Frequent Urination – Causes and Treatment of a Frequent Urge to Urinate (Polyuria)

A day when you urinate more often may simply mean you've had more to drink – nothing to worry about. But if it happens again the next day, and the day after that, and then you start waking up at night needing the loo, "I just drank too much water" starts to sound rather less convincing.

Frequent urination can have many causes – from urinary tract infections to chronic conditions – and it's important to seek treatment early to avoid complications. Read on to find out how often urinating is normal and when it's worth seeing a doctor.

What frequent urination (pollakiuria) means 

Polyuria, or frequent urination, is the medical term for excessive urine production. Put simply: your body is producing more urine than usual.

A healthy adult's body typically produces no more than 3 litres of urine per day. In exceptional cases, however – such as during pregnancy, with diabetes, a urinary tract infection or other causes of polyuria – the body can produce up to 15 litres of urine.

Do bear in mind, though, that polyuria and pollakiuria are two different things. While polyuria refers to frequent urination with clearly identifiable causes, which we'll come to shortly, pollakiuria (or benign idiopathic urinary frequency) refers to frequent urination without a specific cause, occurring mainly in children between the ages of 3 and 5.

How often is urinating normal 

The normal average is 6 to 8 times a day. However, the normal number of daily trips to the loo depends on several factors, particularly age.

In young children, urinating up to 8 to 14 times a day can be normal. As they get older, the number may drop to between 6 and 12 times within 24 hours, and in adolescence to as few as 4 to 6.

Frequent urination – causes

A healthy adult urinates on average 6 to 8 times a day. If the urge to urinate occurs more often, this is known as frequent urination, which can have many causes:

• Urinary tract infections (the most common cause, often accompanied by pain and burning when urinating, fever, chills and abdominal pain)
• Cystitis (inflammation of the bladder)
• Diabetes (frequent urination is one of the first signs of diabetes)
• Pregnancy (due to increased blood flow to the kidneys and pressure from the foetus on the pelvic organs)
• Medication (diuretics, anticonvulsants, antihypertensives, which also act on the renal system)
• Caffeine consumption (as well as high consumption of tea and alcohol)
• Disorders of the nervous system (cerebrovascular, haemorrhagic or ischaemic conditions)
• Spinal cord injuries (affecting the nerves that control the bladder)
• Mental health conditions (anxiety and depression can have frequent urination as a symptom)
• Other  conditions of the urinary tract (such as kidney stones blocking the flow of urine)

Frequent urination (pollakiuria) – risk factors 

Anyone can experience a frequent urge to urinate at some point in life, but certain groups are particularly susceptible:

• People over the age of 70
• Pregnant women
• Men with an enlarged prostate

There are other risk factors that can trigger pollakiuria:

• Certain neurological disorders
• A disruption in the signalling between the brain and the bladder
• Certain hormonal changes
• Weakening of the pelvic floor muscles or the onset of spasms
• Urinary tract infections
• Side effects of certain medicines
• Conditions affecting the brain or spinal cord (e.g. stroke or multiple sclerosis).

Symptoms that accompany frequent urination 

Frequent urination can have numerous causes, and the accompanying symptoms will differ depending on the cause.

With an infection, frequent urination may come with discomfort, pain or burning when urinating, blood in the urine (haematuria), unusual vaginal discharge, nausea, vomiting, lower back pain, fever or chills.

Broadly speaking, the most common symptoms accompanying frequent urination – whatever the cause – are the following:

• Excessive thirst (polydipsia), as the body becomes dehydrated.
• Nocturia (urinating at night, 2 to 3 times per night).
• Fatigue, particularly where nocturia is also present.

• Other symptoms that may point to an underlying condition.

  

When to see a doctor about frequent urination 

You should see a doctor as soon as your body gives you reason to suspect that a health problem lies behind the frequent urge to urinate. For example, if you need to urinate more often without having drunk more fluids, or if the polyuria lasts longer than a few days.

Certain symptoms should also prompt you to seek medical attention straight away:

• Fever
• Back pain
• Weakness in the legs
• Sudden onset of polyuria
• Night sweats
• Mental confusion
• Weight loss

Diagnosing pollakiuria 

The first thing the doctor will do is establish what has caused the frequent urination and exactly which symptoms are present. They will ask you when the first signs appeared, how often you urinate and whether there are any other symptoms, including involuntary leakage of urine and when this occurs.

The doctor may also order further tests to assess your state of health:

• Urine test, to determine whether there is a urinary tract infection or another condition (diabetes or kidney problems)
• Blood tests, to detect possible kidney disease, diabetes or bladder conditions
• Cystoscopy, to examine the inside of the bladder
• Ultrasound, also to check the bladder
• X-ray or CT scan of the abdomen
• MRI scan
• Cystometry
• Urodynamic testing
• Neurological examination

Treatment of pollakiuria (frequent urination) 

Depending on the diagnosis, a treatment plan will be drawn up that targets the cause of the frequent urination:

• Antibiotic therapy to treat urinary tract infections.
• Specific treatment for diabetes or other chronic conditions.
• Physiotherapy for the pelvic floor muscles to treat an overactive bladder.
• Kegel exercises, where the frequent urination is accompanied by leakage.
• Adjusting your daily fluid intake (how much and what you drink).

How to prevent a frequent urge to urinate 

The first step in preventing polyuria is to treat the underlying cause. However, if there is no infection or other health problem involved, small changes to your lifestyle can help prevent frequent urination:

• Avoid drinking fluids for around two hours before bedtime.
• Cut down on caffeine, alcohol and fizzy drinks.

• Use panty liners or regular sanitary towels to feel more comfortable if you leak urine. They won't prevent involuntary leakage or frequent urination, but they can be a temporary solution during treatment so you can get on with your daily life.

  

Frequently asked questions about polyuria (frequent urination) 

Frequent urination is a common experience that can occur now and again without any more serious problem behind it. If it persists, however, it may point to an underlying condition, and it's important to begin the appropriate treatment. In this section, then, we answer the most common questions about polyuria, so you can better understand what's normal and when to see a doctor.

How many times a day is urinating normal?

On average, a healthy person urinates 4 to 8 times a day. The frequency can vary depending on how much you drink, your age, your activity level and your general state of health.

If, however, you feel the need to urinate considerably more often – particularly if you pass large volumes each time – this could be a sign of polyuria.

Is it normal to urinate several times during the night? 

It's normal to wake 1 to 2 times a night to urinate, and all the more so as you get older. But if urinating at night disrupts your sleep, wakes you more than twice night after night and prevents you getting proper rest, this is known as nocturia. It is often linked to diabetes, heart failure or other bladder problems.

Is there a difference between polyuria and urinary incontinence? 

Yes. Polyuria and urinary incontinence are two different things.

Polyuria refers to an increased volume of urine that the body produces and passes under control. Urinary incontinence, by contrast, means involuntary leakage of urine, often with no control over when it happens or how much is passed.

Can a cold or cold weather increase how often you urinate? 

Yes. After exposure to cold, the body may respond by producing and passing more urine. There's even a specific term for this phenomenon: cold diuresis. Some respiratory infections, or drinking more hot drinks during the colder months, can also temporarily lead to more frequent urination. Do see a doctor, however, if it persists or if other symptoms develop.

How do I know whether frequent urination is a medical problem?  

If you need to urinate more often than usual, or if urinating is accompanied by discomfort, burning, pain, excessive thirst, fatigue or weight loss, these may be signs of health problems such as urinary tract infections, diabetes, hormonal disorders or other conditions. In that case, you should see a doctor as soon as possible.

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