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WebMD Information and Resources: “Cystoscopy.”
Frequent Urination: Causes and Treatments
Gotta go all the time? The technical name for your problem is frequent urination. In most people the bladder is able to store urine until it is convenient to go to the toilet, typically 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 could mean you’re drinking too much and/or too close to bedtime. Or it could signal a health problem.
Causes of Frequent Urination
Frequent urination can be a symptom of many different problems from kidney disease to simply drinking too much fluid. When frequent urination is accompanied by fever, an urgent need to urinate, and pain or discomfort in the abdomen, you may have a urinary tract infection. Other possible causes of frequent urination include:
Diabetes. Frequent urination with an abnormally large amount of urine is often an early symptom of both type 1 and type 2 diabetes as the body tries to rid itself of unused glucose through the urine.
Pregnancy. From the early weeks of pregnancy the growing uterus places pressure on the bladder, causing frequent urination.
Prostate problems. An enlarged prostate can press against the urethra (the tube that carries urine out the body) and block the flow of urine. This causes the bladder wall to become irritable. The bladder begins to contract even when it contains small amounts of urine, causing more frequent urination.
Interstitial cystitis. This condition of unknown cause is characterized by pain in the bladder and pelvic region. Often, symptoms include an urgent and/or frequent need to urinate.
Diuretic use. These medications that are used to treat high blood pressure or fluid buildup work in the kidney and flush excess fluid from the body, causing 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.
Hypercalcemia. It means the calcium levels in your blood are above normal. Causes include overactive parathyroid glands (hyperthyroidism or hyperparathyroidism), other illness (tuberculosis, sarcoidosis), inactivity, and even cancer (lung, breast, kidney, multiple myeloma). Besides frequent urination, symptoms of hypercalcemia may include:
- Excessive thirst
- Stomach upset
- Nausea and vomiting
- Bone and muscle pain and weakness
- Brain issues: Confusion, fatigue, and depression
- Heart issues (rare): Racing or skipping pulse (arrhythmia) and other heart problems
Diabetes insipidus. This is a rare condition that causes your body to make a lot of urine that is “insipid,” or colorless and odorless. Most people pee out 1 to 2 quarts a day.
Other causes.Less common causes include pelvic organ prolapse (in females), bladder cancer, ovarian cancer, bladder dysfunction, and radiation therapy.
Often, frequent urination is not a symptom of a problem, but is the problem. In people with overactive bladder syndrome, involuntary bladder contractions lead to frequent and often urgent urination, meaning you have to get to a bathroom right now — even if your bladder is not full. It may also lead you to wake up once or more during the night to use the bathroom.
Diagnosing the Cause of Frequent Urination
If urinary frequency interferes with your lifestyle or is accompanied by other symptoms such as fever, back or side pain, vomiting, chills, increased appetite or thirst, fatigue, bloody or cloudy urine, or a discharge from the penis or vagina, it’s important to see your doctor.
To diagnose the cause of frequent urination, your doctor will perform a physical exam and take a medical history, asking questions such as the following:
- Are you taking any medications?
- Are you experiencing other symptoms?
- Do you have the problem only during the day or also at night?
- Are you drinking more than usual?
- Is your urine darker or lighter than usual?
- Do you drink alcohol or caffeinated beverages?
Depending on the findings of the physical exam and medical history, your doctor may order tests, including:
Blood Tests. Routine blood test can check for kidney function, electrolytes, and blood sugars
Urinalysis. The microscopic examination of urine that also involves a number of tests to detect and measure various compounds that pass through the urine.
Cystometry. A test that measures the pressure inside of the bladder to see how well the bladder is working; cystometry is done to determine if a muscle or nerve problem may be causing problems with how well the bladder holds or releases urine. There’s a broader term called urodynamics that includes tests such as cystometry, uroflowmetry, urethral pressure and others.
Cystoscopy. A test that allows your doctor to look at the inside of the bladder and urethra using a thin, lighted instrument called a cystoscope. There’s a broader term called urodynamics that includes tests such as cystometry, uroflowmetry, urethral pressure and others.
Neurological Tests. Diagnostic tests and procedures that help the doctor confirm or rule out the presence of a nerve disorder.
Ultrasonography. A diagnostic imaging test using sound waves to visualize an internal body structure.
