Ask the Experts: Can Intense Exercise Cause Hematuria?

If you see blood in your urine after an intense workout, you may have something called “exercise-induced hematuria.” It is most common in runners, especially those running more than 10,000 meters (more than 6 miles). It can also occur after any prolonged, intense physical activity like high intensity interval training. The good news is this problem will most likely go away on its own as you recover from your workout.

Working out can affect the process of filtering urine from the bloodstream, which allows red blood cells to mix with urine. If you stop having blood in your urine 72 hours after intense exercise, you do not likely need to worry. But, if blood in the urine keeps showing up, doesn’t go away after 72 hours, if you notice decreased or no urine output, or have any questions, you should talk to your doctor. It may be a good idea to have your urine looked at through a microscope. You should also see your doctor if you have symptoms such as flank pain or fever. These can be signs of an infection or kidney stone. Certain medications such as blood thinners may worsen blood in the urine.

Blood in urine can also be caused by other conditions. While most of these are not cancer related, blood in the urine can also result from urinary tract cancers. If you are older than 40, have a history of smoking, or a family history of urinary tract cancers, you should discuss screening with your doctor whenever you see blood in your urine.

To help prevent exercise-induced hematuria, drink plenty of water during exercise. Being dehydrated may make blood in the urine due to exercise worse. If you play contact sports, wear proper protective gear.

Dr. Ben Ristau, a urologist at UConn Health, specializes in the surgical management of genitourinary cancers with a focus on robotic and minimally invasive approaches.