What It Means if You Have Cloudy Urine

Cloudy urine often comes and goes without any obvious cause or reason for concern. “Two-thirds of the time, we don’t diagnose why you have cloudy urine,” says Zeynep Gul, MD, a urologist and Assistant Professor of Urologic Surgery at Washington University School of Medicine.

You might have other symptoms that accompany persistent cloudy urine that could help identify the cause. So don’t be surprised if your doctor asks you about any other symptoms happening at the same time.

However, the only way to know for sure is to have your urine analyzed under a microscope, according to Elizabeth Kavaler, MD, a double-board certified urologist, Medical Director of Total Urology Care of New York, and author of A Seat on the Aisle, Please!: The Essential Guide to Urinary Tract Problems in Women.

What is cloudy pee?

“Cloudy urine basically means you cannot see through it,” says Sandeep Mehta, MD, a Urologist at Houston Methodist Baytown. “Urine should typically be transparent, and if you notice any thick material in it, that’s a sign of cloudy urine.”  

Reasons for cloudy pee

Cloudy pee is typically harmless, according to 2024 research published in Nutrients. It’s often a result of diet, intensive physical exercise, inadequate hydration, or medication. 

For instance, a high alkaline level in your urine is among the most common causes of a cloudy appearance. This means your pee is less acidic than normal, and it’s often associated with eating lots of fruits and vegetables and low levels of protein, per the Nutrients research. Medications, infections, and holding in your pee for too long can also make your urine more alkaline. Increasing your hydration and following a healthy diet usually gets your urine back to normal. 

However, inflammation is also a major cause of cloudy urine, Dr. Mehta says. This could stem from a number of issues that may require treatment—such as kidney stones or an infection—which our experts explain in more detail below. 

1. Urinary tract infections

Urinary tract infections, or UTIs, are usually caused by E. coli bacteria and are among the most common infections in women. The white blood cells that collect to fight infection can contribute to cloudy urine, says Dr. Kavaler.

The Nutrients research notes that UTIs can also cause a strong alkaline reaction, which contributes to cloudy-looking pee. 

Other common signs of a UTI could include:

• An urgent need to pee right away (even if it’s just a few drops)
• Painful burning while you urinate
• Urine that’s foul-smelling, is dark, or has a reddish tint
• General tiredness and fatigue
• Pain, pressure, or cramping in your lower abdomen, lower back, and/or groin area
• in more severe cases, fever, nausea, and other flu-like symptoms

Treatment

Antibiotics easily treat most UTIs, but pregnant women who develop these infections need to be extra careful as they can raise the risk of preterm birth, among other complications.

2. Sexually transmitted infections

“The most common STI causing cloudy discharge from the urethra is gonorrhea,” Dr. Mehta says. Chlamydia is also associated with cloudy urine, per the Nutrients research. 

Like with UTIs, this is often because your body produces white blood cells to fight off the infection, which can end up in your urine, making it look cloudy. These STIs can also produce abnormal gray or white discharge that can mix into your urine. 

“Typically, STIs like gonorrhea or chlamydia cause urethritis, which is inflammation of the urethra,” Dr. Mehta explains. While these UTIs often have no symptoms, the inflammation can make urination painful or difficult. “You may experience pain, discharge, and a sensation of straining to urinate,” Dr. Mehta says. 

“If you have high-risk sexual partners, it’s worth getting checked,” he advises. “Today, STIs can be tested easily with a simple urine or blood test, rather than needing a urethral swab.” 

Treatment

The treatment for both gonorrhea and chlamydia is antibiotics. Gonorrhea is typically treated with a single injection. Antibiotic treatment options for chlamydia vary—your doctor may prescribe a single high-strength dose or a course of treatment over one to two weeks. 

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3. Kidney and bladder stones

Cloudy urine can also indicate high levels of compounds called phosphates, which may be related to kidney stones, says Dr. Gul.

Kidney stones are hard, crystal-like masses that form when chemicals in the urine clump together—and sometimes, they grow too big to be excreted in your urine. That’s when they can lodge in your kidney or urinary tract, causing blockages and intense pain as well as cloudy, frothy, or foamy urine.

