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Liver disease can result in a distinct, musty urine odor due to the accumulation of certain waste products that the liver typically processes. Symptoms of liver disease can include jaundice (yellowing of the skin and eyes), fatigue, and abdominal pain. If you suspect liver issues, seek medical evaluation for appropriate tests and treatment.

Some medications can alter the smell of your urine. Antibiotics, vitamins (especially B vitamins), and certain chemotherapy drugs are known culprits. If you start a new medication and notice a change in urine odor, consult with your healthcare provider to ensure this side effect is expected and not harmful.

Metabolic disorders like maple syrup urine disease or trimethylaminuria can lead to distinct urine odors due to the body’s inability to break down certain compounds. These conditions are often diagnosed in infancy but can persist into adulthood. Management typically involves dietary changes and other medical interventions.

Bacterial vaginosis (BV) can cause a fishy urine odor due to an imbalance in vaginal bacteria. This condition is more common in women of reproductive age and can also cause vaginal discharge and itching. Treatment usually involves antibiotics prescribed by a healthcare provider.