Dear Alice,

I have noticed a bad urine smell lately whenever I go to the bathroom. It is so noticeable. I'm very conscious of it during the day. My husband said he noticed it just standing near me! I have never had anything like this before. What could be causing this?

Dear Reader,

Normally, urine doesn't have much of a smell to it. If you're dehydrated and your urine becomes overly concentrated, it can have a stronger-than-usual scent. Vitamins and certain foods (asparagus, for example) can give urine an unusual smell. Infection can cause the urine to smell unpleasant. Uncommon, but more serious, causes of urine odor include:

  • Rare diseases, in which certain chemicals build up in the urine (e.g., ketonuria, maple sugar urine disease [an inherited metabolic disorder that's characterized by urine that smells similar to maple syrup], and phenylketonuria).
  • An abnormal connection between the rectum and the bladder (rectal fistula).
  • Liver failure.

Sometimes it can be difficult to tell where the smell is coming from: at times, women think that their urine has an unpleasant odor, when actually the source is their vagina. The common vaginal infection trichomoniasis can cause a strong, foul, fishy smell. Another vaginal infection, gardnerella, can also cause an offensive odor. Both of these infections are easily treated with antibiotics. In most cases, a sexual partner of an infected woman will require treatment with antibiotics also, and condoms need to be used until the full schedule of antibiotics is finished.

Have you noticed any other symptoms? For example, a urinary tract infection (UTI) usually causes people to urinate more frequently, and can cause burning and pain while peeing.

It's a good idea for you to visit your health care provider to try to find out the source of this new, unpleasant odor. The solution may be as simple as a course of antibiotics. Hope this helps!


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