Can an Ovarian Cyst Cause Blood in the Urine?

By Lorra Garrick | Last updated 11/21

You’ve just discovered what appears to be blood in your urine. Could this be from a harmless ovarian cyst?

If you’ve already been diagnosed with an ovarian cyst, perhaps you’re wondering if the newly discovered blood in your urine is from that cyst – rather than from a more sinister condition such as blood from uterine or vaginal cancer getting mixed in your urine.

What appears to be blood in the urine stream, or landing in the toilet along with the urine and seemingly mixed in with it, may not necessarily have originated in the urinary tract.

But an origination from an ovarian cyst?

“Blood in the urine would not be a typical presentation for an ovarian cyst,” says Karen Patrusky, a board certified OBGYN and F.A.C.O.G. in private practice for 20+ years.

“There are many types of ovarian cysts, some functional and not worrisome and others that are not meant to be there or described as pathologic — and these can be benign or cancer.

“Reasons to intervene would be the age of the woman on presentation, the size of the cyst, what the cyst looks like on sonogram, is she having pain from the cyst, and her medical and family history.”

What about a ruptured ovarian cyst that’s bleeding?

The patient may not even know this has happened. Or, there may be abdominal pain from a more significant rupture.

However, this blood eventually gets reabsorbed into the body, rather than traveling through a Fallopian tube, into the uterus, through the cervix and vagina and then mixing with one’s urine.

So if you’ve been diagnosed with an ovarian cyst and have noticed blood in your urine, you can rule out the cyst as the cause.

Or, from another perspective … you need not wonder if an undiagnosed ovarian cyst is the cause.

So why might there be blood in your urine?

“If a woman is experiencing blood in her urine then she should have a urologic workup,” says Dr. Patrusky.

“This can be due to infection, inflammation or a tumor in her urinary tract.”

Before you panic, you’ll first want to determine if, indeed, you have visual blood in your urine – which is called gross hematuria.

For instance, whole beets or beet juice can give urine a pinkish or reddish-fuchsia tinge.

Discolored urine from beets. Jmarchn/CC BY-SA 3.0

For some individuals, a high intake of carrot juice in one day can color the urine orange.

Dehydration, too, can result in orange urine.

Another mimicker of gross hematuria is a supplement called di-indole methane – commonly known as DIM and marketed as a breast health supplement.

When DIM breaks down in the body, its metabolites are amber in color. When these metabolites are voided, your urine may be a brilliant amber, or what appears to be a 50/50 blend of liquid bronze and liquid ruby.

Discoloration from DIM

Blood in urine can also be from excessively intense exercise, kidney or liver disease. A complete blood workup should be taken.

Blood with Urine, not IN Urine

In addition to seeing a urologist, you should also see a gynecologist to rule out a pathology in the reproductive tract, such as cervical or uterine cancer, or polyps in those organs.

At a minimum you should have a Pap smear, transvaginal ultrasound (abbreviated is okay) and endometrial biopsy.

If all three tests, plus a clinical exam, are negative, this is significant reassurance that you do not have a reproductive cancer.

If an ultrasound just by coincidence reveals an ovarian cyst, this is just that: a coincidence.

If you’re postmenopausal, the thin, atrophied tissue in the reproductive tract can bleed (especially after intimacy), and that blood can mix with your urine.

If you see blood on the tissue paper but not in the toilet bowl, this can be from an irritated skin tag just outside the vagina, urethra or anus, as well as from a urethral caruncle caused by postmenopausal atrophy.