Frequent Urination: Causes, Treatment, & More

Courtney Battaglia, RN
·9 min read

Medically reviewed by Alexandra Dubinskaya, MD

Frequent urination is when you feel the need to urinate multiple times during the day and/or night. Frequent urination can occur with excessive urination, but it doesn't need to. Urinary frequency is often a symptom of a condition of the lower genitourinary tract, such as the kidneys, ureters, bladder urethra, and other organs.

Frequent and excessive urination can happen together but don't necessarily mean the same thing. Frequent urination means you need to urinate more often than usual and excessive urination is when you have an increase in the volume of urine, known as polyuria. The need to urinate frequently can be a bothersome but generally unconcerning symptom, but it is important to discuss it with your healthcare provider because some conditions that cause frequent urination can be serious.

Symptoms

Urination is usually triggered when about one cup of urine is in the bladder, although most people's bladders can hold more than two cups of urine. The typical person urinates about four to six times a day while awake. Those who experience frequent urination will have to go more than that, and they may also experience a frequent need to urinate at night, known as nocturia.

If you are experiencing frequent urination, you may feel as if your bladder is not fully emptied after urinating. You may even attempt to urinate again but not have any output. Urge incontinence may also occur, which is an intense, sudden urge to urinate, causing pain in the bladder and making it difficult to postpone using the restroom. Urge incontinence can cause your bladder to spasm, leaking a small amount of urine.

Causes

As people age, the bladder loses its elasticity (ability to stretch) and can't hold as much urine. Pelvic floor muscles can weaken due to aging, childbirth, and hormonal changes, making it harder to empty the bladder completely. Medications such as diuretics can contribute to frequent urination.

Around the third trimester of pregnancy, it's common to experience frequent urination as the uterus grows and presses on the bladder.

Certain beverages such as caffeine or alcohol can have a diuretic effect. This increases the need to urinate.

Frequent urination can happen for many reasons; most cases are minor and fixable, but some can be a warning sign of a medical condition such as a urinary tract infection, urinary calculi, benign prostate hyperplasia, or overactive bladder syndrome.

Urinary Tract Infection

Urinary tract infections (UTIs) are infections of the urinary tract (where urine exits the body) usually caused by bacteria. UTIs can happen in the bladder, kidneys, ureters, or urethra. In addition to urinary frequency, people experiencing a UTI may also have:

  • Cloudy, bloody, or foul-smelling urine

  • Low-grade fever

  • Pain when urinating

  • Pressure or pain felt in the lower back or abdomen

Urinary Caliculi

Stones, or calculi, are hard masses that form in the kidney and can pass through to the ureter or bladder. When the stone forms, it can cause pain, bleeding, infection, and block urine flow. The stones form when there is too much salt in the urine or not enough inhibitors (such as citrate) to stop stones from forming.

When the stones are small, they usually do not cause any symptoms. Larger stones can cause symptoms such as:

  • Nausea and vomiting

  • Sweating

  • Bloody urine

  • Chills

  • Fever

  • Burning with urination

  • Cloudy, foul-smelling urine

Benign Prostate Hyperplasia

Benign prostate hyperplasia (BPH) is an enlargement of the prostate gland in people assigned male at birth. The prostate gland is underneath the bladder, and it surrounds the urethra. Its size starts roughly as big as a walnut in young men but gets larger with age. As the prostate grows in size, it can squeeze the urethra and block the flow of urine out of the bladder.

Symptoms of BPH will usually start as the prostate blocks urine, causing difficulties with starting urination as well as a feeling of not emptying the bladder. Urination may become more urgent and can often occur at night. The amount of urine that flows out may be little, with dribbling at the end of urination.

Overactive Bladder Syndrome

Overactive bladder (OAB) is a chronic condition that can affect all sexes. People assigned female at birth are more likely to experience urgency incontinence, and those assigned male at birth typically experience both urgency and frequency. The cause of OAB is not fully understood and can vary from person to person.

Symptoms of OAB are more severe with older age and include urgency, frequency, nocturia, and urge incontinence. A diagnosis of OAB must include having an urgent need to urinate. Sometimes this urgency also comes with incontinence and nocturia that can disturb sleep habits.

When to See a Healthcare Provider

Urinary frequency can be a symptom of an undiagnosed condition, so seeking advice from a healthcare provider is critical. Contact your healthcare provider if you are experiencing leg weakness, fever, back pain, blood in your urine, or night sweats. Other important signs to contact your healthcare provider are:

  • If you are not pregnant, have not been drinking large amounts of fluid, and have urinary frequency

  • You are having incontinence (leaking urine)

  • If your urine appears cloudy or bloody

  • You are having unusual discharge from your penis or vagina

Your healthcare provider will take your medical history and review the symptoms you are experiencing and how long they have been happening. They will want to know about your typical fluid intake and what types of fluids you consume. They will also ask you about your medications because some medications, like diuretics, can make you urinate more often.