Treatment for Frequent Urination
Treatment for frequent urination will address the underlying problem that is causing it. For example, if diabetes is the cause, treatment will involve keeping blood sugar levels under control.
The treatment for overactive bladder should begin with behavioral therapies, such as:
- Bladder retraining. This involves increasing the intervals between using the bathroom over the course of about 12 weeks. This helps retrain your bladder to hold urine longer and to urinate less frequently.
- Diet modification. You should avoid any food that appears to irritate your bladder or acts as a diuretic. These may include caffeine, alcohol, carbonated drinks, tomato-based products, chocolate, artificial sweeteners, and spicy foods. It’s also important to eat high-fiber foods, because constipation may worsen the symptoms of overactive bladder syndrome.
- Monitoring fluid food intake. You should drink enough to prevent constipation and over-concentration of urine. Avoid drinking just before bedtime, which can lead to nighttime urination.
- Kegel exercises. These exercises help strengthen the muscles around the bladder and urethra to improve bladder control and reduce urinary urgency and frequency. Exercising pelvic muscles for five minutes three times a day can make a difference in bladder control.
- Biofeedback. This technique can help you learn how your pelvic muscles work to help you better control them.
Treatment may also include drugs such as darifenacin (Enablex), desmopressin acetate (Noctiva), imipramine (Tofranil), mirabegron (Myrbetriq), oxybutynin (Ditropan), oxybutynin skin patch (Oxytrol), solifenacin (Vesicare), tolterodine extended-release (Detrol LA), and trospium extended-release (Sanctura XR). Oxytrol for women is the only drug available over the counter. Darifenacin is specifically for people who wake up more than twice a night to urinate.
There are other options for those who do not respond to lifestyle changes and medication. The drug Botox can be injected into the bladder muscle causing the bladder to relax, increasing its storage capacity, and reducing episodes of leakage.
Several types of surgery are also available. The least invasive involve implanting small nerve stimulators just beneath the skin. The nerves they stimulate control the pelvic floor and the devices can manipulate contractions in the organs and muscles within the pelvic floor.
International Painful Bladder Foundation: “The Urinary Tract and How It Works.”
MedlinePlus Medical Encyclopedia: “Frequent or Urgent Urination.”
American Diabetes Association: “Dropping Insulin to Drop Pounds.”
March of Dimes: “Changes During Pregnancy”
National Institute of Diabetes and Digestive and Kidney Diseases: “Prostate Enlargement: Benign Prostatic Hyperplasia,” “Interstitial Cystitis/ Painful Bladder Syndrome.”
University of Wisconsin Hospitals and Clinics Authority: “After a Stroke, Managing Your Bladder.”
MedlinePlus Medical Encyclopedia: “Frequent or Urgent Urination,” “Urinalysis,” “Cystometry.”
WebMD Information and Resources: “Cystoscopy.”
National Institute of Neurological Disorders and Stroke: “Neurological Diagnostic Tests and Procedures.”
The American Heritage Medical Dictionary, Houghton Mifflin Company, 2007.
National Center of Biotechnology Information: “Comparing Drugs for Overactive Bladder Syndrome.”
National Association for Continence: “Overactive Bladder Syndrome.”
News release, FDA.
American Urological Association: “Diagnosis and Treatment of Overactive Bladder (Non-Neurogenic) in Adults: AUA/SUFU Guideline.”
Mayo Clinic: “Overactive Bladder,” “Hypercalcemia.’
UpToDate: “Hypercalcemia of malignancy: Mechanisms.”
Why Are You Peeing Too Much?
If you ever ask yourself why am I peeing so much you may have problems with frequent urination, which is the urge to pee at any time, day or night. Your bladder will usually feel full and you may feel a strong urge to pee, which can cause you to lose control of your bladder. Frequent urination is also called overactive bladder and many people suffer from this condition. The key to treating an overactive bladder is addressing the underlying cause.
The Causes of Frequent Urination
It is normal to need to urinate frequently if you are drinking large amounts of fluids like water, alcoholic or caffeinated beverages or taking diuretics, which are medications designed to remove fluid from the body. Consuming some foods, such as chocolate, spicy food and drinking protein shakes may also trigger the need to urinate.
