Blood in urine after menopause: what to know

Red, pink, or tea-coloured urine can be visible blood, while a urine test can detect blood that is not visible. Possible explanations include a urinary tract infection, a kidney stone, irritation, medicines that affect bleeding, or a problem in the bladder or kidneys. Bleeding from the vagina or rectum can sometimes be mistaken for blood in urine after menopause. A clinician may ask for a urine sample, examine the source of bleeding, and arrange further tests if needed. Blood in urine is a presentation of several conditions; it does not by itself identify the cause. Learn more about Urinary Tract Infection and Bladder Cancer.

Arrange a medical assessment even if the urine returns to its usual colour or there is no pain. Note when the change started, whether it happened once or repeatedly, and whether you have burning, urgency, fever, side pain, clots, or difficulty passing urine. Bring a list of medicines and supplements, especially blood-thinning treatment. Do not stop a prescribed medicine without medical advice. Drink normally unless you have been told to restrict fluids; extra water will not replace an assessment. A clinician may repeat the urine test after treating an infection.

Seek urgent medical care if you cannot pass urine, see large clots, have severe side or back pain, feel faint or confused, or have fever with shaking chills. Vomiting with pain or an inability to keep fluids down also needs prompt attention. If the bleeding is accompanied by heavy vaginal bleeding, severe weakness, or new swelling, seek urgent help. Do not wait for symptoms to become more intense before arranging a routine review.

Ask: Could the blood be from the urinary tract, vagina, or another source? Which urine tests are needed? Could my medicines contribute? What symptoms should make me seek urgent care? If the first test is normal but bleeding returns, what is the next step?