Frequent Urination

Medical Author: John P. Cunha, DO, FACOEP

| Medical Editor: Jerry R. Balentine, DO, FACEP
Reviewed on 9/27/2019

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What Is Frequent Urination?

Infrequent urination may be caused by a number of different conditions

Most people typically urinate four to eight times a day. Needing to go more than eight times
a day or waking up in the night to go to the bathroom more than once in the night is
considered frequent urination. Though the bladder can often hold as much as 600 ml of
urine (about 2 ½ cups), the urge to urinate is usually felt when the bladder contains about 150
ml of urine (just over ½ cup).

There are two different ways to look at frequent urination:

either as an increase in total volume of urine produced (excessive urination, or

polyuria) or

a dysfunction in the storage and emptying of urine.

What Are Common Causes of Frequent Urination?

The many causes of frequent urination include prostate problems, diabetes, and pregnancy.

Urinary tract infection (UTI) or bladder infection: The lining of the urethra (the
tube that carries urine from the bladder out of the body) and bladder becomes

inflamed and irritated due to byproducts of an infection (blood, white blood cells,
bacteria). This irritation of the bladder wall causes the urge to empty the bladder

frequently (called frequency). The amount of urine during each emptying is often

smaller than a usual amount.

Diabetes mellitus and diabetes insipidus: An early symptom of both type 1 and

type 2 diabetes can be frequent urination, as the body tries to rid itself of unused
glucose (blood sugar) through the urine. Diabetes can also damage the nerves that

control the bladder, causing frequent urination and difficulty controlling your bladder

Diuretic use: Medications used to treat high blood pressure or fluid buildup work in

the kidney and flush excess fluid from the body, causing frequent urination.

Prostate problems: An enlarged prostate (benign prostatic hyperplasia, or BPH) can

press against the urethra and block the flow of urine, causing the bladder wall to
 become irritated. The bladder contracts even when it contains small amounts of urine,

causing more frequent urination.

Pregnancy: Hormonal changes and the growing uterus placing pressure on the

bladder cause frequent urination, even in the early weeks of gestation. The trauma
from vaginal childbirth can also cause damage to the urethra.

Stress incontinence: This condition occurs mostly in women. The involuntary release
of urine during physical activity, such as running, coughing, sneezing, and even

laughing is characteristic of stress incontinence.

Interstitial cystitis: This condition is characterized by pain in the bladder and pelvic

region, often leading to frequent urination.

Stroke or other neurological diseases: Damage to nerves that supply the bladder
can lead to problems with bladder function, including frequent and sudden urges to

urinate.

Bladder cancer: Tumors taking up space or causing bleeding in the bladder may lead

to more frequent urination.

Multiple sclerosis (MS): Bladder dysfunction, including frequent urination, can occur

in at least 80% of MS patients. MS lesions can block or disrupt transmission of nerve

signals that control the bladder and urinary sphincters.

Overactive bladder (OAB) syndrome: Often frequent urination is itself the problem.
Involuntary bladder contractions lead to frequent and often urgent urination, even if
the bladder is not full.

Drinking too much: Ingesting more fluids than your body needs can cause the body
to urinate more often.

Artificial sweeteners, alcohol, caffeine and other foods: Alcohol and caffeine can
act as diuretics, which can cause more frequent urination. Carbonated drinks, artificial

sweeteners (such as Splenda or Equal), and citrus fruits are known to irritate the

bladder, causing more frequent urination.

Other causes of frequent urination include anxiety, bladder stones or kidney stones, urethral
stricture (narrowing of the urethra), radiation exposure of the pelvis (as part of cancer
treatment), diverticulitis, and sexually transmitted infections (STIs).
What Are Signs and Symptoms of Frequent
Urination?

What Are Signs and Symptoms of Frequent Urination?

If you urinate more than eight times a day, you may have frequent urination issues.

Even though there are numerous causes for frequent urination, the symptoms are generally
the same. Below are some terms that are used to describe symptoms that may accompany
frequent urination.

Frequency: urinating more than eight times during the day or more than once
overnight

Hesitancy: incomplete evacuation of the bladder during each episode of urination.

There may be a sudden stoppage of the urine flow due to spasms in the bladder or

urethra or there may be difficulty starting the flow of urine.

Urgency: the uncomfortable feeling of pressure in the bladder that makes you feel

you have to go "right now"

Urinary incontinence: the inability to control the flow of urine, leading to either

constant or intermittent accidental leakage

Dysuria: pain or burning sensation during or immediately following urination. This may

be a sign of a urinary tract infection.

Hematuria: Blood in the urine can be small amounts, clots, or very bloody. This will

usually cause the urine to appear darker in color.

