An Overview of Frequent Urination

Why It Happens and What You Can Do About It

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Having the constant urge to pee, even when you've just finished, is medically referred to as frequent urination or urinary frequency. Some people may specifically experience this at night, while others may have it throughout the day. While frequent urination could be the result of something as simple as a medication you're on or a urinary tract infection (UTI), it could also be a sign of condition such as diabetes.

On average, people empty their bladders anywhere from four to eight times per day. If you suddenly find that you need to go more frequently than that and have a hard time holding it, it's best to see your doctor.

Symptoms

The obvious symptom of frequent urination is just that—needing to pee more often than is typical. Frequent urination that occurs at night is called nocturia. Most people can sleep for six to eight hours without having to urinate, so if you are using the bathroom at night, this is a sign of a possible problem.

Other symptoms may accompany urinary frequency including fever, back pain, vomiting, chills, increased thirst, fatigue, changes in urine, or a discharge from the penis or vagina. Each of these can provide clues as to what may be at the root of your urination habits.

Causes

A review of symptoms can often lead a doctor to consider the most likely causes of urinary frequency. These include:

  • Urinary tract infection (UTI): This refers to an infection of the urethra, bladder, ureter, or kidneys. When it affects the lower urinary tract, a UTI can cause a person to feel like they need to pee all the time. The presence of small amounts of blood in the urine may also be an indication of this condition. UTIs are much more common in women than in men.
  • Overactive bladder: Having an overactive bladder means that you experience the frequent and urgent need to urinate. Overactive bladder may or may not include incontinence, which is urinary leakage. Involuntary bladder contractions make you feel like you have to pee even after you just went or cause you to wake up at night to urinate.
  • Diuretics: These medications are used to treat high blood pressure or the excessive accumulation of fluids in tissue. Use can cause a marked increase in urination. Caffeinated beverages, such as coffee and cola, can also have a diuretic effect.
  • Interstitial cystitis: This painful bladder condition that can lead a person to urinate as many as 60 times per day.
  • Pregnancy can increase the need to pee as the pressure of the baby against the bladder almost always increases urinary frequency.
  • Type 1 and type 2 diabetes: Both are known to cause excessive peeing as the body works to rid itself of unused glucose.
  • Neurological conditions can damage the nerves that supply the bladder, such as can happen with a stroke or Parkinson's disease. This can lead to bladder problems including the constant urge to pee.
  • Bladder cancer is often accompanied by the frequent need to urinate and the presence of blood in the urine, usually without pain.
  • Ovarian cancer is often called a "silent killer" due to a lack of symptoms in the early stages. That said, having the urge to pee and not being able to go, or urinating more often than normal, may be early signs.
  • Prostate disease—including benign prostatic hypertrophy, cancer, and prostatitis (inflammation of the prostate gland)—can impede the flow of flow of urine through the urethra (the tube that carries urine out of the body). This can lead to incomplete emptying of the bladder and urinary frequency.
  • Chemotherapy has a number of side effects, among which is the frequent urge to pee. The urine can often be cloudy, have a strong smell, or have different colors as a result of chemo medications.

Diagnosis

As you can see, the frequent urge to pee can be a symptom of many different conditions. In order to diagnose the cause in your case, your doctor will usually perform a physical exam and ask whether you are on any medications, have any symptoms of infection, or have had any change in your eating or drinking habits.

After learning more about this, your doctor will likely ask for a urine sample to check for bacteria or blood that could indicate an infection. Other possible tests include a cystometry to test how to muscles of your bladder are working, cytoscopy to look inside your bladder, or an ultrasound to look for cancers and other causes of frequent urination.

Treatment

Treating the underlying condition is usually the best way to deal with frequent urination. This may mean controlling a person's diabetes, treating a urinary tract infection with antibiotics, or undergoing cancer therapy.

If the condition is diagnosed as overactive bladder, treatment may include diet modification, Kegel exercises, monitoring fluid intake, and behavioral therapies such as bladder training and biofeedback.

Bladder training entails keeping to a strict urination schedule and increasing the time between when you empty your bladder over time. The aim is to increase both the amount of time between when you urinate and how much liquid your bladder can hold. With biofeedback, you'll learn to better control your pelvic floor muscles.

Self-treating or presuming that it's a passing infection that will "go away on its own" is never a good idea. While the condition could very well be minor, it could also be an early sign of something serious. The best advice is to get it checked early, if only for your own peace of mind.

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