Cloudy urine: 8 reasons from UTIs to bladder cancer - Insider

• Cloudy urine is usually a sign of dehydration or an infection like a UTI or STI.
• Cloudy urine can also be a side effect of your diet or if you're taking certain medications.
• In rare cases, cloudy urine may be a sign of bladder cancer.

Your pee probably varies slightly in color day-to-day depending on what you ate and how much water you drank, and those small changes are perfectly normal. 

As long as your urine is clear to slightly yellow in color and largely transparent, you needn't worry. However, if your urine suddenly appears cloudy or milky, it's time to contact a healthcare provider. 

"Any time there's any change in color or appearance, that's cause for seeking medical attention," says Aria Olumi, MD, chief of urology at Beth Israel Deaconess Medical Center, at Boston hospital.

Cloudy urine can be caused by a number of things, from an infection to dehydration. Here are ten reasons why your pee might be cloudy and what to do about it.

1. Urinary tract infection

Cloudy pee is a primary symptom of urinary tract infections, or UTIs, says Marc S. Cohen, MD, a urologist with Bastion Health, a telehealth platform for men.. 

When your urinary tract is infected, bacteria collect in your urine, giving it a cloudy appearance.  

UTIs are very common and can occur in anyone. About 40% of women and 12% of men will experience a UTI in their lifetime. In men, UTIs are associated with an enlarged prostate, particularly as you get older, although enlarged prostates themselves do not cause cloudy pee. 

In addition to cloudy urine, the symptoms of a UTI may include:

• Reddish appearance to urine
• Pain or burning when urinating
• Foul-smelling urine
• Pain in the lower belly and back
• Frequent urination
• Fever, tiredness, and shaking

What to do about it: UTIs are most often treated with a course of antibiotics, so you'll need to see a doctor for a prescription. Symptoms usually resolve within a few days of taking these medications. 

Note: While UTIs can be extremely painful, most are harmless to long-term health. But if left untreated, a UTI can lead to serious health issues including kidney disease and sepsis. If you think you might have a UTI, see your doctor for a diagnosis and treatment. 

2. Dehydration

The better hydrated you are, the more clear your urine will appear. On the other hand, dehydration can lead to dark-colored and cloudy urine. 

Dehydration can be caused by:

• Not drinking enough
• Diarrhea
• Vomiting, including morning sickness
• Sweating too much
• Frequent urination caused by medication or illness

In addition to cloudy urine, the symptoms of dehydration are:

• Thirst 
• Dry mouth and skin
• Feeling tired
• Dizziness, confusion and fainting as dehydration gets worse

What to do about it: To avoid dehydration, be sure to consume enough fluids. Men should get 125 fluid ounces each day, while women should consume 91 ounces. This can be in the form of water, other hydrating beverages, or foods that contain water.

If you are sick, speak with your healthcare provider about how to stay properly hydrated. Once you become dehydrated, you'll need water and electrolytes, like those in sports drinks, to rehydrate.

3. Diet and medications

Foods and medications that lead to dark yellow or orange urine can give the appearance of cloudiness, says Cohen. These include foods that are rich in vitamin B and carotene, like carrots, spinach, broccoli and other fruits and vegetables. 

Cloudy urine can also be caused by certain medications, including:

What to do about it: Urine changes due to a food or medication are usually not dangerous, should resolve within a day, and don't require treatment, says Cohen and Olumi.

4. Sexually transmitted infections

Certain sexually transmitted infections (STIs) including chlamydia and gonorrhea can lead to cloudy urine. 

Chlamydia is one of the most common STIs, affecting up to 5% of young women. Infections can be serious, especially for pregnant people, but are often asymptomatic. In addition to cloudy pee you might notice:

• Painful urination
• Genital itching or soreness
• Anal or vaginal discharge
• Conjunctivitis

Cloudy pee from gonorrhea happens when discharge from the penis or vagina caused by the infection makes contact with urine, giving it a cloudy appearance. Other symptoms of gonorrhea include:

• Painful or burning urination
• Vaginal bleeding between periods
• Swollen testicals
• Painful or itchy anus
• Anal discharge or bleeding

What to do about it: If you believe you may have an STI, see your doctor for testing and treatment. If you have chlamydia, you'll likely be given a prescription of antibiotics . For gonorrhea the recommended treatment is an injection of the antibiotic ceftriaxone. 