Nocturia: This is having to wake up to urinate. It can also be associated with nighttime

urinary incontinence. (In children, this includes wetting the bed.)

Pollakiuria: frequent daytime urination (often with small volumes)

Dribbling: After finishing urination, urine continues to drip or dribble out.

Straining: having to squeeze or bear down to initiate the urine stream


SLIDESHOW
 Urinary Incontinence in
Women: Types, Causes, and
Treatments for Bladder
Control

See Slideshow

When Should a Person Seek Medical Care for

Frequent Urination?

If frequent urination includes incontinence, nighttime urination (nocturia), or it otherwise

interferes with your lifestyle, consult your doctor.

Seek emergency medical care if the following symptoms or signs accompany frequent
urination:

Fever

Abdominal pain

Back or side pain

Bloody, dark, or cloudy urine

Vomiting

Chills

Increased appetite or excessive thirst

Fatigue

Discharge from the vagina or penis or painful ejaculation

What Exams and Tests Assess and Diagnose

Frequent Urination?
 What Exams and Tests Assess and Diagnose Frequent Urination?

Your doctor will ask several questions to determine the cause of your frequent urination.

Your doctor will perform a physical exam and will ask you questions about your medical
history and medications you may be taking.

Your doctor may ask the following questions:

How many times in the day and night are you urinating?

Are there changes in the color of your urine? Do you have light or dark urine?

Do you have frequent pain, discomfort or a burning sensation while urinating?

Have you made any recent dietary changes?

Do you have other symptoms (increased thirst, weight loss, fever, back pain)?

Your doctor may order any of the following tests, depending on the findings of the physical
exam and medical history.

Urinalysis and urine culture: These tests detect and measure various components

of the urine. A urine culture can detect bacteria that may be the cause of a urinary tract
infection (UTI).

Ultrasonography: This noninvasive imaging test is used to visualize your kidneys and

bladder to detect any structural abnormalities or tumors.

Cystometry: This test measures the pressure inside the bladder and checks for the

possibility of muscle or nerve problems that may cause frequent urination.

Cystoscopy: This is an invasive test that allows a doctor to look at the inside of the

bladder and urethra using a thin, lighted instrument called a cystoscope.

Neurological tests: Diagnostic tests such as urodynamics, imaging, EEG, and EMG

are procedures that help the doctor confirm or rule out the presence of a nerve

disorder.

Are There Home Remedies for Frequent Urination?

Are There Home Remedies for Frequent Urination?

You can retrain your bladder over time.

If there is no underlying medical condition that requires treatment by a physician, there are
things that can be done to reduce urinary frequency.

Bladder retraining: This treatment is helpful for overactive bladder syndrome. It

involves holding your urine for a slightly longer time than you usually do. The intervals
are lengthened, often over the course of about 12 weeks. This helps retrain the bladder

to hold urine longer and to urinate less frequently.

Kegel exercises: These are exercises in which you contract and release the pelvic

floor muscles. These are the muscles you use when you voluntarily stop and then

restart the flow of urine. Toning these muscles can help improve bladder control and

reduce urinary urgency and frequency. Squeeze for three seconds, then relax for three

seconds. Repeat 10 to 15 times per session, and do this at least three times a day.

Kegel exercises are only effective when done regularly.

Modify your diet: Avoid foods that appear to irritate your bladder or act as a diuretic,

including caffeine, alcohol, carbonated drinks, artificial sweeteners, tomato-based

products, chocolate, and spicy foods. Eat a high-fiber diet, because constipation can

worsen the symptoms of overactive bladder syndrome.

Monitor fluid intake: Drink enough to prevent constipation and over-concentration of

urine. Drink as little as possible four to five hours before bedtime to reduce or eliminate

nighttime urination.

What Are Medical Treatments for Frequent

Urination?

The treatment for frequent urination depends upon underlying cause.

Urinary tract infection: The doctor will prescribe antibiotics to treat a UTI. Drinking
plenty of fluids is recommended.

Diabetes: When blood sugar levels get very high, frequent urination is often one of
the first symptoms. Treatment for frequent urination in diabetics involves close

management of blood sugar levels.

Diuretic use: Ask your doctor if you can take your diuretics in the morning, or less

frequently. This may cause less trips to the bathroom at night (nocturia).
Prostate problems: Problems with the prostate are usually treated by a specialist

called a urologist. There are two common drug types prescribed for enlarged prostate:
5ARIs (5-alpha-reductase inhibitors), which reduce the level of the hormone that

causes the prostate to grow, and alpha blockers, which relax the smooth muscle cells,

including the bladder. Surgery may also be considered to treat prostate problems.

