that you have a UTI.
Basically, the strange urine odor is the bacteria's fault (because bacteria is what causes UTIs in the first place). That bacteria is also what makes your urine appear cloudy or bloody and gives you that telltale burning while peeing sensation, according to OWH. If you suspect a UTI, talk to your doctor immediately so you can get started on an antibiotic.
The fix: Even after you finish those antibiotics, keep a vigilant eye (or..umm...nose) on how your pee smells. About four in 10 vagina-owners who get a UTI will get another one within the next six months, according to OWH. Since off-smelling pee can be the first sign of this particular medical condition, paying attention to your urine odor can get you into the gyno sooner rather than later.
5. You might have diabetes or prediabetes.
One of the first ways diabetes manifests is in the bathroom, causing you to have to urinate more frequently, says Muhammad Shamim Khan, MD, a urologist at Guy’s and St Thomas’ Hospital.
Because your body doesn’t process sugar the same way others’ do, you may also have fruity or sweet-smelling urine, thanks to the extra sugar being excreted by your kidneys. Most likely, sweet-smelling urine will be a sign of type 2 diabetes—the type that happens when your body doesn’t use insulin well and therefore can’t regulate blood sugar, rather than type 1, which is much rarer and happens when someone’s body doesn’t make insulin at all. Type 2 diabetes is typically diagnosed in adults, according to the CDC, because it develops over many years.
Certain populations have higher rates of diabetes and prediabetes, including Black, Latinx, Native American, and some Asian American communities, in part because of disparities in health care access, as well as access to exercise and nutrition resources, research has found.
So, if you’re noticing fruity pee as an adult, it’s possible that type 2 diabetes is the culprit. That scent, coupled with needing to run to the bathroom more than usual, means you may want to get your blood sugar levels checked, says Dr. Khan.
The fix: If you have already been diagnosed with either type 1 or type 2 diabetes (or even gestational diabetes, which can happen when you’re pregnant) and then start having sweet-smelling urine, it’s a sign that you’re not managing your disease well, according to the U.S. National Library of Medicine. And you’ll probably want to talk with your doc ASAP about making adjustments to your treatment or lifestyle.
6. You use douche products.
Douching with scented feminine hygiene products is common in certain cultures, per OWH. Many women practice the habit to improve cleanliness, vaginal odor, or to treat vaginal infections in some cases.
But unfortunately, douching can expose you to organic compounds that are dangerous for your health, according to a 2020 study published in the Journal of Women's Health. It's also more likely to cause infections than remedy them. Not only does douching not clean your vagina, but it can also mess up the microbiome (a.k.a. the environment of healthy bacteria) of your entire genital area, worsening bad smells rather than improving them, says Dr. Ross. And that includes the smell of your pee.
The fix: Skip the douche. If you're practicing good hygiene (washing the outside bits of your vulva with fragrance-free soap and warm water only) and there's nothing else going on with your vag, you totally don't need to douche anyway. A healthy vagina has a mix of both good and bad bacteria, according to OWH. When you douche, you risk washing out too many of the good bacteria and giving the bad bacteria an upper hand, which can easily lead to an infection.
If you’re worried about the odor of your vagina, see a doctor to pinpoint the real cause instead of trying to mask it with douching.
7. You have kidney stones.
Kidney stones are hard masses that can form in your kidneys when certain chemicals in your urine start to crystallize. If that’s not clear enough, let us spell it out: Kidney stones are made of pee, according to the National Kidney Foundation.
So it’s not too shocking that kidney stones are one cause of smelly urine. While a kidney stone tries to make its way out of your body, it causes a backup of urine (and possibly a urinary tract infection). That results in foul-smelling pee that may also look cloudy.
The fix: If your pee is smelly and is accompanied by cloudy urine and pain in your back or side, see a doctor to get that kidney stone out of there ASAP.
Unfortunately, there may not be too much you can do to prevent kidney stones in the first place, as infections and family history of kidney stones are common causes. But drinking too little water, exercising either too little or too much, and consuming too much salt or sugar (especially fructose) could also contribute to kidney stones, the National Kidney Foundation says. If you’ve had one stone and don’t want another, adjusting those lifestyle factors might help.
8. You have a yeast infection.
Itchy yeast infections happen when a naturally occurring fungus that lives in your vagina gets a chance to grow wild. Every person has a different vaginal microbiome, but some ways yeast gets the hint that it’s party time are when you take antibiotics, you’re pregnant, you have uncontrolled diabetes, you have an impaired immune system, or you start taking either hormonal birth control or hormones prescribed for menopause, according to the Mayo Clinic.
Yeast infections come with a distinctive “yeasty” smell, thanks to the imbalance of vaginal bacteria, says Dr. Ross. While, yes, yeast infections are technically in your vagina, because your urethra is so close, your urine can pick up the scent as well.
The fix: OTC creams and suppositories (like Monistat) can get your microbiome back to normal, and if those aren't getting rid of the itch or increased discharge, talk to your doc. They can prescribe an antibiotic that can help you get over the infection.