Other symptoms of kidney stones may include:

• Sudden and severe pain in the stomach, groin, and/or back
• Blood in your urine
• Nausea and vomiting
• Feeling sweaty 
• An infection

Treatment:

The typical treatment for kidney stones is allowing them to pass naturally—but this can involve pain management treatments from your doctor, according to 2022 research from JAMA. These options may include:

• NSAIDs (nonsteroidal anti-inflammatory drugs)
• Opioids for severe pain
• Intravenous fluids to help with hydration
• Alpha-adrenergic blocker medication, which can help move kidney stones out faster

In more severe cases, surgery may be necessary—particularly if it’s a large kidney stone (more than 10 millimeters in diameter) or the kidney stone has not passed on its own within four to six weeks. 

4. Certain foods

If certain foods irritate your bladder, you may get cloudy urine. Exactly which foods, if any, varies between people. “Everyone is different,” says Dr. Kavaler. “It could be caffeine, alcohol, spicy foods, or you could be allergic to something.”

Organ meat, red meat, and other foods rich in purines may also turn your urine cloudy, says Dr. Gul. Purines are needed to produce uric acid, which can contribute to kidney stones. Other high-purine foods to avoid: some seafood like sardines, scallops, high-fat dairy, and beer.

“You may also notice cloudy urine after eating a large meal,” Dr. Mehta adds. Like purines, phosphates in foods like bread, nuts, dairy, and meat can temporarily make your urine appear a bit cloudy after a rich, heavy meal. 

5. Dehydration

Fluids are essential for pretty much every cell in your body and for every process that keeps you alive. It helps you digest food, is an important blood component, maintains your temperature, and contributes to fighting infections. If you’re not taking in enough water or you’re expelling more than you are ingesting (say, because you’re sweating, running a fever, or have diarrhea and/or vomiting), you could become dehydrated. And dehydration can result in murky urine, says Dr. Gul.

As your kidneys try to hold onto more water, your urine contains a more concentrated amount of waste products—which can make it look cloudy, per the Nutrients research. It might also result in darker yellow or foamy pee and, if dehydration goes on long enough, it can lead to confusion and weakness and may even be life-threatening.

Other symptoms of dehydration include:

• Thirst
• Headache
• Dry skin, lips, mouth, and/or eyes
• Decreased urination
• Constipation
• Bad breath
• Sugar cravings 
• Muscle cramps
• Rapid heart rate (in severe cases)

Treatment:

Mild dehydration can usually be treated at home by drinking more fluids, according to the Cleveland Clinic. If you’re dehydrated from heavy sweating, vomiting, or diarrhea, it’s recommended to drink something with electrolytes (such as Gatorade or powders/tablets that you add to water). You should feel better relatively quickly.

However, if you continue to experience signs of dehydration—or have severe symptoms such as a racing heart, confusion, or weakness—you should seek medical care. Moderate to severe dehydration may require IV fluids to get your hydration levels back to normal. 

6. Retrograde ejaculation

Retrograde ejaculation is when men orgasm but don’t ejaculate much, if any, semen. It’s sometimes called a dry orgasm. 

In men, semen and urine share the same passageway (the urethra) out of the body. When men ejaculate, the bladder should close over to keep semen out. If it doesn’t, the semen can leak into the bladder and eventually into the urine.

It’s not a common problem and often doesn’t require treatment—unless it’s interfering with conception. While rare, retrograde ejaculation can cause male infertility, according to The World Journal of Men’s Health. 

Retrograde ejaculation can be caused by:

• A structural issue that you were born with
• Medical treatments, such as prostate surgery
• Certain medications, including prostate meds and antidepressants

Still, retrograde ejaculation can be a sign of an underlying condition, such as diabetes or an enlarged prostate. If it’s a recurring issue, you should seek your doctor to investigate and treat any potential issues.

Treatment:

Treatment for retrograde ejaculation depends on the cause. If it’s due to medications or diabetes, for instance, it can often be remedied by switching medications (with your doctor’s guidance) or by managing diabetes. 

In other cases, medications can help manage the condition—or surgery may be necessary if it’s due to a structural issue or complications from a previous surgery. 

However, in most cases, retrograde ejaculation doesn’t require treatment unless you’re trying to conceive. 

7. Enlarged prostate

One of the most common problems affecting men as they age is benign prostatic hyperplasia, better known as an enlarged prostate. This is when the prostate, the gland that makes the fluid portion of semen, enlarges enough to block parts of the urinary tract.

This can interfere with the bladder emptying completely, which means microbes can linger and proliferate in the urinary tract, leading to an infection, a higher white blood cell count, and cloudy urine. 

Researchers aren’t sure what causes an enlarged prostate, but it may be associated with hormonal changes that occur with age. 

