Unusual Urine Smells: Causes and Treatments

Most of us don’t usually give much thought to our urine and the way it smells.

After all, it’s just waste that our bodies need to get rid of.

However, there are times when our urine might have an unusual smell.

This could be caused by a number of things, such as what we’ve been eating or drinking, a change in our hormone levels, or a medical condition.

If you’re concerned about the way your urine smells, it’s important to see a healthcare professional to rule out any underlying medical conditions.

In this article, we explore some of the possible causes of unusual urine smells and what you can do about them.

What Makes Urine Smell

Urine usually consists of water, urea (from amino acid metabolism), inorganic salts, creatinine, ammonia, and pigmented products of blood breakdown, one of which (urochrome) gives urine its typically yellowish color.

Urine has a natural odor that is unique to each person.

However, you may notice that yours occasionally has a stronger smell than you’re used to.

This isn’t always a cause for concern, but sometimes strong or unusual smelling urine is a sign of an underlying medical problem.

Types of Urine Smells

Ammonia

If you detect a hint of ammonia in your urine, it could be a sign of a urinary tract infection.

This odor suggests that an overgrowth of bacteria might be in your urinary system, most likely in your urethra, kidneys, or bladder.

Other potential causes of urine that carry the whiff of ammonia include:

• Kidney stones or kidney disease
• Liver disease
• Menopause
• Prostate infection
• Sexually transmitted diseases such as chlamydia

Sweet-smelling

Urine with a sugary or fruity fragrance can serve as a warning sign of diabetes or high blood sugar.

The sweet smell comes from your body unloading excess glucose, or sugars.

In children, particularly newborns, sweet-smelling urine might indicate maple syrup urine disease.

This rare, life-threatening metabolic disorder prevents the body from breaking down specific amino acids found in food.

Causes

Dehydration 

One of the most common reasons for strong-smelling pee is dehydration.

Everyone’s urine has ammonia in it.

The more hydrated you are, the less concentrated the ammonia is.

When you’re dehydrated, the ammonia concentration is higher, and therefore, the smell is stronger.

This also explains why your urine smells stronger in the morning right after you wake up.

Dark-colored urine is another sign of dehydration.

Staying hydrated is extremely important for overall health.

Typically, by the time you feel thirsty, you’re already dehydrated, so stay ahead of the game with water intake throughout the day.

Urinary Tract Infection

Urinary tract infections (UTIs) are another common cause of strong-smelling urine.

An intense urge to urinate, needing to urinate frequently, and a burning sensation upon urination are the most common additional symptoms of a UTI.

Bacteria in your urine cause urinary tract infections.

If your healthcare professional determines you have a UTI, they’ll give you antibiotics to kill the bacteria.

Sexually Transmitted Infection

Chlamydia is a sexually transmitted disease that might cause your urine to smell off.

It can be easily cured, but is often difficult to detect.

This is because it can be asymptomatic or symptoms might be disregarded or misdiagnosed as a side effect of other ailments.

These symptoms include:

• Unusual vaginal discharge
• Pain in the lower abdomen
• Pain or swelling of the labia
• Pain or discomfort when you urinate
• Cloudy, smelly urine caused by pus

Diabetes or Diabetic Complications 

Diabetes, as well as the medications prescribed to treat it, may change the smell of urine.

Some people might notice a sweet smell, which happens when there is too much sugar in the urine.

Other symptoms of diabetes include:

• Going to the bathroom frequently, especially at night
• Intense thirst
• Fatigue
• Weight loss, in some cases
• Genital itchiness
• Slow wound healing
• Blurred vision
• High blood pressure

Metabolic Disorders 

Though very uncommon, metabolic disorders (which affect our body’s ability to convert the food we eat into energy), can impact the smell of our urine.

Maple syrup urine disease is a deficiency in enzymes needed to break down certain amino acids.

This causes sweet-smelling urine.

The disorder is usually caught and treated in infancy.

Other metabolic disorders, like phenylketonuria (also known as PKU), can also influence urine smell.

In PKU, a defective gene prevents the breakdown of the amino acid phenylalanine, which builds up and causes musty-smelling breath and urine.

This disorder is also usually caught and treated in infancy.

Pregnancy 

During pregnancy, it’s possible to notice a change in the smell of urine.

This could be due to a number of things, including a change in vitamins, diet, and the fact that many pregnant people may find themselves dealing with UTIs more often. 

Foods

One food that many people say makes their urine smell strong is asparagus.

The culprit of urine odor from asparagus is caused by the level of naturally occurring sulfurous compounds that the food contains.

This compound is called asparagusic acid.

While it doesn’t harm the body, it does create a strong, odd smell after you eat something that contains it, such as asparagus.

Typically, the smell will go away after the asparagus has passed through your system.

You should contact your healthcare professional to check for other causes if the odor persists.

Certain Medications

Certain vitamins and medications are known to change the smell of urine.

Some of these include:

• Vitamin D
• B vitamins
• Sulfonamide antibiotics
• Certain medications for diabetes
• Certain medications for rheumatoid arthritis

Diagnosis

To determine if your urine odor is caused by a medical condition, your healthcare professional will use several tests. Some of these may include:

Urinalysis 

In this test, certain physical properties, solutes, cells, casts, crystals, organisms, or particulate matter of your urine are tested to look for infections or other problems.

The parts that are tested include the pH, protein, glucose, ketones, bilirubin, and blood.

Urine Culture

Your healthcare professional will take a sample of urine to check for which bacteria is in it, and which antibiotics will treat the infection.

Blood Work 

If your healthcare professional suspects a metabolic disorder, they may order blood tests to check for deficiencies.

Imaging

Imaging isn’t used often with urine odor.

But if the odor persists and there isn’t any sign of infection from the urinalysis, your healthcare professional may advise imaging.

Treatment

The treatment for your urine odor will depend on what is causing it.

• If you have a UTI, your healthcare professional will prescribe antibiotics to clear the infection.
• If your diabetes is uncontrolled, working with a healthcare professional to get your blood sugar levels back in a healthy range with medications and diet is essential.
• If you’re pregnant and have a UTI, your healthcare professional may prescribe antibiotics to clear the infection and keep you healthy.
• If you have PKU or other metabolic disorders, your healthcare professional will help you find ways to manage the symptoms and control your condition. This may include changes in diet, taking supplements, and working with specialists like nutritionists and dietitians.

If you are experiencing an unusual urine smell, it is important to see a healthcare professional for a proper diagnosis and treatment.

Prevention

The following are some good habits to keep your bladder healthy.

• Try to pee at least every 3 to 4 hours. If you aren’t going that frequently, you may need to drink more water.
• Drink enough water during the day so that your urine is clear. 
• Try to be as relaxed as you can while peeing. Relaxing your muscles will make it easier to urinate.
• Don’t rush the process. It’s better to take your time and fully empty your bladder than hold extra urine for too long.
• Physical activity is helpful for many things, including bladder health.
• Wear cotton underwear when possible. Other fabrics like nylon can trap moisture and increase the likelihood of bacterial growth.

When to See a Medical Professional

Make an appointment with your healthcare professional if you have a strong or abnormal urine odor that lasts for more than 2 days or if you have symptoms such as:

• Sweet-smelling urine
• Mental confusion
• Bloating
• Nausea
• Vomiting
• Fevers

How K Health Can Help

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