9. You actually have an undiagnosed genetic disorder.
This is probably the least likely scenario here, but certain genetic disorders are associated with a bad urine odor. If your pee smells foul, sour, or fishy, you might have a medical condition called trimethylaminuria, which gives you terrible body odor no matter how much you brush your teeth, shower, or bathe.
Trimethylaminuria is more common in women, according to the National Human Genome Research Institute, and it might be more prevalent among Black American women, multiple studies suggest. Symptoms can worsen or become more noticeable around puberty, before or during your period, after taking oral contraceptives, or around menopause.
The fix: There's no cure for the disorder, but by working with your doctor, there are lifestyle changes you can make to reduce the smell. For example, you may need to avoid foods that include trimethylamine and other compounds, such as milk, eggs, peas, beans, peanuts, and brassicas (which include Brussels sprouts, broccoli, cabbage, and cauliflower). They may also suggest certain supplements, as well as taking low doses of antibiotics to reduce the amount of bacteria in your gut.
10. You’re pregnant.
Here's a fun fact: The hormonal changes that make it possible to grow a baby—estrogen and progesterone—can make your pee smell a bit different...to you, at least.
“Urine can have a more pungent smell from the hormones produced during pregnancy, especially during the first trimester,” says Dr. Ross—but it's not necessarily a huge change in your pee; rather, your ability to smell it (women tend to have a slightly increased sense of smell during pregnancy).
The fix: Unfortunately, there’s not much you can do to counteract the smell in this case. Maybe just plug your nose when you pee?
11. You’re ovulating.
The same hormones that gestate a baby (again, estrogen and progesterone) are also at work during your regular cycle, albeit on a smaller scale, according to Dr. Ross. That means you may be more aware of the scent of your own pee when you're ovulating—though there’s actually nothing off about your urine’s odor.
The fix: Again, the hormones aren’t necessarily changing the odor of your urine itself, they are amping up your ability to smell it. Not much you can do for this one but flush and get outta the bathroom quickly.
12. You might have an STI.
As if sexually transmitted infections weren't enough fun (sarcasm, clearly), some of them can also cause foul-smelling urine.
Chlamydia is the most common culprit, followed by trichomoniasis, a sexually transmitted parasite. Both often show no or very mild symptoms at their onset (which is why it’s so important to regularly get tested for STIs)—wait too long and they could progress, making smelly pee the least of your problems.
When you do show symptoms, chlamydia can cause abnormal vaginal discharge and a burning sensation when you pee, while trichomoniasis can also cause a change in vaginal discharge and uncomfortable urination as well as itching, burning, redness, or soreness in your genital area, according to the CDC.
The fix: If you even suspect you have one of these diseases, Dr. Ross says to get screened immediately so you can get the meds you need to get rid of them.
13. You just started taking certain meds or supplements.
Some supplements, vitamins, and medications can cause changes in your urine smell. "These include B1 (thiamine) and B6 (pyridoxine), both of which are common in multivitamins and prenatal supplements, as well as sulfa-containing medications, which include antibiotics such as Bactrim, and diabetes medications such as glyburide,” says Dr. Pannell.
“Sulfonamide antibiotics, diabetic medications, such as Diabeta and Glynase PresTabs, and medications for rheumatoid arthritis, specifically, Azulfidine, may make urine smell like eggs by creating a sulfuric chemical excreted in the urine,” adds Dr. Garvey. “Calcium supplements and vitamin D may make the urine smell fishy, while iron supplements and kelp may precipitate a metallic smell to the urine."
Also, artificial flavors are put in some pill coatings to make them more palatable, but they can also change the scent of your urine.
The fix: The most likely offenders? Pills high in vitamin B6, including some multivitamins, heart, and pregnancy medications. It's not particularly worrisome, says Dr. Ross, but be sure to mention your urine odor to your doctor if you're concerned about it, if it changes suddenly, or if you experience other negative side effects along with the smell.
How to Reduce Smelly Pee
“Hydration is the most important way to prevent smelly urine,” says Dr. Adelstein. This helps make the odor-causing compounds in your urine less concentrated.
You also want to make sure you're taking regular trips to the bathroom throughout the day. “When people do not empty the bladder fully (this is called retention), the urine can become stagnant and bacterial overgrowth (of the body’s natural “good” bacteria) can also cause an abnormal smell,” says Dr. Adelstein.
Otherwise, don't worry too much about funky-smelling urine. If you notice a change after consuming certain foods or drinks, the odor should return to normal after a day or so, per the Cleveland Clinic.
When to See a Doctor
Smelly pee is annoying but usually pretty harmless and disappears on its own with a few lifestyle tweaks. But, again, if you have blood in your urine, pain or painful urination, frequent urination, fever or chills, or back pain, you should check in with your doc.
“If you cannot improve smelly urine with dietary changes and hydration, a doctor can help make sure no serious medical problems are causing the smell,” says Dr. Adelstein.
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