The human body dispels nearly 3 million red blood cells from the body via urine on a daily basis. These RBCs are usually dead, old, or inefficiently functioning cells. Sometimes, abnormal levels of RBCs are passed out along with urine. This condition is known as hematuria in the medical world; it can occur due to simple causes such as intake of certain drugs, dehydration, etc., or it may be a symptom of some serious underlying disease.

It may be noted that reddish coloration of urine may not necessarily mean blood in urine. It can occur due to excessive intake of Vitamin C or B supplements or foods such as blackberries, rhubarb, or beet. Blood in urine in females refers to the presence of RBCs in urine and it can occur with or without pain.

Some of the common causes of blood in urine in women are discussed below.

• Urinary tract infections or UTIs: The urinary system is made of the ureters, urethra, kidneys, bladder, and other renal tissues. It is prone to infections by pathogens, especially E. coli and other gram negative bacteria. These germs can enter the urinary tract of women either directly from the urethra while passing urine or from the bloodstream. The pathogens may attack the different tissues and organs in the urinary system and result in bleeding from the delicate blood vessels. This blood may then get eliminated as blood in urine. Women are more prone to developing UTIs than men because of the proximity of the vagina to the germ-rich anus.
  • Women with UTIs may experience hematuria with or without pain. Patients may also suffer from many other signs and symptoms such as burning sensations when passing urine, cloudy urine, foul smelling urine, and frequent urination. UTIs are normally treated with antibiotics and other medicines, better genital self-care, and other lifestyle changes.
• Bladder and kidney stones: Urine consists of varied compounds and minerals like oxalates, calcium, and uric acid, etc. Any kind of bladder or kidney dysfunction can cause accumulation of concentrated urine. Over time, the minerals in concentrated urine tend to crystallize and develop into kidney or bladder stones. These stones can damage surrounding tissues and blood vessels thereby causing bleeding and blood in urine in affected females.
  • Kidney and bladder stones may not cause any pain in the initial stages. However, as the stones move out and across the urinary tract, then affected women may experience severe pain, painful urination, flank pain, weight loss, appetite loss, fever, chills, fatigue, and/or abdominal discomfort. The condition is treated with medications, shock-wave therapy, or surgery. Drinking lots of water, regular exercising, and intake of a balanced diet can help females prevent the formation of bladder or kidney stones.
• Pregnancy: It is possible for women to experience blood in urine during pregnancy. It may be normal or can be indicative of some severe condition; hence immediate medical attention is necessary as it can lead to varied complications. Preeclampsia is one such severe condition that women may experience during the last trimester of pregnancy. It is marked by high blood pressure, proteinuria, and blood in urine.
• Kidney Infection: An infected kidney and other kinds of kidney diseases can also result in blood in urine in females without pain. In most cases, kidney infection is usually caused when a pre-existing case of UTI remains untreated; the infection then spreads upwards and affects the organs. Additional symptoms include edema, i.e., facial swelling, and/or swollen hands, ankles, and feet; lethargy; vomiting and nausea; fever; increased desire to pass urine frequently; and smelly urine. Consult a doctor for treatment.
• Medications: Use of medications like penicillin, aspirin, phenolphthalein, quinine, pyridium, phenytoin, warfarin, heparin, and rifampin; certain laxatives; and the anti-cancer drug Cytoxan/cyclophosphamide can result in a temporary case of blood in urine in females with no pain.
• Cancer: Cervical cancer, uterus cancer, bladder cancer, and other kinds of malignancies that affect the urinary system in women may sometimes cause blood in urine with no pain. Painless hematuria in females may also occur due to growth of tumors or cysts in the tract. These abnormalities tend to damage the tissues and cause bleeding. Additional symptoms include loss of weight, reduced appetite, dizziness, easy exhaustion, and nausea, etc. Consult an oncologist for diagnosis and treatment options like surgery, chemotherapy, and/or radiation therapy.
• Excessive exercising: Intensive aerobic workouts, running, and vigorous exercising, etc. may sometimes cause blood in urine in women without pain. The cause for this anomaly is not known, but associated hematuria is usually temporary and resolves on its own.
• Sickle cell anemia: It is a blood disorder marked by presence of abnormally shaped red blood cells. The RBCs are shaped like sickles and hence cannot efficiently carry out the function of carrying oxygen across the body. These RBCs get eliminated along with urine, thereby causing painless hematuria