Causes of Frequent or Excessive Urination

Frequent and Excessive Urination Definition

By the medical definition, in individuals older than 5 years of age, urinating 4-7 times per day is considered normal and urinating 8 times or more per day is considered frequent. For the purpose of this article I describe urinating more than 5 times per day as frequent.

In adults, excessive urination means excreting more than 3 liters of urine per day. Excessive urination is, obviously, always also frequent urination.

Here, I will describe common conditions that can cause either frequent or excessive urination and typical symptoms associated with them, so they will be easier to recognize.

A. Frequent Urination

In the "frequent urination" part of the article I mention conditions with frequent, but not excessive urination, that is without significant increase of total daily urine volume.

1. Psychological or Physical Stress

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Emotional stress may make you more aware of your bladder fullness and urinate more frequently as you actually need. Often, it is enough if you just wait a bit and the urge to urinate will go away.

If you feel cold, the arteries in your skin will narrow in order to prevent heat loss. This will slightly increase the blood pressure and force your kidneys to excrete some water from the blood into the urine. Anything what can warm you, can help prevent frequent urinaton.

Walking or any other physical activity can make you urinate more often.

If you drink in the evening, it is likely you will need to get up and urinate in the middle of the night.


2. Constipation or Bloating

A piece of hard stool can expand your rectum, which can press upon the bladder and irritate it. You can try to prevent constipation by consuming enough insoluble fiber, for example, from whole grains, by drinking enough water and by being physically active.

The gas that builds up in your intestine, for example, from eating a lot of foods high in soluble fiber, such as oats, barley, beans and peas, or milk or fruits, can cause your intestine to press upon your bladder and irritate it. If you are constantly bloated you can try to eat less foods high in soluble fiber or discuss with your doctor if you have any food or nutrient intolerance, such as celiac disease, lactose intolerance or fructose malabsorption.

3. Urinary Tract Infection

Thick urine in severe urinary tract infection
Thick urine in severe urinary tract infection | Source

Typical symptoms of urinary tract infections, including sexually transmitted diseases, are burning and frequent urination and smelly urine. If the bladder or kidneys are also infected, high fever may develop.

Mild urinary tract infections can clear by themselves in several days. More severe infections may require treatment with prescribed antibiotics.

Dehydration with frequent excretion of small amounts of yellow and smelly urine may look much like urinary tract infection. If you think you are dehydrated, try to drink more water.

4. Overactive Bladder and Interstitial Cystitis

Overactive bladder is a hypersensitive bladder with a constant urge to urinate, sometimes also at night, from no apparent reason, but without burning or pain. Possible causes include psychological stress, sexual abuse in childhood and problems with pelvic floor muscles. Avoiding smoking and certain foods, such as citrus foods, spices, chocolate, tomatoes, coffee and alcoholic or carbonated beverages, may help.

Interstitial cystitis is a rare inflammation of the bladder lining from uncertain causes, usually in women. Symptoms, which can come in flares, include a frequent urge to urinate, especially at night, and, unlike in overactive bladder, burning or severe pain during urination or pelvic pain at any time of the day. Diagnosis can be made by an endoscopic investigation of the bladder (cystoscopy). Currently, no definite treatment is known, but dietary and lifestyle changes and certain medications can help.

5. Kidney Disorders

Kidney inflammation (acute or chronic nephritis) caused by certain drugs or autoimmune disorders can cause frequent urination.

Kidney stones can cause sudden, severe flank pain that can radiate into the groin or thighs, and frequent, burning urination. Sometimes, a small stone can pass into the urine.

6. Medications

Medications, such as nonsteroidal anti-inflammatory drugs (aspirin, ibuprofen, naproxene, diclofenac, indometacin), acetazolamide (for glaucoma), amphetamine (for ADHD) and chemotherapeutics can cause frequent urination.

Dietary supplements, such as vitamin B3 (niacin) and vitamin C can have frequent urination as a side effect.