Pregnancy: Frequent urination often accompanies pregnancy. There may not be

much that can be done to reduce frequent urination, especially later in the pregnancy.

Reduce consumption of diuretic fluids that contain caffeine, such as tea, soda or

coffee, however, do not reduce overall fluid intake, as it is important to stay hydrated

while pregnant. Consume most fluids during the day to reduce nighttime trips to the

bathroom. When using the bathroom, it may help to lean forward slightly to help

completely empty out the bladder.

Stress incontinence: Treatment includes behavior modifications such as weight loss

and quitting smoking. Other treatment options include pelvic floor muscle exercises,

pelvic floor stimulation, biofeedback, radio frequency energy treatment, topical

estrogen, and in severe cases, surgery.

Interstitial cystitis: This condition usually requires treatment by a urologist who

specializes in interstitial cystitis. It may be treated medically with medications,

including drug pentosan polysulfate sodium (Elmiron), tricyclic antidepressants, pain

medications or antihistamines. Surgical treatment may be necessary.

Stroke or other neurological diseases: Depending upon the cause, the urinary

frequency may be treated with medication or behavioral therapy, such as bladder

retraining (see below).

Bladder cancer: Treatment for bladder cancer should be directed by a urologist. It

may involve surgery, chemotherapy and radiation.

Multiple sclerosis: Treatment for urinary frequency that accompanies MS includes

diet modifications, reducing fluid intake up to a few hours before bedtime, bladder

training or planned voiding, medications, pelvic floor physical therapy, percutaneous

tibial nerve stimulation (PTNS), intermittent self-catheterization (ISC), and other surgical

interventions.

Overactive bladder syndrome: The first-line treatment for overactive bladder

syndrome usually involves bladder retraining (see below). Treatment also may include

drugs such as tolterodine (Detrol LA), oral oxybutynin (Ditropan), darifenacin (Enablex),
transdermal oxybutynin (Oxytrol), trospium (Sanctura XR), solifenacin (VESIcare),
 mirabegron (Myrbetriq), or onabotulinumtoxinA (Botox). Treatments that involve nerve
stimulation include percutaneous tibial nerve stimulation (PTNS) and sacral nerve

stimulation (SNS).

Artificial sweeteners, alcohol, caffeine and other foods: Avoid foods and

beverages that irritate your bladder or act as a diuretic.

What Follow-up May Be Needed After Treatment of

Frequent Urination?

Continued problems with frequent urination should be evaluated by your doctor and

possibly a urologist.

If medications are recommended, follow instructions given to you by your doctor.

Report any problems or side effects from the medication to your doctor.

If you are advised to do bladder retraining or modify your diet or other behavioral

changes, follow all instructions from your doctor.

Is It Possible to Prevent Frequent Urination?

Because there are so many different causes for frequent urination, there is no one way
to prevent it.

Proper diet and avoiding excess fluids and foods that act as diuretics can reduce

urinary frequency.

Kegel exercises can keep the pelvic-floor muscles well toned and may help stave off

urinary frequency as one ages.

Discussing any concerning symptoms with your doctor as soon as they appear may

allow for early treatment or may prevent worsening of symptoms.

What Is the Prognosis of Frequent Urination?

 Many of the causes of frequent urination are temporary and treatable.

Treating the cause will reduce or eliminate the symptom of frequent urination.

For More Information on Frequent Urination

American Urological Association

1000 Corporate Boulevard

Linthicum, MD 21090

Toll Free (U.S. only): 1-866-RING AUA (1-866-746-4282)

Phone: 410-689-3700

Fax: 410-689-3800

http://www.auanet.org/

Interstitial Cystitis Association

7918 Jones Branch Drive, Suite 300

McLean, VA 22102

Phone: 703-442-2070

Fax: 703-506-3266

http://www.ichelp.org/

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Myths and Facts

About Your Bladder

Cause of Frequent Urination

Overactive Bladder
 Overactive bladder (OAB) is a bladder disorder that results in an abnormal urge to
urinate, urinary frequency, and nocturia (voiding at night). Some patients may also
experience urinary incontinence (involuntary loss of bladder control).
OAB usually caused by abnormal contractions of the muscles of the urinary bladder
(mainly detrusor muscle), resulting in a sudden, uncontrollable urge to urinate (called
urinary urgency) with or without actual leakage of urine, even thought only small
amounts of urine may be in the bladder.
The symptoms of OAB may have other causes such as urinary tract infection,
diabetes, medication use such as diuretics (water pills), prostate disease, bladder
tumors, or interstitial cystitis (causing pelvic pain, urinary frequency, and urgency).

Discover more about overactive bladder »

Reviewed on 9/27/2019

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