What is a typical initial management for exercise-induced hematuria?

• A. Decrease intensity/frequency of exercise
• B. Fluids
• C. Stop exercising completely
• D. Increase intensity

Answer: (A)

Exercise-induced hematuria typically stems from transient irritation and microtrauma to the urinary tract when activities involve repetitive, high-impact motion. The best initial step is to reduce the training load—lower the intensity or frequency of exercise—so the urinary tract isn’t subjected to the same mechanical stress, allowing the mucosa to heal and the bleeding to resolve. Hydration helps support normal urine flow and can lessen irritation, but simply increasing fluids doesn’t address the underlying mechanical cause. Stopping exercise completely is usually unnecessary unless symptoms persist or recur, and increasing intensity would likely worsen the bleeding. If bleeding continues after a period of rest and reduced activity, or if there are other concerning symptoms, further medical evaluation is warranted.