7. Frequent Urination in Men, Women and Children

Causes of frequent urination specific for men, women and children:

Men: prostate enlargement, retrograde ejaculation, inflammation of the testis (orchitis) or epididymis (epididymitis) and reactive arthritis after an infection with chlamydia.

Women: frequent rinsing of the vagina, premenstrual syndrome, early pregnancy, dysfunction of pelvic floor muscles, sexually transmitted diseases, endometriosis of the bladder or bowel and adhesions or tumors in the pelvic cavity.

Children. Very frequent daytime urination without pain or change in urine color in children 3-14 years of age (pollakiuria) can be caused by psychological stress. The condition usualy resolves on its own within a year.

B. Excessive Urination

In the "excessive urination" part I describe conditions with excessive urination (>3 liters of urine per day). Excessive urination is always associated with frequent urination.

1. Excessive Drinking

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You need to drink only as much water as you lose it from your body. If you urinate more than 5 times a day, you probably drink more water than you need.

Any water you drink in excess of your body needs will be excreted with the urine in a short time. There is no firmly proven health benefit of drinking large amounts of water. It is, of course good to drink enough, but this does not mean you have to drink a lot.

If you maintain your body weight from day to day, you can know you are well hydrated. By every liter of water you lose from your body and do not replace, you will lose 1 kilogram of body weight. So, weighing yourself in the morning, after you empty your bladder and bowel and before you eat or drink anything is a reliable way to check if you are well hydrated.

Many people drink a lot because they think this is healthy, removes toxins from the body or help in weigh loss, none of which is true.

Apart from a sudden weight loss, other common symptoms of dehydration include dry mouth, excretion of small amounts of yellow urine, anxiety, fatigue, thirst and mild headache.

2. Diabetes Mellitus

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A sudden onset of excessive urination, thirst, hunger and fatigue may be the first symptoms of diabetes mellitus. In untreated diabetes, the build up of glucose in the blood can result in the excretion of glucose and excessive amount of water into the urine. Lowering blood glucose levels results in normalization of urine excretion.

Excessive urination usually occurs in untreated diabetes type 1 in younger people, but can also occur in older individuals with diabetes type 2.

3. Diabetes Insipidus

Diabetes insipidus means excretion large amounts of urine due to health conditions other than diabetes mellitus. Main causes include:

  • Low blood potassium (hypokalemia) or high calcium (hypercalcemia)
  • Chronic kidney disease
  • Brain disorders, including brain tumors, multiple sclerosis, tuberculosis, brain surgery or radiation therapy

Symptoms may include frequent urination, excessive thirst, craving for ice cold water, fatigue, headache, flank pain or bloody or foamy urine.

4. Medications

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Examples of medications that can cause excessive urination:

  • Diuretics
  • Antimicrobials: acyclovir, amphotericin B, ciprofloxacin, demeclocycline, ethambutol, gentamicin, isoniazid, tetracycline
  • Medications to lowe gastric acidity: cimetidine, ranitidine, omeprazole
  • Theophylline (for asthma)
  • Diazepam (for anxiety or seizures)
  • Long-term abuse of aspirin, ibuprofen, indomethacin or naproxen
  • Lithium (for bipolar disorder)
  • Steroids: prednisone
  • Chemotherapeutics
  • Illegal drugs: ecstasy (MDMA)
  • Other: allopurinol, captopril, cyclosporine, phenytoin
  • Herbs overdose: foxglove, Chinese medicinal herbal mixtures containing aristolochic acid

Summary

FREQUENT Urination
EXCESSIVE Urination
Stress
Drinking too much
Constipation, bloating
Diabetes mellitus
Urinary tract infection
Diabetes insipidus (kidney or brain disorder)
Overactive bladder
Medications (diuretics, lithium, diazepam)
Men: prostate enlargement
 
Women: pelvic floor dysfunction, early pregnnacy
 
Children: pollakiuria
 

Poll

How much water or other beverages do you drink per day?

  • less than 2 liters
  • 2-3 liters
  • 3-5 liters
  • More than 5 liters
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