Based on PubMed | Is blood in urine a symptom of fibromyalgia?

Blood in the urine (hematuria) is not considered a typical symptom of fibromyalgia. ^[1] Fibromyalgia mainly involves widespread musculoskeletal pain, fatigue, sleep problems, and “fibro fog” (concentration or memory issues), along with common overlaps like irritable bowel syndrome and various genitourinary complaints such as urinary urgency or frequency but not bleeding. ^{[2] [3]}

What fibromyalgia commonly causes

Fibromyalgia is defined by chronic, widespread pain and tenderness, often accompanied by non-restorative sleep and daytime fatigue. ^[1] People frequently report additional symptoms such as headaches, dizziness, dry eyes, gastrointestinal issues (like IBS), and urinary urgency or frequency. ^{[4] [5]} These urinary symptoms are functional (related to bladder sensitivity or overactivity) rather than structural bleeding problems. ^{[6] [5]}

Hematuria has many other causes

Seeing red or pink urine, or having microscopic blood detected on a urine test, usually points to conditions outside fibromyalgia. ^[7] Common causes include urinary tract infections, kidney stones, enlarged prostate (in older men), cancers of the urinary tract, vigorous exercise, certain foods (beets, blackberries, rhubarb), and medications (like rifampin or phenazopyridine). ^{[8] [7]} A medical evaluation typically investigates these possibilities because they can require specific treatment or monitoring. ^[9]

Rare pain–hematuria syndromes

There is a distinct condition called loin pain hematuria syndrome, marked by severe flank pain with microscopic or visible blood in urine, and it is unrelated to fibromyalgia’s typical mechanisms. ^[10] While some older reports note genitourinary complaints in fibromyalgia (such as “female urethral syndrome”), those describe irritative urinary symptoms rather than true bleeding. ^[11] In controlled observations, fibromyalgia overlaps more with functional disorders (including genitourinary sensitivity) than with diseases that cause hematuria. ^[5]

Practical guidance

• If you notice blood in your urine, it’s safer to treat this as a sign of a urinary or kidney issue rather than fibromyalgia. You would generally benefit from a prompt medical evaluation, including urinalysis and, if needed, imaging, to rule out infection, stones, or other causes. ^[9]
• If you live with fibromyalgia and have urinary frequency or urgency, those symptoms can be part of the condition’s overlap with overactive bladder and may improve with bladder training, pelvic floor therapy, or targeted medications. However, the presence of blood should not be attributed to fibromyalgia without a thorough workup. ^{[6] [5]}

Bottom line

Fibromyalgia commonly includes pain, fatigue, sleep problems, and sometimes urinary urgency or frequency, but hematuria is not a recognized or typical feature of fibromyalgia and should be evaluated for other causes. ^{[1] [2] [5]}