An enlarged prostate may cause no symptoms. But the Cleveland Clinic says that some signs can include:

• Frequent urge to pee, even if your bladder is empty
• Sudden need to urinate
• Difficulty peeing or straining to urinate
• Weak/delayed urine flow 
• Inability to empty your bladder (or dribbling/leakage after urinating)
• Incontinence 
• Foul-smelling urine 
• Bloody urine

8. Prostatitis

Prostatitis can also cause cloudy urine. This condition occurs when the prostate gland is inflamed—and as the immune system kicks into action, excess white blood cells can mix into urine, causing a cloudy appearance. Prostatitis is the No. 1 urinary tract problem for men under 50. 

Chronic prostatitis (also known as chronic pelvic pain syndrome) is the most common type of prostate inflammation, though its exact cause is unknown. Researchers believe it may result from nerve damage, an immune system response to a previous UTI, chemicals in the urine, or an unidentified type of infection, according to the National Institute of Diabetes and Digestive and Kidney Diseases. 

Signs of chronic prostatitis can include:

• Pain or discomfort that lasts for more than three months in the lower abdomen, lower back, penis, scrotum, and/or area between the scrotum and anus.
• Pain during or after ejaculation
• Pain during or after urinating
• Frequent, urgent need to urinate
• Weak or interrupted urine flow 

Bacterial prostatitis—another type of this prostate inflammation—is caused by an infection. There are two types: acute prostatitis triggers symptoms suddenly, while chronic bacterial prostatitis comes on more gradually. 

Bacterial prostatitis can cause symptoms similar to those of chronic prostatitis. Acute bacterial prostatitis can also cause fever, chills, nausea, vomiting, body aches, or a complete inability to urinate. 

Treatment

Treatment for chronic prostatitis generally involves medication and/or physical therapy, depending on the symptoms and severity. 

Bacterial prostatitis requires antibiotic treatment. Other medications and dietary changes may be prescribed to help manage symptoms as well. 

9. Diabetes

If you have uncontrolled or undiagnosed diabetes, which results in persistent high blood sugar levels, you could end up with cloudy urine, among other issues. Bacteria and yeast feed on this sugar, which is the perfect set-up for UTIs or yeast infections. The resulting inflammation and white blood cells can cloud your urine, says Dr. Kavaler.

If you have frequent UTIs, see a doctor. If it’s due to diabetes, you’ll learn ways to keep your blood sugar levels low and stable. This is the best way to prevent permanent organ damage. Uncontrolled diabetes is the leading cause of kidney disease. That, too, can lead to urinary symptoms.

Other signs of uncontrolled/undiagnosed diabetes may include:

• Frequent urination
• Frequent thirst
• Fatigue 
• Weight loss
• Blurry vision

Treatment:

Lifestyle interventions are the first-line treatment for all people with diabetes, including making dietary changes, getting regular exercise, and prioritizing quality sleep. For some people with type 2 diabetes, these changes may be enough to manage the condition. 

If lifestyle changes alone do not keep blood sugar levels in check, oral or injectable insulin is generally the next step in a treatment plan. However, for people with type 1 diabetes, lifelong insulin treatment is required.

10. Pregnancy

“If a woman is pregnant and notices cloudy urine, she should probably get it checked out,” Dr. Mehta advises. It could be related to something harmless, such as eating a large meal or experiencing excess discharge (that mixes with your urine) due to hormonal changes. If you’re vomiting a lot due to morning sickness, your urine could look cloudy from dehydration as well. 

However, other causes of cloudy urine put pregnant women at a higher risk for health complications. 

Infections

“If cloudiness persists and is unrelated to eating, it could be a vaginal infection, which needs attention,” Dr. Mehta says. “Vaginal infections and urinary tract infections can be serious, especially during pregnancy, so it’s worth getting checked out.” 

Vaginal infections and UTIs can cause itchiness and frequent urination—both of which are common symptoms for all pregnant women. However, see your doctor to check for an infection if you have other symptoms, including:

• Burning sensation when you pee
• Lower abdominal pain
• Foul-smelling or bloody urine
• Severe itchiness
• Unusual discharge

Ketosis

The Nutrients research also points out that ketosis can occur during pregnancy—and ketones (acid byproducts) in your urine can make it look cloudy. Ketosis is a state where the body burns fat for energy instead of carbohydrates, and this can happen due to the increased energy needs during pregnancy (especially in the third trimester). 