They may decide to do a physical exam and order certain tests depending on the discussed symptoms. Tests your healthcare provider may collect are:

  • Urinalysis: In a urinalysis, healthcare providers collect a urine sample and send it to the lab. The lab technician will examine your urine's color and appearance to note discoloration or cloudiness. Under a microscope, the technician can look further to determine if any cells, bacteria, or other substances are present.

  • Urine culture: A urine culture is helpful to determine if a UTI is present. A sample of urine is collected and sent to the lab, where a technician will be able to see if any bacteria or yeasts have grown.

  • Blood tests: A blood draw may be necessary to examine your kidney function, such as the creatine level. A hemoglobin A1c may also be helpful to help diagnose diabetes.

  • Cystometric study: This type of study helps measure how much fluid is needed in your bladder before you feel the need to urinate and how much fluid your bladder needs before you feel it is full.

  • Ultrasound: An ultrasound uses high-frequency sound waves to create pictures of internal organs. The sound waves reflect off body structures that then get sent to a computer to create images to help detect any abnormalities. A post-void residual can be used with an ultrasound to determine how much urine remains in your bladder after urination.

Treatments for Frequent Urination

The treatment for frequent urination depends on what condition is causing the symptom. If caffeine or alcohol is the culprit, it will be recommended that you decrease how much you consume. Your medications may also need to be adjusted. Some disorders require different treatment plans, so understanding the underlying condition is the first step in treating frequent urination.

Treating Urinary Tract Infections

After confirming a UTI diagnosis through testing, the UTI can then be treated with antibiotics. Length of treatment will vary and depend on the severity, including whether the infection is only in the bladder or if it has traveled to the kidneys. Most courses of antibiotics are prescribed for 7 to 14 days.

Treating Urinary Caliculi

If the stone is small and does not cause problems or other infections, it will likely pass on its own. Increasing water intake may help you pass the stone through the urinary tract. You may be prescribed Flomax (tamsulosin) to help.

If the stone is large and unable to pass on its own, surgery might be necessary. Surgery can involve either a stent placement to allow the stone to pass or a procedure called a shock wave lithotripsy. A shock wave lithotripsy breaks up the stone into little pieces that will later pass through the urine.

Treating Benign Prostate Hypertrophy

Treating BPH starts once the symptoms become troublesome or cause other problems like infections. The first-line medication for BPH is Flomax (tamsulosin). This medication helps to relax the prostate and bladder muscles to allow better urine flow.

If medications do not provide relief, then surgery might be the next step. Although there are other surgical options available, a procedure called transurethral resection of the prostate (TURP) is generally recommended. A TURP involves removing a portion of the prostate.

Treating Overactive Bladder Syndrome

Treating OAB can be a long process. Supportive lifestyle changes include:

  • Maintaining a healthy weight

  • Decreasing fluid intake to about six to eight cups of water a day

  • Stop drinking soda and alcohol

  • Increasing physical activity

Bladder training may also be beneficial. Bladder training is when you urinate at regular intervals. First, start with urination at 30 minutes and then expand these intervals to every three- to four-hour intervals until there is better control of urination. Pelvic floor muscle training, like kegel exercises, may also help treat OAB.

How to Manage Frequent Urination

Some people may find it helpful to use a voiding or bladder diary. Write down each time you urinate, how much you have voided, and what you consumed or activities you did before you needed to urinate. If you have incontinence, try using absorbent products or have a change of clothes handy.

Maintaining a healthy urinary system is also helpful when managing frequent urination. Try these tips for keeping your bladder healthy:

  • Avoid holding in urine too long because this could weaken the bladder muscles.

  • Sit down and relax when urinating to make urine flow easier.

  • Do not try to rush when you urinate to give your bladder time to fully empty.

  • Urinate after sex to prevent bacteria from traveling into the urethra.

  • Wear underwear made of breathable material (like cotton) and loose-fitting clothes to keep your urethra dry.

  • Avoid spicy and tomato-based foods, sodas, citrus fruits, and artificial sweeteners because they can worsen bladder problems.

  • Avoid smoking, as people who smoke are more likely to have bladder problems.

A Quick Review

Frequent urination is a symptom that makes you feel the need to urinate more often than usual. The amount of urine may seem like an average amount, or it could be very little. Certain lifestyle factors typically cause frequent urination, but an underlying medical condition is also possible.

If you notice that you are having to urinate frequently, starting urination is becoming more difficult, or if you feel your bladder isn't emptying, then seek evaluation from your healthcare provider to treat your symptoms and help prevent complications.

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