How your bladder functions every day can tell you a lot about your overall health. How often you urinate during the day and during the night, the color of your urine and whether you can hold it all provide clues to health conditions that don’t involve your urinary system.
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“Eighty percent of the causes of bladder problems are related to conditions outside of the bladder,” says urogynecologist Raymond Rackley, MD. These can include problems with the nervous or cardiovascular systems, he says.
So what should you look out for? Any problem that is a departure from your usual habits, says Ob/Gyn Cecile Ferrando, MD, MPH.
Here are three major signs to watch for:
- 1. Increase in frequency
- 2. A pink, red or brown hue
- 3. Incontinence
- What is “frequent” urination?
- What causes frequent urination in women?
- When should I see a doctor about my frequent urination?
- How do I stop frequent urination?
- What are the next steps?
- Tips, Tricks, and Exercises to Control Your Bladder
1. Increase in frequency
How often you have to urinate is a good indicator of your body’s overall state of hydration. It’s considered normal to have to urinate about six to eight times in a 24-hour period.
If you’re going more often than that, it could simply mean that you may be drinking too much fluid or consuming too much caffeine, which is a diuretic and flushes liquids out of the body.
But frequent urination also can be a sign of several more serious conditions, including a bladder infection, prostate problems, a heart condition, leg swelling, or interstitial cystitis (also called painful bladder syndrome), which is a chronic inflammatory disorder of the bladder.
Frequent urination also can be a symptom of an overactive bladder, a common, easily treated condition that could be caused by several problems, including nerve damage, medications, infections, being overweight and estrogen deficiency.
If you’re a woman, the need to urinate frequently also may be a sign of poorly supported pelvic organs, such as the bladder. This is when the bladder drops into the vaginal opening because of weak pelvic floor muscles, typically following childbirth.
Some people find they need to urinate more frequently at night as they get older. That’s fairly typical, Dr. Rackley says.
“People will have an increase in nighttime voiding as they age,” Dr. Rackley says. “But most people after the age of 60 rarely get up more than twice a night, so more than that can be related to an overall indication of your health.”
2. A pink, red or brown hue
If your urine appears pink or reddish ― and you haven’t eaten a lot of beets, blackberries or rhubarb recently ― the color could indicate blood in your urine. This is a serious symptom, one you should see your doctor about as soon as possible.
“Blood in your urine is never, ever normal, and requires immediate medical attention,” Dr. Ferrando says. Bloody urine could be indicative of cancer.
Darker colors such as amber or brown usually indicate dehydration. Increase the amount of fluids that you drink and lay off the caffeine. If your urine remains dark, talk to your doctor.
Incontinence refers to the involuntary loss of urine. There are two main types of urinary incontinence: stress incontinence and urge incontinence.
When a woman leaks urine when coughing, laughing, sneezing or exercising strenuously, it is called stress incontinence and is typically related to a weakness in the urethra. Stress incontinence also is related to being overweight, which puts additional pressure on a woman’s pelvic floor muscles, which support the urinary system. Stress incontinence can be treated with weight loss, pelvic muscle exercises or a small surgery.
Women who feel an overwhelming urgency to urinate and leak urine before reaching the toilet may have urge incontinence. This is a condition related to overactive bladder in which the bladder muscle begins to squeeze prematurely.
It can be treated with bladder retraining, medications, botulinum toxin injections that paralyze part of the bladder muscle, or a pacemaker-like device implanted under the skin that affects the nerves that control the bladder.
You know the feeling; you’ll be sat at your office desk and all of a sudden you’ll realise you’re desperate to go for a wee. Which would be fine, if it wasn’t 10am and you hadn’t gone three times already.
Okay, maybe it doesn’t happen in quite that quick succession, but you get the drift. When you need to go, you need to go, and it can prove quite inconvenient when you enter one of your ‘pissing like a tap’ phases.
So what’s causing it? We asked Dr. Seth Rankin of the London Doctors Clinic to round up the possible reasons you might be spending more time in your work toilets than at your desk.
Simon VerrallGetty Images
First Dr. Rankin explains why our bodies need to pee as a bit of context to what might be going on in there if you’re needing to go so regularly. We urinate to flush out any waste products, which means a higher ‘output’ of urine, if you will, is usually simply a sign of good hydration.
