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.
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.
But maybe don't wait until your toilet turns a shade of mustard yellow to start adding in 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 the color of pale straw or “transparent yellow” (which we’re guessing looks a bit like 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 this article, it's actually called asparagus anosmia, and it's due to genetic variations in 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, alcohol, and even coffee can change the smell," says Dr. Ross. And, of course, we’ve all heard the myth that pineapple can make your urine smell sweet—and also change the taste of your netherbits—but there’s no real scientific evidence to back that up (for some reason, it seems scientists don’t think fruity vagina smells are important enough to study).
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).
General medical advice says it’s best to slash the salt. Your body will feel better and your urine won’t smell so foul.
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's broken down in your body).
Couple that with the fact that coffee is a diuretic and you could have dehydrated (read: more concentrated) pee that's already smelly, along with these metabolites. So, if it happens regularly after drinking a cup of Joe, it's really NBD. But still, maybe it’s best to drink 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 head off any dehydration.
4. You have a urinary tract infection.
The most common medically concerning reason for smelly pee in women is a urinary tract infection (UTI), according to Dr. Ross. 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 the Office on Women's Health (OWH). If you suspect a UTI, talk to your doctor immediately so you can get started on an antibiotic.
Even after you finish those antibiotics, keep a vigilant eye (or..umm...nose) on how your pee smells. About four in 10 vagina-havers 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 pre-diabetes.
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. So if you find yourself running to the toilet more than usual, you may want to get your blood sugar levels checked, says Dr. Khan.
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. So if you’re smelling fruity pee as an adult, it’s possible that type 2 diabetes is the culprit.
Yet, 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're still douching—even though you shouldn't be.
If you're still douching, I've got one word for you: stop. Not only does douching not clean your vagina, but it can also mess up the microbiome (a.k.a., that 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.
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.
Plus, messing up that delicate environment could actually double your risk of ovarian cancer. 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.
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. 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.
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 symptoms can worsen or become more noticeable around puberty, before or during your period, after taking oral contraceptives, or around menopause. 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 food 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.
11. 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).
Unfortunately, there’s not much you can do to counteract the smell in this case. Maybe just plug your nose when you pee?
10. 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.
Again, the hormones aren’t necessarily changing the odor of your urine itself, they are amping up your ability to smell it, making the ammonia scent more noticeable to your super-sensitive sniffer.
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. If you even suspect you have one of these diseases, Dr. Ross says to get screened immediately. 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 they 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.
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.
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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