5. Kidney stones

Kidney stones occur in about 10% of people, and can cause cloudy pee. 

A kidney stone is a hard object that is made from the crystals of waste chemicals naturally found in urine. These crystals form when there is too little liquid in the urine, which can happen due to being dehydrated, exercising too much, or chronic UTIs or other bacterial infections. Genetics also plays a role.

In addition to cloudy pee, you may notice the following symptoms:

• Severe pain concentrated in one side of the lower back
• Stomach ache, nausea and vomiting 
• Blood in the pee
• Foul-smelling urine
• Fever and chills

What to do about it: If you have kidney stones, see a doctor who will probably encourage you to drink lots of water to help the stone pass. They might also prescribe medications to change the composition of your urine or relax the ureters to allow the stone to pass. In rare cases, kidney stones need to be surgically removed.

6. Retrograde ejaculation

Retrograde ejaculation is a condition where instead of ejaculating through the tip of the urethra, semen travels into the bladder upon orgasm. This can cause cloudy pee for the next one to two times you urinate.

If you have retrograde ejaculation, you might notice very little or no fluid after orgasming. The condition isn't dangerous, Olumi says. However, it can cause infertility or just be distressing. 

What to do about it: Retrograde ejaculation isn't harmful, so it doesn't necessarily require treatment. However, if it's bothering you, doctors can often treat retrograde ejaculation with off-label medications, including Imipramine, an antidepressant, Midodrine, a medicine that constricts blood vessels, or antihistamines.  

7. Bladder cancer 

The tell-tale sign of bladder cancer is blood in the urine, which can sometimes cause the urine to appear cloudy, says Olumi. 

Note: If you have blood in your urine, it's unlikely bladder cancer and more likely an infection of some sort.

Bladder cancer is the fourth most common cancer in men and affects more than 80,000 Americans each year. 

Other symptoms of bladder cancer include:

• Frequent and urgent urination
• Waking at night to urinate
• Pain or burning during urination
• Trouble peeing, or interrupted flow

What to do about it: If you are concerned about these symptoms, you should see your doctor for possible screening for bladder cancer. Bladder cancer can be treated with surgery, chemotherapy, radiation, and targeted treatments. 

8. Diabetes

Diabetes on its own doesn't cause cloudy pee, Olumi says. However, people with diabetes are at higher risk for other healthy conditions, including UTIs, bladder infections, kidney disease, and retrograde ejaculation. 

Because of that, people with diabetes are more likely to notice cloudy pee in their toilet bowls. 

What to do about it: If you have diabetes and notice cloudy urine you should speak with your doctor, since this might be a sign that you have an infection or another health concern.

When to see a doctor

Cloudy pee isn't necessarily a cause for concern. Some people naturally have more cloudy-looking pee than others, says Cohen. 

However, there are certain signs that might indicate you should get medical care, says Olumi. These include:

• Changes to urine appearance that last more than a day or two
• Foul-smelling urine
• Blood in the urine
• Burning or pain when urinating
• Changes to urine appearance accompanied by fever

The appearance of pee is subjective, so it's important to see a doctor who can run a urinalysis for a diagnosis, Olumi says. 

Insider's takeaway

Healthy urine should be clear and light-colored, without a strong scent. Cloudy urine is most closely associated with UTIs, says Olumi. However, other conditions including dehydration and STIs can also cause cloudy urine. 

Although many of us prefer not to look too closely at our pee, paying attention to your urine can help you catch health concerns early, says Cohen. 

"It gives you an idea of what's going on inside your body," he says. "It's a window into the system."

Kelly Burch