Peeing also keeps body fluid levels down, because if this fails to happen, “we get fluid build-up in the form of oedema – commonly seen in the form of puffy ankles,” the doctor says. So really, you should be thinking of frequent peeing as a good thing, but here are some of the possible reasons why it happens:
1. Drinking too much
Without meaning to state the obvious, if we drink too much we will pee more often. “There’s so much made about the health benefits of drinking 2 litres of water every day, but this is a myth,” says Dr. Rankin, before he goes on to explain why. “Research many years ago showed an average person needs about 2 litres of water every day for optimum health. This same research noted that about 1.6 litres comes from the food we eat. Even what seems dry as a bone in your mouth is mostly water.”
The doctor advises that we actually need around 400-600 ml – around 2 glasses of water – a day. But he adds: “This of course differs if you have cystitis or another reason to want to pee more.”
2. Overactive bladder
Overly-frequent toilet trips and the occasional accident could be a sign of an overactive bladder, the doctor advises, which is when “the bladder suddenly and uncontrollably contracts, even when not full, for no apparent reason.”
Dr. Rankin adds that “if this contraction is associated with loss of bladder control, it’s known as ‘urge incontinence’. While the cause is unknown, pelvic floor exercises and bladder training can help regain bladder control, along with weight loss (if necessary) and drinking less caffeine.”
“One of the main symptoms of diabetes is feeling excessively thirsty,” notes the medical expert. “So undiagnosed diabetics often end up drinking far more than usual before they get diagnosed. And as we all know – what goes in must come out!” If you’re concerned about this, it might be time to pop to your GP to get your glucose levels checked.
4. Urinary incontinence
Defined as “the unintentional passing of urine”, urinary incontinence can feel embarrassing, but it’s actually very common, apparently. Causes can range from damage during childbirth, to being a repercussion of certain surgeries like hysterectomies.
Dr. Rankin explains that for people suffering with this, “laughing, coughing and sneezing can increase the pressure in the bladder beyond its ability to hold urine in, resulting in an accident.” But once again, training your pelvic floor muscles can help with this.
5. Nervous peeing
Right before that big interview, on your way to that blind date, or before that exam you’ve been dreading – we all know the nervous pee. You know your bladder isn’t full and you don’t actually need to pee, but your mind won’t seem to rest until you’ve at least tried.
“This is an inconvenient part of the body’s sympathetic nervous system – the ‘fight or flight’ response to stressful situations,” says Dr. Rankin. “This releases a surge of the hormone adrenaline into the blood, which in turn increases urine flow.”
6. A small bladder
“The bladder holds on average 300-500ml of water, which is just a couple of cups of tea, or one small bottle of water,” explains the doctor. So it’s not surprising to think that just a couple of drinks is enough to fill the bladder. “But if you find that just one drink sends you running for the loo, this might just be because you have a small bladder.
“Similarly, if for any reason your bladder is being compressed, such as in the late stages of pregnancy, you’ll find yourself needing to pee far more often,” he adds.
7. That coffee addiction…
“Caffeine is a diuretic, meaning it causes increased urine output and reduces the body’s total fluid volume,” Dr. Rankin tells Cosmopolitan. So the more tea and coffee you drink, the more trips to the loo you need to make. And apparently the same goes for alcohol, which explains the whole breaking the seal thing and why you always wake up with a mouth drier than the Sahara Desert the following day.
8. Habitual peeing
“Sometimes, you don’t even need to pee, it’s just a habit,” suggests the medical expert. “Whether it’s before starting watching a long film, when you’re about to leave for a long car journey (or if the journey has just begun, if you’re that kind of annoying person), or last thing at night, that habitual trip to you run off to the loo may merely psychological.”
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Catriona Harvey-Jenner Digital Features Editor Cat is Cosmopolitan UK’s features editor covering women’s issues, health and current affairs.
Maybe it’s the ninth inning of a Twins game during girls’ night out. Maybe you’re just about to fall asleep. And then, you’ve got to pee. Again.
Sometimes it feels like the urge to pee strikes at the worst moment, sending you to the bathroom when you’d rather be anywhere else. This happens to all women occasionally. But if it’s happening to you over and over, it may seem like your bladder controls you, rather than the other way around.
Frequent urination can affect you for many reasons. Below, we’ll review the most common causes, when to see a doctor and how to get help to stop frequent urination.
What is “frequent” urination?
Every woman goes on her own schedule, but generally, peeing 6–8 times every 24 hours is normal. More than that – including peeing a lot at night (more than once) – and you may have frequent urination.
While they’re often mentioned together, frequent urination isn’t the same as incontinence, which is involuntary urination that can result in leakage. But frequent urination can be just as inconvenient to your day-to-day life. Besides the disruption to your routines and activities, constant trips to the bathroom can also feel distressing, especially if you’re not sure of the cause.
