I Am Female And 21 Years Old. For The Past

Posted on Tue, 11 Dec 2018

Question: I am female and 21 years old. For the past year, I have been bleeding heavily from my urethra during and for several days after penetrative vaginal sex or masturbation. My urine is so bloody it is the color of cranberry juice for up to three or four days after the sexual activity. I tested negative for UTIs and I had a cystoscopy a couple months ago that revealed nothing. I have stumped 4 urologists. What could possibly be causing this?

Answered by Dr. Anders Mark Christensen (13 minutes later)

Brief Answer:
It can be many things

Detailed Answer:
Hi Adira XXXXXXX

I am sorry to hear about your troubles. First of all, it is important to ascertain if the red urine, in fact, is blood. Has this been tested? I ask because excessive intake of beets can lead to red urine.

A porphyria is a mixed group of conditions that can be associated with red urine, which is caused by porphyrins and not blood. Lastly, myoglobin released from muscle during strenuous exercise can be excreted in the kidneys and lead to red urine.

Also, when does the blood come? Only when you urinate? If so, at the beginning or end of urinating (or both)? Does the blood also come when you are not urinating?

If all of the above can be ruled out (and your endoscopy was normal) the problem must arise from your kidneys. Kidney disease can be examined by ultrasound, CT scan, urine tests for protein, blood tests, etc. Have you been examined for kidney disease?

Looking forward to hearing from you.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Anders Mark Christensen (23 minutes later)

Labs confirm that there is specifically blood in my urine. The bleeding starts while I am having any sort of vaginal sex. My urethra starts to bulge and visibly bleed; if I am masturbating, I'll notice blood smearing on my hand and I'll look down and see my urethra dripping blood. The next handful of times I pee after the sexual activity, my urine comes out red -- less red the more times I ago until my urine looks normal again two or three days later. I've noticed that the blood seems to come especially at the end of the urine stream. I had an ultrasound of my kidneys and bladder, a blood test for kidney function, a cystoscopy, and a vaginoscopy, all of which came back normal. I've been told that it does not appear the bleeding is coming from my kidneys.

Answered by Dr. Anders Mark Christensen (19 minutes later)

Brief Answer:
That is all good

Detailed Answer:
Hi again Adira XXXXXXX

That is all good news, in the sense that serious disease has been ruled out.

Alternatively, if you frequently engage in sexual activities (including masturbation), you could try a pause for a week or two, and see if the bleeding has stopped on subsequent sexual intercourse. Do ensure to use an adequate amount of jelly to avoid any undue friction related to trauma.

Feel free to ask further.

Above answer was peer-reviewed by : Dr. Arnab Banerjee

Follow up: Dr. Anders Mark Christensen (38 minutes later)

I have tried using several different lubricants to avoid friction, none of which helps. I also refrained from all sexual activity for a period of 5 months to allow any injuries I could have possibly incurred to heal. As soon as I tried to (gently) masturbate again, the issue resurfaced. I read a little bit about urinary tract endometriosis recently -- does this seem like a possibility?

Answered by Dr. Anders Mark Christensen (10 hours later)

Brief Answer:
It can be

Detailed Answer:
Hi again,

It can definitely be endometriosis. This usually shows as cyclic pain in relation to menstruation. The treatment of this can be continuous hormonal anticonception.

Hope this helps.

Note: Consult a Urologist online for consultation about prostate and bladder problems, sexual dysfunction, kidney stones, prostate enlargement, urinary incontinence, impotence and erectile dysfunction - Click here.

Above answer was peer-reviewed by : Dr. Vaishalee Punj