The most obvious cause of foamy urine is the speed of urination. Just as water foams up when it comes out of the tap quickly, urine foams if it hits the toilet quickly. This kind of foam should also clear up quickly.
Sometimes, urine can also foam up when it’s concentrated. Your urine is more concentrated if you haven’t had much water to drink and you’re dehydrated.
Foamy urine can also indicate that you have too much of a protein, such as an albumin, in your urine. The protein in your urine reacts with the air to create foam.
Normally, your kidneys filter extra water and waste products out of your blood into your urine. Protein and other important substances that your body needs are too big to fit through the kidneys’ filters, so they stay in your bloodstream.
But when your kidneys are damaged, they don’t filter as well as they should. Damaged kidneys can allow too much protein to leak into your urine. This is called proteinuria. It’s a sign of chronic kidney disease or the late stage of kidney damage, called end-stage renal disease.
A less common cause of foamy urine is retrograde ejaculation, which is a condition that happens in men when semen backs up into the bladder instead of being released from the penis.
Amyloidosis is a rare condition that can also cause foamy urine, fluid buildup, and problems for the kidneys. It is caused by the buildup of a specific protein and can affect many organs.
Taking the medicine phenazopyridine (Pyridium, AZO Standard, Uristat, AZO) is another less common cause of foamy urine. People take this medication to treat the pain from urinary tract infections.
And sometimes, the problem is actually just your toilet. Some toilet cleaning chemicals can make your urine look foamy. If this is the cause, the foam should stop as soon as you flush the cleaner out of the toilet.
What are the risk factors?
You might be more likely to have foamy urine if you have a full bladder, which can make your urine stream more forceful and faster.
The urine can also get foamy if it’s more concentrated, which can occur due to dehydration or pregnancy.
Protein in the urine can also cause foaminess and is usually due to kidney disease. You’re more likely to get kidney disease if you have:
- diabetes
- a family history of kidney disease
- high blood pressure
The causes of retrograde ejaculation include:
- diabetes
- drugs used to treat high blood pressure, enlarged prostate, or mood
- nerve damage from a spinal cord injury, diabetes, or multiple sclerosis
- surgery on the prostate or urethra
Contact your doctor if you suspect you have kidney disease or retrograde ejaculation, or if your urine continues to look foamy.
How is the cause of foamy urine diagnosed?
Your doctor will likely take a urine sample to test protein levels in your urine. One urine test, taken over a 24-hour period, compares albumin levels to levels of creatinine, which is a substance produced when muscles break down.
This is called the urine albumin-to-creatinine ratio (UACR). It shows how well your kidneys are filtering your blood. If your UACR is higher than 30 milligrams per gram (mg/g), you might have kidney disease. Your doctor will do other tests to check how well your kidneys are working.
If retrograde ejaculation is a suspected cause for your foamy urine, your doctor will check for sperm in your urine.
How are the causes of foamy urine treated?
Treatment for foamy urine depends on its cause. If your urine is concentrated, drinking more water and other fluids will relieve dehydration and stop the foaming.
Treatment for diabetes and high blood pressure
When foamy urine is caused by kidney damage, you’ll need to treat the cause. Often, diabetes and high blood pressure cause kidney disease. You can slow down the progression of kidney damage by managing these conditions well.
Your doctor will recommend that you eat a balanced diet and get plenty of exercises to help treat diabetes. You’ll have to test your blood sugar often to make sure it’s staying within a healthy range.
High blood sugar can damage your kidneys. You might also need to take medicine that lowers your blood sugar.
For high blood pressure, you’ll also want to watch your diet and stay active. Limiting the salt and protein in your diet can both bring down blood pressure and prevent your kidneys from having to work so hard.
Your doctor can prescribe calcium channel blockers, diuretics, or other drugs that lower blood pressure. Angiotensin-converting enzyme inhibitors and angiotensin receptor blockers are two drugs that lower blood pressure and protect the kidneys from additional damage.
Treatment for retrograde ejaculation
Retrograde ejaculation doesn’t need to be treated unless you want to father a child or the dry orgasms bother you. Your doctor can treat this condition with drugs that are approved for use for other conditions but that also close the bladder neck so that semen can’t get inside your bladder.
Off-label use of the following drugs can help treat this condition:
- brompheniramine
- chlorpheniramine (Chlor-Trimeton Allergy 12 Hour, Chlorphen SR)
- ephedrine
- imipramine (Tofranil)
- phenylephrine (4-Way Nasal, Neo-Synephrine, Neo-Synephrine Mild, Neo-Synephrine Extra Strength)
- pseudoephedrine (Sudafed Congestion, Nexafed, Zephrex-D)
“Off-label drug use” means that a drug that’s been approved by the FDA for one purpose is used for a different purpose that hasn’t been approved. However, a doctor can still use the drug for that purpose.
This is because the FDA regulates the testing and approval of drugs, but not how doctors use drugs to treat their patients. So, your doctor can prescribe a drug however they think it is best for your care.
What’s the outlook?
Foamy urine may not be a problem if it happens every once in a while. If it continues, it could be a sign that you have kidney damage. Usually, this symptom appears late in kidney disease, so immediate treatment is important.
Less often, it could be a sign of retrograde ejaculation if you’re a male, or it could be an effect of a drug you’re taking. Treating the condition or stopping the drug that’s causing it should stop the foaming.
Most of the time, foamy urine is nothing to worry about. Often, you can relieve foamy urine simply by drinking more water.
But see your doctor if:
- the foamy urine doesn’t go away within a few days
- you also have symptoms like swelling, nausea, vomiting, appetite loss, and fatigue
- your urine is also cloudy or bloody
- if you’re a male, your orgasms produce little to no fluid or you’ve been trying to get your female partner pregnant for a year or longer without success