Frequent urination may only be just that, or it may appear alongside other symptoms. Regardless, understanding why you have to pee so often is the first step toward getting relief. Often, customized treatment can help stop frequent urination and let you get back to life on your own schedule.
What causes frequent urination in women?
Habits, medical conditions and certain life circumstances can all cause you to spend too much time in the bathroom. Here are twelve common causes for frequent urination in women:
1. Too many fluids
If you’re continually hydrating, your body gets rid of what it’s not using, and this will naturally result in peeing more often. Your hydration needs will differ depending on your activity level and environment. But if you’re peeing frequently, you could simply be drinking more liquids than you require.
2. Alcohol, caffeine or other diuretics
A diuretic is something that makes you urinate more frequently than normal. You’re probably familiar with common diuretics like alcohol (beer, wine or liquor) and caffeine (coffee, tea or pop). Artificial sweeteners can also act as diuretics. So can acidic foods and drinks, like those that contain citrus fruits or tomatoes. If you consume any of these regularly, you’ll likely have more frequent trips to the bathroom. In addition, some medications used to treat other conditions, like high blood pressure, can have diuretic side effects.
3. A urinary tract infection (UTI)
Most women have at least one urinary tract infection (UTI) at some point in their lives. UTIs happen when bacteria or something else infects parts of your urinary system, which includes your bladder, urethra and kidneys. Besides frequent urination, signs of a UTI include a burning feeling when you pee, discolored urine and constantly feeling like you have to pee (even after peeing). You may also feel pressure or discomfort in your back or around your pelvis. Fever is another symptom of a UTI.
With vaginitis, your vagina or vulva becomes inflamed and sore. There are several reasons for this common condition – in most cases, some sort of infection is the cause. Along with genital pain and discomfort, frequent urination can be another telltale sign of vaginitis. You may also feel burning or itching when you pee. A vaginal discharge that’s white and thick, gray and fishy-smelling or yellowish-green and foamy could be present, too.
5. Overactive bladder (OAB)
Overactive bladder (OAB) is just what it sounds like: Your bladder empties more often than it needs to, which causes you to pee too much. It can affect anyone, but it’s more common among elderly people (though not a typical part of aging). There can be a variety of underlying causes, and sometimes no cause at all. Besides frequent urination, another common sign of OAB is a sudden, urgent need to pee immediately.
6. Interstitial cystitis (IC)
Interstitial cystitis (IC) is when the muscles in and around your bladder become irritated. The exact cause isn’t known, but the condition affects more women than men. Symptoms may come and go, and their intensity varies from person to person, but frequent urination is a common complaint.
With IC you also typically urinate small amounts and often feel like you still have to pee even after peeing. You may feel chronic pain or pressure in your pelvis and abdominal region, a symptom responsible for IC’s other name: painful bladder syndrome (PBS).
7. Bladder stones
Similar to kidney stones, bladder stones appear when naturally occurring minerals in your urine join together to form small, hard clumps. They tend to be more common in men, but they affect women, too. Besides having to pee often, you may experience burning when you urinate, along with discomfort in your abdominal region.
It’s a well-worn cliché, but it actually is very true that pregnant women generally need to pee more frequently than usual. An expanding uterus puts pressure on the bladder, which in turn causes the bladder to empty more often. This is a regular part of pregnancy. If you don’t have any other symptoms, you can expect your bathroom schedule to return to normal a few weeks after birth.
9. Stress and anxiety
Frequent urination can sometimes be a response to feelings of worry or nervousness. It’s not really clear why, but it may involve your body’s natural fight or flight reaction to stress. If you’re experiencing anxiety in your home life, work life, social life or anywhere else, finding ways to effectively manage stress may help decrease your urination frequency.
10. Decreased estrogen, like during menopause
You’ve probably heard of estrogen as the female sex hormone. But estrogen also plays a role in supporting the sides of your bladder. That means if your estrogen levels are low, like during menopause, you may experience more frequent (and more urgent) urination as your bladder feels squeezed. Reduced estrogen levels can also cause you to have to pee often at night.
11. Weakened pelvic floor muscles
Your pelvic floor muscles hold up many of the organs in your urinary system, including your bladder. If these muscles weaken, organs can slip slightly out of place and lead to more frequent urination. Vaginal childbirth is one way the pelvic floor muscles can become strained and start to lose their strength. Aging may also lead to pelvic floor muscle weakening. Many times, it can be hard to tell if weakened pelvic floor muscles are causing your frequent urination. A urogynecologist will be able to tell you whether this is the case.