However, if don’t drink an excessive amount of fluids or take diuretics and you are still peeing eight times a day or more or waking up in the middle of the night needing to relieve yourself, then you may gave a condition known as polyuria. People who have this condition may produce an excessive amount of urine, at least 2.5 liters in a 24 hour period.
Polyuria can be caused by:
- Pregnancy – the growing uterus puts pressure on the bladder resulting in frequent urination.
- Diabetes – polyuria is often an early symptom of Type 1 and Type 2 diabetes as the body tries to get rid of unused glucose through the urine.
- Medical Conditions – polyuria is a symptom of several medical conditions like chronic diarrhea sickle cell anemia, urinary tract infections and interstitial cystitis. Less common causes of polyuria include a dysfunctional bladder or bladder cancer, liver failure, and cushing’s syndrome (high levels of the cortisol in the body which can sometimes lead to diabetes).
A Closer Look at Some of the Causes
If you ever wonder ‘why am I peeing so much?’, you may have one of these conditions and knowing the additional symptoms can help you identify the potential cause of your frequent urination.
1. Urinary Tract Infection – UTI
UTIs can develop anywhere in the urinary tract, from the kidneys to the bladder, but they usually develop in the bladder and urethra. They are caused by bacteria and women get them more often than men because their urethra is shorter, which easily exposes the bladder to bacteria. The main symptoms of a UTI is the need to urinate more frequently, burning or pain while urinating, urine that has a strong or foul odor and lower abdominal pain. If not treated right away, a UTI can worsen and you may experience a fever and chills, nausea and urinary incontinence.
People who have either Type 1 or Type 2 diabetes often have issues with frequent urination. Polyuria is one of the main symptoms of the disease. The kidneys are responsible for filtering the blood to make urine and when you have diabetes, the amount of sugar in your body is abnormally high, which is hard to completely filter out of the bloodstream.
When the kidneys try to filter your blood, they reabsorb some sugar, but they cannot reabsorb all of it and the unused sugar ends up in your urine. This causes it to draw water and produces large volumes of urine. Another symptom of diabetes is being frequently thirsty, which will add more fluid to your system as you try to satisfy your thirst.
3. Kidney Failure
The kidneys are the organs that filter waste products from the blood and help to remove them from the body through urination. The need to frequently urinate can be a symptom of kidney failure, but initially, kidney failure doesn’t have any symptoms. When kidneys start failing, they cannot filter waste products effectively and the buildup of waste products in the blood causes other symptoms like lethargy, weakness, shortness of breath and confusion.
There are many causes of kidney failure, but it can usually be successfully treated if caught early enough. However, if they fail altogether, you may need to be placed on dialysis or have a kidney transplant.
4. Sickle Cell Anemia
Sickle cell anemia is an inherited form of anemia that prevents the formation of healthy red blood cells. Since red blood cells help carry oxygen throughout the body, people with sickle cell anemia do not get enough oxygen because their red blood cells are not healthy enough to adequately supply it.
The red blood cells in those with this disease are crescent moon shaped or “S” shaped and sticky, which often leads them to getting stuck in smaller blood vessels. This will block the flow of blood and oxygen to the rest of the body. Symptoms of sickle cell anemia include:
- Pain episodes
- Bacterial Infections, including UTIs
- Leg ulcers
- Eye damage
- Liver congestion
One of the complications of this condition is frequent urination because it can cause kidney problems.
When to Contact a Doctor
If you are wondering ‘why am I peeing so much?’ and it has lasted for several days with no known explanation, you should make an appointment to see your doctor. Excessive urination can lead to dehydration, which can further complicate any condition causing your frequent urination. If you are concerned about how much you urinate, you can monitor it by recording how much fluid you are drinking, how often you are urinating and how much urine you are producing, and by weighing yourself every day.
What Can You Do By Yourself to Prevent Frequent Urination?
If there is no medical condition causing you to question why am I peeing so much?, you can help prevent episodes of frequent urination by limiting the amount of alcohol and caffeine you drink, maintaining a healthy diet and, if you smoke, quitting the habit. In addition, include plenty of fiber in your diet as being constipated can increase the pressure on your bladder causing you to urinate more. Also, learn Kegel exercises to help strengthen your pelvic floor.