Frequent Urination: When Is It Too Much?
When it comes to using the bathroom, how often is too often? Urination frequency (how often you need to urinate) can change over time as you age or develop new habits. However, in some cases frequent urination may be a sign of underlying disease. If you notice these types of changes in your bathroom use, it is a good idea to talk to your physician and help determine the next best steps for you and your health.
What Is Frequent Urination?
Some studies have found that healthy adults need to urinate an average of about 6 times per day. However, this number varies quite a bit from person to person. Some people without any health problems may urinate as few as 4 times per day, while others may need to go as many as 10 times per day.
Frequent urination means that you need to urinate more often than is usual for you. The number of times that you would consider frequent may be different than what would be frequent for someone else.
When frequent urination happens at night, we call this “nocturia” in medical terminology. Most people can make it through 6 to 8 hours of sleeping without waking up to use the bathroom. When a person has nocturia, he or she wakes up multiple times during the night. Obviously, this can get in the way of normal sleep rhythms, and can cause this person to feel tired the next day and to possibly develop additional health problems.
Frequent urination is related to another symptom called urgent urination. People who experience urinary urgency feel the need to use the bathroom right away. Another similar symptom is urinary incontinence, in which urine leaks out unexpectedly and can be due to several different causes and, as such, is termed differently depending on the cause and type of incontinence. Different health conditions may cause one, some, or all of these urinary symptoms.
What Can Cause Frequent Urination?
In some cases, frequent urination is not a health concern. It may come as the result of aging, changes in drinking habits, physical fitness, and also medication.
Other times, frequent urination can be a signal of a new illness. These illnesses may affect the different organs and tissues of the urinary system, including:
- Kidneys: Bean-shaped organs that filter waste products from the blood and make urine
- Ureters: Tubes that connect the kidneys to the bladder
- Bladder: The organ that stores urine until it can be released
- Urethra: The tube that carries urine from the bladder to the outside of the body
Many of the conditions that lead to urination changes can affect anyone, regardless of gender or age. However, certain conditions can be more likely to affect specific groups of people. Prostate problems are more likely to affect men. Women may experience frequent urination as a result of pregnancy or vaginitis, which is an infection in the vaginal area due to several different possible causes. Please talk with your physician if you are concerned about any of these health conditions.
Drinking Too Many Fluids
When you drink more liquids than normal, you will need to urinate more. In general, it is important to drink enough water to stay healthy. However, drinking less water before bedtime may help you avoid needing to wake up to urinate.
There may be reasons why you feel like you need to drink more than usual. You may feel the need to drink more fluids when you eat spicy or salty foods or when you are feeling warm. In some cases, feeling extra thirsty can be a sign of another underlying health condition, such as diabetes, heart disease, or liver or kidney failure.
Increase in Caffeine Consumption
Caffeine can act as a diuretic — a substance that makes the body produce more urine and removes sodium from the body. Caffeine has this effect because it makes the kidneys put more sodium into the urine. The process of osmosis then causes more fluid from the body to enter into the urine to balance out the sodium levels.
Some research has shown that caffeine may increase the risk of urinary frequency and urgency. However, other research has found that people only experience urinary differences when they drink large amounts of caffeine — considered to be around 2 to 3 cups of coffee, or 5 to 8 cups of tea.
Does this mean your morning coffee habit is to blame for your frequent urination? Not necessarily, because when you drink caffeine regularly, you become tolerant to its effects. Reaching for a cup or two every morning probably won’t cause frequent urination. However, if you have recently started drinking more coffee, tea, soda, or energy drinks, they may be to blame. Cutting back on caffeine could make you urinate less often, which will, in turn, reduce some dehydration that you might be experiencing.
Drinking Too Much Alcohol
Alcohol can also act as a diuretic. It prevents the body from making vasopressin, a hormone that helps the body conserve water. Drinking alcohol lowers vasopressin levels and boosts urine levels.
