If Your Pee Smells Funky, It Could Be A Sign Of A UTI, Yeast Infection, Or STI

Korin Miller, Charlotte Hilton Andersen, Kasandra Brabaw
·13 mins read
Photo credit: George Mdivanian / EyeEm - Getty Images
Photo credit: George Mdivanian / EyeEm - Getty Images

From Women's Health

For most, peeing is such a mundane task that you do it without giving it too much thought (unless, you know, you're wearing a romper—so complicated).

But what if, when you sit down and relieve yourself, you notice...smelly urine? Whether it's extra pungent or, uh, fishy, having a weird smell emanating from down there can be freaky. But honestly, there are some perfectly logical (and totally harmless) causes of smelly urine odor.

Here's what could be causing that stinky pee, and how to address each issue.

1. You're dehydrated.

The number-one cause of smelly pee? Not drinking enough water. "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.

What to do about it: Don't wait until your toilet water turns a shade of mustard yellow to start adding some extra H2O to your diet. 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 medical experts at UC San Diego Health.

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 (yes, 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: 40 percent of people can actually smell a difference in their pee after eating asparagus, according to a 2016 study in the British Medical Journal (according to the study, it's actually called asparagus anosmia, and it's due to genetic variations in our senses of smell, not the pee itself).

But asparagus isn't 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. But if too much salt is the cause of your smelly urine, you might have bigger problems. Some research has linked high-salt diets with stomach ulcers and infections, and 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).

What to do about it: 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 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).

What to do about it: Really, coffee-smelling pee is NBD, but the fact that coffee is a diuretic means you could have dehydrated (read: more concentrated) pee, and that could be an issue. Try drinking 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.

What to do about it: 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 more rare 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 smelling fruity pee as an adult, it’s possible that type 2 diabetes is the culprit. That scent, coupled with needing to run to the toilet more than usual, means you may want to get your blood sugar levels checked, says Dr. Khan.

What to do about it: If you already have 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 handling your disease well, according to the U.S. National Library of Medicine. And you’ll probably want to talk with your doc ASAP.

6. You use douche products.

Douching using scented feminine hygiene products is common in certain cultures, OWH reports. 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.

Plus, messing up that delicate environment could actually double your risk of ovarian cancer.

What to do about it: 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. Many of the causes of smelly urine have something to do with bacteria, and douching messes up the bacteria that naturally live in and around your vagina. A healthy vagina has a mix of both good and harmful 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 immediately 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 backup leads to foul smelling pee that may also look cloudy.

What to do about it: 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 one cause. But the National Kidney Foundation says that drinking too little water, exercising either too little or too much, and too much salt or sugar (especially fructose) could also contribute to kidney stones. If you’ve had one stone and don’t want another (cause why would you), 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.

What to do about it: 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.

According to the National Human Genome Research Institute, trimethylaminuria is more common in women, and multiple studies suggest that it might be more prevalent among Black American women. Symptoms can worsen or become more noticeable around puberty, before or during your period, after taking oral contraceptives, or around menopause.

What to do about it: 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, doctors may suggest avoiding foods that include trimethylamine and certain other compounds, such as milk, eggs, peas, beans, peanuts, and brassicas (which include foods like 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 hormone 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).

What to do about it: 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, says 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.

What to do about it: 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, says Dr. Ross.

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.

What to do about it: 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 supplements.

Some supplements, vitamins, and medications can cause changes in your urine smell, says Dr. Ross. Artificial flavors are put in some pill coatings to make them more palatable, but they can also change the scent of your urine.

What to do about it: 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.

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