Mild ketone levels during pregnancy are generally expected and are no cause for concern, but high concentrations can be dangerous. According to the Cleveland Clinic, high ketone levels can also be a sign of gestational diabetes—which, if left untreated, can contribute to pregnancy complications and health risks for your baby. 

Signs that you may have high levels of ketones in your body while pregnant can include:

• Nausea, vomiting, and/or stomach pain
• Increased thirst, dry mouth, and/or bad breath
• Frequent urination
• Confusion and/or excessive fatigue
• Frequent vaginal or bladder infections

Treatment

If you have a UTI or vaginal infection during pregnancy, your doctor will prescribe antibiotics that are safe to take while pregnant. These pregnancy-safe antibiotics generally include penicillins and cephalosporins, according to 2021 research published in the International Journal of Environmental Research and Public Health. 

If your cloudy urine is due to ketosis, your treatment depends on the cause, per the Cleveland Clinic. Treatments could include:

• Anti-nausea medications to help prevent dehydration from morning sickness/vomiting
• Dietary modifications that encourage your body to burn carbs instead of fat
• Drinking more water
• Gestational diabetes management, which generally involves blood sugar tracking and nutritional changes but may also require insulin therapy

11. Certain medications

“Certain medications can cause cloudy urine,” Dr. Mehta says. “It’s normal for medications to have this effect, but if you’re concerned or if the cloudiness persists, it’s worth consulting your doctor.”

The Nutrients research says that some medications are known to have a strong alkaline urine reaction, which can make your pee look cloudy. These include:

• Sodium bicarbonate, used to treat heartburn and indigestion
• Potassium citrate, used to treat certain kidney stone conditions
• Acetazolamide, a medication sometimes used to treat heart conditions, epilepsy, or glaucoma 

Medications, such as diuretics, penicillin and other antibiotics, proton pump inhibitors, and NSAIDs like aspirin and ibuprofen, may also cause cloudy urine, per the research. 

12. Vaginitis

Vaginitis is a term that refers to inflammation of the vagina. This can be caused by an infection, irritation, or hormonal changes. 

Bacterial vaginosis (BV) is the most common type, and a typical symptom is a grayish-white discharge that can mix with your urine, making it look cloudy, according to the Nutrients research. Yeast infections are another form of vaginitis, which often causes a thick, white discharge that mixes with urine. White blood cells trying to fight off infection can cloud your pee as well.

Vaginitis is generally the result of an imbalance between the “good” and “bad” bacteria in your vagina. That’s why yeast infections are so common after taking antibiotics for a UTI or bladder infection—the antibiotics, while treating the infection, inadvertently kill off beneficial bacteria, allowing for an overgrowth of yeast (candida). 

“Vaginitis is separate from a UTI, but it can present in a similar way,” Dr. Mehta says. Sometimes, vaginitis causes no symptoms at all. But in general, signs of vaginitis can include:

• Unusual changes in vaginal discharge
• Itching, irritation, burning, or general discomfort
• Pain when urinating 
• Pain during sex

Treatment

Treatment for vaginitis depends on the cause. For instance, antibiotics are generally used to treat bacterial vaginosis, and antifungal medications are the go-to treatment for yeast infections. 

Mild cases of vaginitis may go away on their own. But if your symptoms persist, it’s a good idea to check in with your doctor.

When to see a doctor for cloudy pee

Cloudy urine is most likely to be transient and unconcerning. “Some of the most common causes are related to food or temporary conditions like asymptomatic bacteriuria, where bacteria in the urine don’t cause symptoms,” Dr. Mehta says. “Our bodies are often good at fighting off infections on their own—if cloudy urine goes away on its own, that’s typically not a concern.”

But there are times to act. 

One is if you have urinary symptoms that won’t go away, especially if they’re associated with pain in your back (which could be a kidney infection) or blood in your urine, says Dr. Gul.

“If [cloudy urine] persists and is associated with pain, discomfort, fever, or if you’re pregnant, it’s worth getting checked out more quickly,” Dr. Mehta adds. You should also see a doctor if you have chills, nausea, or vomiting.

How a doctor will diagnose you

“One of the most common tests is a urinalysis,” Dr. Mehta says. “The doctor will ask for a urine sample, and a quick test, often a dipstick test, will give an estimate of whether there’s an infection.” 

He says the most important test, however, is a urine culture. “Not all doctors or urgent care centers will send a sample for a urine culture, so it’s worth asking if it will be sent to grow bacteria in a petri dish,” he explains. “It takes a couple of days, and it’s important to follow up with the facility to check on the results, as this will help guide treatment.” 

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