Drinking alcohol-containing drinks can make the body produce more urine compared to drinking the same amount of an alcohol-free drink. In some cases, people who drink alcohol regularly are more at risk for frequent or urgent urination.
Healthy adults tend to need to urinate more the older they get. This is because the kidneys and bladder undergo changes with age. The kidneys shrink, making it harder for them to properly filter the blood. The bladder becomes stiffer, making it unable to hold large amounts of urine.
Adopting healthy habits may help prevent certain urinary problems. Things that may keep your urinary system in good health include:
- Getting physical activity
- Limiting how much alcohol you drink
- Quitting smoking
- Properly managing other health problems
- Avoiding foods that are spicy, acidic, or contain artificial sweeteners
Aging-related changes happen very slowly, over a long time. Sudden changes may be a sign of underlying disease. Aging can also increase the risk of kidney disease, bladder problems, and UTIs.
Urinary Tract Infection
Urinary tract infections (UTIs) are the most common health condition that leads to frequent urination. UTIs develop when bacteria start growing within the urinary organs. UTIs can infect any part of the urinary system but are most likely to affect the bladder.
UTIs also cause other symptoms, including:
- Pain or a burning sensation while urinating
- Blood in the urine
- Pain or discomfort in the abdomen, lower back, or sides of your back
- Fever or chills
- Nausea or vomiting
- Urinary incontinence
- Confusion, or altered mental status, especially in the elderly
If you think you may have a UTI, talk to your physician. These infections can often be cleared by taking antibiotics.
Other Bladder Problems
In addition to bladder infections, other bladder problems can also lead to frequent urination. Interstitial cystitis is a chronic condition that causes discomfort, pressure, or pain in the bladder or surrounding tissues. It is much more likely to affect women than men. Doctors don’t understand what causes interstitial cystitis, and there is no cure. However, medications, changes to the diet, and physical therapy can help manage the condition.
Overactive bladder syndrome (OAB) is a condition that affects as many as 16.5% of people. Older adults are most likely to develop OAB. This condition always causes urinary urgency, and often leads to frequent urination, especially at night. Medications, healthy lifestyle changes, and pelvic floor exercises may help treat OAB.
Bladder stones are small, hard lumps in the bladder. They can cause a variety of urinary symptoms, including frequent urination, pain while urinating, blood in the urine, or feeling like you haven’t passed all of your urine. Sometimes, medication can help dissolve bladder stones. In other cases, surgery may be needed.
Another potential problem is bladder cancer, which can also lead to frequent urination. However, this condition is rare. Frequent urination is most likely caused by other factors.
Chronic kidney disease develops when the kidneys become too damaged to work properly. In addition to frequent urination, kidney disease can cause swelling, fatigue, headaches, chest pain, itching, muscle cramps, nausea or vomiting, or weight loss. If kidney disease is left untreated, it can lead to kidney failure, in which the kidneys completely shut down.
Feeling very thirsty and needing to urinate more often are some common signs of diabetes. For people with diabetes, the body can’t properly control blood sugar levels. Diabetes can also lead to other symptoms like increased appetite, fatigue, blurry vision, dry skin, infections, and numbness or tingling in the hands or feet. Diabetes can be managed with diet changes, physical activity, or medication.
Nerves control the urinary system by connecting different organs and tissues to the brain. When these nerves are damaged, it may be harder to control the bladder. Nerve damage may develop as a result of infections, injuries, diabetes, a stroke, multiple sclerosis, or childbirth. You may be able to manage nerve-related bladder problems by establishing a routine or schedule, i.e. going to the bathroom at the same time each day, doing pelvic floor exercises, undergoing electrical stimulation treatments, or taking medications.
