What Causes Frequent Urination and 5 Treatment Pathways

If you’re experiencing frequent urination and unsure if it’s a health problem, here’s one spot-on way to know: If it bothers you, it’s a problem.

On average, the typical person goes to the bathroom six to seven times a day. Sure, there are variables: you might need to go more on days when you drink a lot of water, or while pregnant, or on certain medications. Age can also increase your need to go. 

Largely, we think of bothersome urinary symptoms (urinating frequently, urgently, etc.) as a quality-of-life concern and the degree of bother varies between individuals. However, you don’t have to accept these urinary symptoms as “normal” and there are variety of ways we can help, depending on each individual situation. Additionally, these symptoms may be an indication of a functional urinary tract issue and can impact your long-term bladder health.  

However, if you urinate excessively during the day and more than twice at night, persistently, you might have a urinary issue that should be addressed. This can be a bother, because frequent urination could be a red flag of something wrong in your urinary system. 

A voiding (urinary) diary can be a helpful way to assess your urinary function and can help your doctor better understand the issues as hand. Try filling out a daily diary for a few weeks.

If you feel like you urinate too frequently, your urologist  can help evaluate the issue and provide different treatment options based on your individual symptoms and other health conditions. Below are a variety of different treatment options, many of which are non-invasive. There also are some natural remedies you can try at home, as well. 

Urological Conditions that are Associated with Frequent Urination

• Urinary tract infection (UTI) – Is the result of bacterial and less commonly viral infection, which is diagnosed with a urine culture. It is associated with burning/painful urination, blood in the urine, urinary frequency, urgency, incontinence. 40-60% of women and 12-14% of men experience a UTI during their lifetime. 
• Overactive bladder (OAB) – Is characterized by a constellation of urinary symptoms; urinary urgency , frequency, nocturia, with or without incontinence. This may be a result of bladder irritants, abnormal bladder sensation, excessive bladder contractions and/or bladder changes that result in reduction in the volume that bladder can hold. This is in the absence of urinary tract infection.
• Interstitial cystitis (IC) – IC is a chronic urinary condition which can present with different patterns of urinary symptoms and is a diagnosis of exclusion. This is theorized to be related to alteration in the protective lining of the bladder.   
• Benign prostatic hyperplasia (BPH) – Is the benign enlargement of the prostate that is common in aging men. The bladder initially can compensate, which may result in altered bladder function manifesting as OAB. 
• Pelvic floor dysfunction/weakness – This is when the pelvic floor is not working as it should and is caused by a variety of factors that may weaken or disrupt the pelvic floor muscles/connective tissue. This can be seen in women after childbirth, during menopause, obesity, abdominal straining, aging, constipation, pelvic, BPH.  

Why You Should Talk to Your Doctor About Frequent Urination

To diagnose the causes of such urinary issues, a urologist will perform a complete examination and ask about your medications, how often you urinate, the type and quantity of fluids you drink.

Diagnostics might also be performed, such as keeping a voiding diary, performing a urodynamics test to evaluate bladder function, and potentially using a cystoscope (small flexible camera) to evaluate the urethra/bladder anatomy with.

Depending on your evaluation, possible treatments for the conditions associated with urinary frequency may include:

• For OAB: 
  • Behavioral changes with the type and quantity of fluid intake – in particular, soft drinks, caffeinated beverages, and tea are well known to cause urinary frequency 
  • Pelvic Floor Physical Therapy – a mainstay OAB treatment, particularly in women
  • Medications – anticholinergics and Beta 3 agonists, which relax the bladder muscle to reduce overactivity 
  • Bladder Botox- which is injected into the bladder muscle as an outpatient procedure to relax the bladder muscle 
  • Neuromodulation – altering the signal between the brain, spinal cord, and bladder with an implantable pacemaker or stimulation of a nerve on the ankle
• For UTIs: Your urine will be sent to a culture and an antibiotic will be used to treat the infection based on the type of bacteria causing the infection. 
• For IC: The treatment requires multi-faceted approach, which may include stress reduction, behavioral changes, bladder training/pelvic floor physical therapy, medications, bladder instillations. 
• For BPH:  
  • Medications to relax the prostate smooth muscle, and to reduce the size of the prostate; these are sometimes combined with medications used for OAB.
  • Procedure-based options such as the minimally invasive prostate artery embolization, which blocks the blood flow to the prostate; transurethral procedures such as surgery (TURP), laser (Greenlight, HoLEP), implants (Urolift), water jet (Aquablation) 
• For Bladder Prolapse: Small disks placed in the upper vagina, called pessaries, support the bladder; estrogen therapy could strengthen the vaginal walls. In acute cases, a surgeon can rebuild your pelvic floor using biological material, including your own tissue.

How You Can Help Yourself: Natural Approaches

Depending on the cause of your frequent urination, these healthy practices can help solve your “gotta go again” problem.

• Balance your liquids. Be sure the number of caffeinated beverages, coffee, tea, and alcohol you drink is balanced out with plenty of water. Coffee and alcohol are diuretics and bladder irritants.
• Exercise your pelvic muscles. Kegels are a squeeze-and-release exercise that can strengthen the pelvic floor in women and men. However, there are also other exercises that may be more beneficial than Kegels. Talk to your doctor to determine which exercises would be best.  
• Bladder training. If you have OAB, don’t rush to the bathroom when the urge to urinate strikes. Relax your mind and body. Extend your wait-time gradually until you can schedule trips. However, prolonged holding your urge can be counterproductive and can result in worsening urinary symptoms. 
• Keep your weight in check. Too many pounds can overburden your bladder and pelvic muscles, making it difficult to hold urine. Ask your doctor about a healthy weight for you.
• Cut back on salt and additives. Ultra-processed foods (which tend to be high in salt), artificial additives, and fats, can cause inflammation and are linked to OAB, ongoing research shows. 

Lastly, know that you don’t have to let frequent urination be a bother. When in doubt, call your doctor.

You can read more about all the urinary conditions we treat on our website. When ready, request an appointment to visit one of our urologist here.