What Causes Frequent Urination?

Frequent urination is often caused by drinking lots of liquids, especially caffeine or alcohol. However, if your frequent urination isn’t related to fluid intake, it may be due to an underlying medical condition.

The most likely reasons for frequent voiding are urinary tract infections (UTI) and medication side effects. A persistent urge to urinate, though, could indicate a chronic condition like diabetes or interstitial cystitis.

This article discusses frequent urination. It explains common reasons why you may feel the urge to pee more often and when to see your healthcare provider about a persistent urge to urinate.

Frequent Urination Symptoms

The obvious symptom of frequent urination is just that—needing to urinate more often than usual. It might happen during the day or more at night, a condition called nocturia.

Symptoms can include the following:

• Having to go to the bathroom more than eight times in 24 hours
• Waking up more than once in the middle of the night to go to the bathroom
• Having the urge to urinate frequently even when you don’t have to go
• Feeling like you need to urinate even if you just went to the bathroom

Causes of Frequent Urination

Your healthcare provider will review your symptoms when determining the likely cause of your urinary frequency. Some of these causes include:

• Aging: Bladder capacity decreases as we get older. Many older adults also experience an increase in bladder contractions, a slower urinary flow rate, or decreased pressure in the urethra. As a result, the bladder does not fully empty, leading to more frequent trips to the bathroom. 
• Bladder cancer: Bladder cancer is a rare cause of frequent urination. It is often accompanied by the frequent need to urinate and blood in the urine (microscopic or gross hematuria, which is visible in urine). While typically there is no pain, sometimes there can be pain with urinating.
• Diabetes (type 1 and type 2): Frequent urination can be one of the signs of diabetes. Diabetes causes an increase in urine as the body works to rid itself of extra glucose.
• Diuretics: These medications are used to treat high blood pressure or the excessive accumulation of fluids in tissue. They can cause an increase in urination.
• Interstitial cystitis (IC): This chronic bladder condition can lead to bladder pressure, pain, and the urge to urinate frequently. With IC, you may experience pain without urgency and frequency, or you might have frequency and urgency without pain.
• Neurological diseases: Conditions like a stroke or Parkinson’s disease can damage the nerves that control the bladder's filling or emptying. This can lead to bladder problems, including the constant urge to urinate.
• Overactive bladder: Having an overactive bladder means that you experience the frequent and urgent need to urinate, even when your bladder isn’t full. Overactive bladder may or may not include urinary leakage, also called incontinence. It may be caused by nerve problems, but often the cause is unknown.
• Pelvic organ prolapse: Frequent urination can be a sign of pelvic organ prolapse. When the muscles and tissues supporting the uterus, bladder, or rectum become weak or loose, the organs can drop from their normal position.
• Pregnancy: When you’re pregnant, it can increase the need to urinate because of hormones and the pressure of the baby against the bladder.
• Prostate disease: Prostate conditions, including benign prostatic hyperplasia (enlarged prostate), cancer, and prostatitis (inflammation of the prostate gland) can impede the 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.
• Radiation therapy: One of the side effects of radiation to the pelvis is urinary frequency. The radiation can irritate the bladder and urinary tract, causing bladder spasms and an urgent need to go to the bathroom.
• Urinary tract infection (UTI): If you have a urinary tract infection, it can cause an urgent need to urinate frequently even after you already emptied your bladder. Symptoms may also include pain with urination, low-grade fever, and cloudy or bloody urine. UTIs are much more common in women than in men. 

When to See a Healthcare Provider

Frequent urination on its own is not usually a problem, but if it is disrupting your sleep or ability to function or accompanied by other symptoms, talk to your healthcare provider.

See your healthcare provider promptly if you experience any of the following symptoms:

• Back or side pain
• Burning during or after voiding
• Bloody or cloudy urine
• Fatigue
• Fever with or without chills
• Incontinence
• Increased appetite or thirst
• Sudden weight loss
• Vomiting
  

Diagnosis

Frequent urination can be a symptom of many different conditions. Your healthcare provider 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.

Your healthcare provider will also likely ask for a urine sample to check for bacteria (urine culture) or white blood cells (urinalysis) that could indicate an infection. If red blood cells are confirmed (three or more), urine cytology will be ordered. Other possible tests include:

• Urodynamics: This tests how the muscles of your bladder are working.
• Cystoscopy: A camera looks inside your bladder.
• Ultrasound or CT scan: These tests look for any cancer or structural abnormality.
  

Treating Frequent Urination

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.

Overactive Bladder Treatments

If the condition is diagnosed as overactive bladder, treatment may include:

• Diet modification, including reducing or eliminating caffeine and alcohol intake
• Kegel exercises to build up strength in the pelvic floor
• Monitoring fluid intake
• Behavioral therapies such as bladder training

It may also include anticholinergic medications, such as Oxytrol (oxybutynin) or a beta-3 adrenergic receptor agonist medication—such as Myrbetriq (mirabegron) or Gemtesa (vibegron)—botox injection, or other procedures to modulate the sacral nerves or other nerves.

Bladder training entails keeping to a strict urination schedule and increasing the time between when you empty your bladder. The aim is to increase the amount of time between urinating and how much liquid your bladder can hold. Your healthcare provider may also prescribe a medicine that calms the muscles and nerves.

Interstitial Cystitis Treatments

Interstitial cystitis doesn’t have a cure, but some treatments may ease your symptoms. These can include:

• Bladder distention (stretching) under anesthesia
• Oral medication
• Bladder training
• Diet and lifestyle changes

There are some causes of nighttime urination that can be controlled. The best thing you can do is to reduce how much you drink at night. This is especially true in the four to six hours before bedtime.

Summary

Frequent urination can be annoying and embarrassing. But more than that, it may be a sign of infection or disease.

Call your healthcare provider if you're urinating more than usual. They'll talk with you about any recent changes to your fluid intake, do an exam, and potentially order some tests to find out the underlying cause of your frequent urination.

Some treatments can help, but the treatment will depend on the underlying cause of the urinary frequency.