The symptoms of female bladder cancer are often overlooked or misdiagnosed. It’s important to consult a healthcare professional as soon as you notice unexpected changes to vaginal bleeding or other unusual symptoms.

The American Cancer Society estimates that new cases of bladder cancer will affect around 62,420 men and 19,870 women in 2023.

Because female bladder cancer is less common, it’s possible to miss the early signs. This often results in a late diagnosis of bladder cancer when survival is less likely.

According to 2019 research, females with bladder cancer tend to have more aggressive tumors and poorer outcomes than their male counterparts.

As with many types of cancer, an early diagnosis is key to improving your outlook. This can entail knowing which symptoms to look for.

Read on to learn more about the symptoms of bladder cancer and when to see a healthcare professional.

Unlike breast cancer, there’s no standard screening test for bladder cancer. For that reason, it’s especially important to know the early symptoms of this condition and to bring them to a healthcare professional’s attention.

Blood in your urine (hematuria)

Blood in your urine (hematuria) is the most common symptom of female bladder cancer. But it can also be a symptom of other conditions, such as urinary tract infections (UTIs).

Hematuria may also result from sexual activity, especially if you have vaginal dryness. If you haven’t gone through menopause, you may assume that blood in your urine is because of your period or breakthrough bleeding.

No matter what you think may be causing blood in your urine, don’t overlook this symptom.

According to 2016 research, clinicians are more likely to diagnose females with hematuria with a UTI. This means clinicians are less likely to refer females to a urologist or another specialist who can test for bladder cancer.

If you see blood in your urine consistently or often, be sure to take it seriously. Let a healthcare professional know about your concerns and advocate for yourself.

Blood may make your urine look red, pink, or brown. You may also see spots of blood on toilet paper after wiping. However, microscopic amounts of blood may not always be visible.

If you’re at higher risk of bladder cancer, talk with a doctor about getting regular urine tests as a failsafe.

Pain or discomfort during urination

Painful urination (dysuria) or trouble urinating can be early symptoms of bladder cancer. You may also have a burning or irritating sensation when you urinate.

As with hematuria, these symptoms are more likely caused by other conditions, including bladder infections.

Urgent or frequent urination

In addition to unusual sensations during urination, you may find that your urinary habits have changed.

Having to urinate more often can be an early symptom of bladder cancer. Sometimes, the need to go to the bathroom may wake you up several times a night.

You may also feel an urgency to go, even if your bladder isn’t full. Difficulty with urination or having a weak urine stream may also occur.

Undiagnosed and untreated bladder cancer may advance, causing additional symptoms. Many of these result from the original tumor getting larger.

As bladder cancer progresses, it penetrates the bladder lining and the surrounding layers of muscle and tissue. If the cancer continues metastasizing (spread), it may cause symptoms in nearby or faraway organs and tissues.

Localized pain

Pain in the pelvis, lower back, or flank can result from a growing tumor that puts pressure on your bladder or nearby internal organs.

If the tumor becomes large enough to block a ureter, you may experience lower back or flank pain on one side. Flanks extend from your upper abdomen to your back along both sides of the body. The ureters connect your kidneys to your bladder.

With this type of pain, you may also have trouble voiding urine.

Pain in other areas of your body

Advanced bladder cancer may spread to these areas of the body:

  • bones
  • lymph nodes
  • liver
  • lungs
  • peritoneum (inner lining of the abdomen)

As cancer metastasizes, it may infiltrate bones throughout your body. This can result in bone pain or tenderness at night or during activity. Your bones may also be more susceptible to breakage.

Cancer that has spread to your lungs may cause chest pain. It may also make it hard for you to breathe, cause a chronic cough, or cause your voice to sound different.

Cancer that has spread to your abdomen or liver may cause stomach pain.

Swollen feet (edema)

If bladder cancer spreads to the lymph nodes, your lower extremities may become swollen. Your lymph nodes help flush fluids out of the body. If the lymph nodes become swollen, fluids build up and become trapped in tissues.

In addition to swollen feet, cancer in the lymph nodes may sometimes cause night sweats.

Generalized symptoms

As bladder cancer progresses, you may experience overall symptoms that include:

Am I at risk of bladder cancer?

Female bladder cancer is less common than male bladder cancer. Still, certain factors may put you at higher risk. This includes:

  • being over 55
  • smoking cigarettes
  • history of chronic UTIs
  • family history of bladder cancer
  • prior diagnosis of bladder cancer
  • exposure to arsenic in drinking water
  • exposure to chemicals such as aromatic amines and polyaromatic hydrocarbons (commonly found in factories and plants that process plastic, sheet metal, and chemicals)
  • prior infection from parasitic worms (less common in the United States than in Africa and the Middle East)

Some research also suggests that hormones may play a role. People who had their first period after age 15, used hormone therapy, or were previously pregnant have a lower risk of female bladder cancer.

It’s important to be proactive if you have early signs and symptoms of this disease. An early diagnosis can greatly improve your outlook.

Because female bladder cancer is less common, a healthcare professional may take a conservative approach. In many instances, bladder cancer symptoms in people with female anatomy do turn out to be other conditions. Still, you may prefer to be cautious.

If you’re uncomfortable with the advice you get from a clinician, consider getting a second opinion. This may be especially important if you have risk factors for bladder cancer.

How long can you have bladder cancer and not know?

From when cell changes begin to when a tumor starts to cause symptoms, it can take months or years, depending on the cancer and how fast it grows.

However, 84% of cases are diagnosed before cancer has spread beyond the bladder, according to the National Cancer Institute.

What are the five warning signs of bladder cancer?

The five primary warning signs or symptoms of bladder cancer are:

  • blood in your urine
  • a frequent need to urinate
  • a painful or burning feeling during urination
  • feeling as if you need to urinate even if your bladder isn’t full
  • back pain

What are the first signs of female bladder cancer?

The first signs of female bladder cancer are similar to those of male bladder cancer, including blood in the urine and other urinary changes.

However, people who menstruate often ignore blood in their urine because they associate it with menstrual bleeding or postmenopausal spotting.

In addition, other common symptoms of bladder cancer, such as a frequent need to urinate or painful urination, may be misdiagnosed as a urinary tract infection.

If symptoms of a bladder infection do not disappear after a course of antibiotics, be sure to return to your doctor for further evaluation.

The most common early symptoms of bladder cancer are blood in your urine and changes to urinary habits. If you experience these with pain or swelling in other parts of your body, it may suggest more advanced cancer.

If you have these or other symptoms, let a healthcare professional know immediately. Bladder cancer is treatable. When caught early, it’s often curable.