Men have a small gland called the prostate located near the bladder. The prostate’s job is to make semen. As men age, the prostate gets bigger. This is called an enlarged prostate or benign prostatic hyperplasia (BPH). BPH can cause several urination changes, such as:
- Frequent urination
- Urgent urination
- Needing to strain to start urinating
- Urine coming out slowly
- Urine stream stopping or starting several times
- Feeling like there is still urine left in the bladder
BPH doesn’t always need treatment. However, sometimes it does need treatment so it is always crucial to obtain the right testing for an accurate diagnosis. Please talk to your physician if you are experiencing any of the symptoms mentioned above. If symptoms start interfering with daily life, medication or surgery can help.
Prostatitis, or inflammation of the prostate, affects half of all men at some point over the course of their life. Prostatitis can lead to urinary changes, fever, sexual problems, or pain in the abdomen, pelvis, or back. Antibiotics can usually help treat prostatitis.
Another potential prostate problem is prostate cancer. Many older men have this cancer, although it often grows so slowly that it never causes symptoms. Prostate cancer generally leads to the same symptoms that are seen in other types of prostate conditions. Your doctor can use several tests to measure your prostate health and identify any problems.
More than three out of four women experience frequent urination during pregnancy. Nocturia, urgent urination, and incontinence are also common. These symtpoms become more common in the third trimester, when the enlarged uterus presses against the bladder, leaving less room to store urine.
Vaginitis can be either an infection of the vagina or irritation of the vagina. There are a few different types of vaginal infections. Bacterial vaginosis is caused by bacteria, yeast infections are caused by fungus, and trichomoniasis is a sexually transmitted infection caused by a parasite. Vaginitis also has other causes besides infection, such as an allergy or hormonal changes.
Vaginal infections can cause white or gray vaginal discharge, odor, itching, redness, and pain. Infections can be treated with either antibiotics or anti-fungal medication. If vaginitis is caused by an allergy or sensitivity, it is important to figure out the source of the irritation so that you can avoid it. Irritants may include sprays, soaps, detergents, douches, or fabric softeners.
Certain medications can lead to frequent urination as a side effect. In particular, diuretics or water pills are used to help the body get rid of extra fluid. They may be taken for many different conditions, including heart failure, high blood pressure, and certain liver and kidney problems. If you have noticed that you are urinating more often after changing medications, ask your doctor or pharmacist whether frequent urination may be a possible side effect.
If you have previously had cancer, some of your treatments may have left you with urinary problems. Surgery on the prostate, uterus, or other pelvic organs may lead to UTIs or to accidental damage to the organs of the urinary system. Chemotherapy and radiation therapy can irritate or damage the kidneys, bladder, or urinary tract. Urinary symptoms may appear during these treatments, but they may go away once the treatments are finished.
If you have a condition that prevents you from getting a good night’s sleep, you may end up waking up more often to use the bathroom. For example, people with a sleep condition called sleep-disordered breathing (SDB) usually use the bathroom many times each night.
Mental Health Disorders
Scientists have found a link between overactive bladder symptoms and anxiety. Nearly half of people with OAB have anxiety. Depression may also be a risk factor for urinary symptoms. Treating mental health conditions may help improve bladder problems.
Tumors or Growths
When tumors begin growing in the pelvis, they may affect surrounding organs including the bladder. In some cases, this may lead to frequent urination. However, this is a rare cause of urination changes.
When Should You See a Doctor?
In some cases, frequent urination may be completely normal. However, you should let your doctor know anytime you notice that something feels different from how it used to, or if there’s no clear cause (for example, you haven’t been drinking more liquids than usual). Many causes of frequent urination can be easily managed or treated.
If frequent urination appears alongside certain other symptoms, it may be a sign of something more urgent. Talk to your physician right away if you experience:
- Fever or chills
- Pain in your back or side
- Increased appetite or thirst
- Sudden weight loss
- Urine that is bloody or cloudy
- Discharge from the vagina or penis
The exact treatments for frequent urination depend on the cause. Most underlying health conditions that cause urinary changes can be managed. Work with your physician to determine what may be causing your frequent urination and to come up with a treatment plan that works for you.