Frequent urination can be a sign of both type 1 and type 2 diabetes, particularly if you produce a lot of urine when you pee. With diabetes, your body can’t regulate sugar levels properly. As a result, there’s often excess sugar in your system which your body is trying to get rid of. This helps to explain why frequent urination is an early sign of the disorder. Other symptoms like tiredness, constant thirst or hunger, a dry mouth or tingling in your hands or feet often also appear.
When should I see a doctor about my frequent urination?
If you’re pretty sure that overhydration, too much caffeine or pregnancy aren’t behind your frequent urination – or if your need to go is interfering with your daily life – it’s definitely the right time to schedule a visit with an OB-GYN. Because a variety of things cause a frequent urge to pee, it’s important to talk to a doctor about your concerns and get an accurate diagnosis.
If your frequent urination is accompanied by other symptoms – painful urination, feeling like you still have to pee even after peeing, smelly or cloudy urine, bloody urine, abdominal pain, back pain, fever, chills, nausea, unusual vaginal discharge or anything else out of the ordinary – you’ll want to make an appointment or go to urgent care as soon as you can to get started on a treatment plan.
How do I stop frequent urination?
Your doctor will emphasize treatments that address your underlying frequent urination cause. The goal is always to improve your quality of life and work toward stopping frequent urination.
Basic remedies include lifestyle changes. A doctor may suggest the following:
- Avoiding drinking fluids before bed
- Cutting back on alcohol, caffeine, artificial sweeteners and acidic foods or beverages
- Doing pelvic floor exercises (like Kegels) to help build your pelvic health
- Trying bladder retraining techniques, such as peeing at fixed intervals that gradually increase
Your doctor may also prescribe medication to treat an underlying condition or to specifically address an overactive bladder.
What are the next steps?
No matter the reason, frequent urination doesn’t have to take over your life. Answers are only an appointment away.
Because once you know what’s causing your frequent urination, you’re that much closer to a peaceful night’s sleep, uninterrupted jog around the lake or worry-free time doing whatever you like – on your own terms.
Find a urogynecologist
Tips, Tricks, and Exercises to Control Your Bladder
Bladder training is a preventive method that helps you retrain your bladder to hold more urine. This is a mind-body approach that helps your brain and bladder learn to tolerate the presence of more urine before creating the urge that you have to go right away.
The steps to bladder training include:
- Keep a diary for three to seven days about when you go to the bathroom. Write down the time, how much urine comes out, and how much fluid you drink throughout the day. You can measure with a urine collector that fits over your toilet bowl.
- Review your journal and identify how your fluid intake stacks up to your urine output. Count how many times a day you go and how long you go between bathroom visits. If you’re peeing less than 1 1/2 to 2 cups every time you go or are going more than every 2 hours, there’s room for improvement.
- Try to get your bladder on a schedule. Commit to going once in the morning when you wake up and giving yourself enough time to fully empty your bladder. After this, try to go every two to three hours.
- Give yourself time when you go and try to get in a comfortable position. For example, hovering over the toilet seat to avoid touching it can create extra pressure on the bladder that keeps it from emptying fully. As a result, you may feel like you have to go again soon because you didn’t get all the urine out the first time.
- Avoid going out of convenience, such as when you see a bathroom. These quick, seemingly harmless trips may be ineffectively telling your bladder you need to urinate more often.
- Practice pelvic floor exercises like Kegel exercises throughout your day. This involves focusing on the muscles you use to stop your urine flow and contracting them for 5 to 10 seconds. Perform five repetitions. Kegels can strengthen your pelvic floor to help you hold urine longer.
- When the urge to go between your bathroom intervals hits, try to sit for a few minutes. Take some deep breaths and focus on something other than your bladder. Make it your goal to reach at least five minutes of waiting. Over time, you can extend this to 10 or even 20 minutes.
- Continue to maintain your bathroom diary so you can chart your progress and identify times in your day that appear to be trouble zones.
Some people may try to cheat their bladder training by cutting down how much they drink in a day. You still need fluids to stay healthy and prevent dehydration. There are some ways that you can still hydrate without triggering your bladder. This includes stopping drinking anything about one to two hours before going to bed.
You can also time your water intake with your meals when you’re likely to go to the bathroom. For example, you can drink a glass or two of water about 30 minutes before you eat a meal. By the time you’re finished, you’ll likely need to go to the bathroom before returning to work, school, or other activities.
While bladder training can be helpful, it’s important to approach it with the understanding that you’ll likely have some setbacks. If you keep trying and don’t see improvement, speak to a doctor.