I have a rancid odor from my urine and happen to be on birth control pills.

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I am a college student. I have a question which I have tried to research and figure out, but it has been to no avail. I have been experiencing a very rancid odor from my urine and it is almost constant – at least I haven’t noticed it with any certain foods or activities. I happen to also be on the pill, but though it may have made the odor worse, the odor was there before I went on the pill about 3 months ago.

I feel I have a well-balanced diet and I’m in great shape, so what could this be? Perhaps the only “differences” have been a little lethargy and thirstiness. Last semester I had to crawl into bed after every class. This has gotten better though I feel part of it was stress. I am slightly embarrassed by this since I live with roommates and even my going to our health center told me nothing. Please at least give any possibilities. Diet? Infection? Disease?

Oh, I did have Lyme’s disease for a couple years. Thanks for your time.

Odorous urine can be caused by many factors and you should have a complete physical including a urinalysis which should check for protein, sugar, ketones, blood, and bacteria in your urine. You did not say what the college health service checked.

I would also recommend you keep a food diary for the doctor to discuss what you eat and fluids you drink. Do you drink at least 64 ounces of enough water so that your urine is colorless per day?

If your urine is positive for ketones, but not sugar, have you been on a high protein, low carbohydrate diet? If your urine is positive for ketones and sugar, then you may have diabetes. Excessive thirst and tiredness are other symptoms of undiagnosed diabetes. If your urine has protein, your kidneys may not be filtering right or you may have an infection. If your urine has blood or a urine culture shows bacteria, then you could have a bladder or kidney infection.

Are you sure the odor is coming from your urine or could it possibly be coming from your vagina? Is the smell only noticeable when you urinate or do you also notice it at other times? Do you also notice the odor when you shower? It is possible that you could have a yeast infection or an infection in your pelvis (pelvic inflammatory disease). Or if you are sexually active, it is possible you could have a sexually transmitted disease. Tell the doctor any symptoms you have and don’t leave any out. The doctor will treat your information confidentially.

You need to go see a doctor as the odor is usually a symptom of something. It probably won’t go away on its own as you mention the odor was present at least 3 months ago and could cause permanent injury to your urinary or reproductive system.

So considering the many possibilities, make an appointment for a physical exam immediately. If you still don’t get a satisfactory answer from your college health services, make an appointment to see a doctor in a medical clinic where you are living. Don’t accept a “we don’t know” answer.

The only food I know of that causes an odor to urine is asparagus, but the smell occurs within 15 minutes of eating asparagus and is temporary, not at all like what you describe. Birth control pills don’t cause an odor to urine either.