‘I’m a urologist – here are five reasons your wee smells funny’

The average, healthy person urinates four to eight times a day, and the bladder is capable of holding around one pint of urine.

Unfortunately, though, there’s no way to get around the fact that urine does have a smell.

There is a huge array of things that can affect the smell and appearance of urine. Even the daily multivitamin pill we pop can be the culprit of smelly urine.

Diet and hydration can affect the appearance and smell of urine, but also the risk of an infection, medications, and medical conditions can all cause pungent-smelling urine.

Sushma Srikrishna, a consultant urogynaecologist at London Bridge Hospital, revealed five reasons your urine may smell a little funny.

Food, supplements, and medication

Sushma said: “Sulfar-containing medications, which include antibiotics such as Bactrim, and diabetes medications such as glyburide and medications for rheumatoid arthritis, specifically, Azulfidine, may make urine smell like eggs by creating a sulfuric chemical excreted in the urine.

“Calcium supplements and vitamin D may also make the urine smell fishy, while iron supplements and kelp may precipitate a metallic smell. There’s nothing to do here- give it a day or two if it’s related to food, cut back on the supplements.”

According to Healthspan nutritionist Rob Hobson, various foods, including coffee, can also alter urine smell.

Foods such as asparagus, Brussels sprouts, onions, certain spices, garlic, curry, salmon, and alcohol affect its odour.

He said: “Additionally, a diet high in salt can increase urine concentration, intensifying its scent. Certain supplements containing water-soluble vitamin B6 may also contribute to a strong urine odour.”

Infections

The most common medically concerning reason for smelly wee is a urinary tract infection.

Dr Jo Bailey, from vaginal health brand VJJ Health, said: “One of the reasons women are particularly prone to UTIs is that their urethras are much shorter than men’s.

“This allows bacteria to get into the bladder. The main bacteria causing UTIs is e-coli, which can hang onto the bladder’s lining.”

Sushma added: “Rarely STIs give the perception of pungent urine although this may be a smell coming from vaginal discharge.

“Chlamydia and trichomoniasis are two STIs that are associated with smelly, pungent wee- so if you suspect this, please get tested and treated straight away.”

A metabolic disorder

A rare genetic disorder can be associated with a bad urine odour.

Sushma continued: “If your pee smells foul, sour, or fishy, you might have a medical condition called trimethylaminuria, which gives you terrible body odour no matter how much you brush your teeth, shower, or bathe.

“Trimethylaminuria is more common in women, and symptoms can worsen or become more noticeable around puberty, before or during your period, after taking oral contraceptives, or around menopause.”

A fistula

Another cause could be a fistula between the rectum and the bladder, which can lead to stool content leaking into the wee but this is highly unlikely.

Sushma said: “This must be dealt with urgently by seeing your doctor for the correct diagnosis and treatment.”

Diabetes

One of the first ways diabetes manifests is often via the bladder, making you want to see more often.

Urine can have a fruity or sweet smell, and this is down to the extra sugar being excreted by the kidneys, which are unable to process sugar properly.

“Most likely, sweet-smelling urine will be a sign of type 2 diabetes – which is diagnosed later in life,” Sushma said.

“You may also have fruity or sweet-smelling urine, thanks to the extra sugar being excreted by your kidneys.

“If you’re noticing fruity wee as an adult, coupled with needing to run to the bathroom more than usual, means you may want to get your blood sugar levels checked. If you are a known diabetic, please talk with your doctor as soon as possible about making adjustments to your treatment or lifestyle.”

When to see a doctor

Sushma added: “Smelly wee is annoying but usually harmless and disappears on its own with a few lifestyle tweaks.

“But if it is persistent or you notice other symptoms such as blood in your urine, pain or painful urination, frequent urination, fever or chills, or back pain, make an appointment to see your doctor straight away.”