Blood in Urine: Is It Menstruation or a Urinary Tract Infection?

Suspected hematuria?

Hello doctor, today when I went to the bathroom, I noticed some bleeding.
At first, I thought it was my period, but after using a sanitary pad, I found no blood at all; there was only blood when I wiped after using the toilet.
I don't feel pain when I start urinating, but I do feel pain after I finish, and then there is bleeding when I wipe.
Is this my period? My period is expected on March 2nd, but I have been taking birth control pills to delay it, and I haven't missed any doses.
Is this my period or a urinary tract infection?

Niming, 20~29 year old female. Ask Date: 2019/03/01

Dr. Huang Jianzhong reply Obstetrics and Gynecology

I noticed bleeding when I went to the bathroom.
At first, I thought it was my menstrual period, but after using a sanitary pad, I found no blood at all; there was only blood when I wiped after using the toilet.
I don't feel pain when I start to urinate, but I do feel pain at the end, and wiping causes bleeding.
Is this my menstrual period? My period is expected on March 2nd, but I have been taking birth control pills to delay it, and I haven't missed any doses.
Is this my period or a urinary tract infection? Answer: It is a urinary tract infection; you should see a doctor.

Reply Date: 2019/03/01

More Info

When it comes to the presence of blood in urine, it is essential to differentiate between menstrual bleeding and potential urinary tract infections (UTIs). Based on your description, it seems that you are experiencing some unusual symptoms that warrant further investigation.

Firstly, the timing of your menstrual cycle is crucial. You mentioned that your expected period was on March 2, and you have been taking birth control pills consistently to delay your menstruation. Birth control pills can indeed alter your menstrual cycle, sometimes leading to lighter periods or even missed periods. However, if you are experiencing bleeding that is not consistent with your usual menstrual pattern, it may be indicative of another issue.

The fact that you are experiencing pain at the end of urination and that you notice blood when wiping could suggest a urinary tract infection. UTIs are common and can cause symptoms such as:
- Pain or burning sensation during urination
- Frequent urge to urinate
- Pain in the lower abdomen or back
- Blood in urine (hematuria)
In your case, the pain at the end of urination and the presence of blood when wiping could align more closely with a UTI rather than menstrual bleeding. It is also worth noting that menstrual blood typically appears more consistently throughout the menstrual cycle, while blood associated with a UTI may be more sporadic and often accompanied by discomfort.

Given these symptoms, it is advisable to consult a healthcare professional for a proper evaluation. A urinalysis can help determine if there is an infection present, and if so, appropriate treatment can be initiated. Additionally, if there is any uncertainty regarding your menstrual cycle due to the use of birth control, your healthcare provider can offer guidance on what to expect and whether any adjustments are necessary.

In summary, while it is possible that the bleeding you are experiencing could be related to your menstrual cycle, the symptoms of pain during urination and the specific nature of the bleeding suggest that a urinary tract infection may be more likely. It is essential to seek medical attention to clarify the situation and receive appropriate care.

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