Dear Alice,

I've been having a problem with frequent urination. I mean going every fifteen to twenty minutes some days. I've been treated for urinary tract infections for about two months, but urine cultures show no infection, just traces of blood. I've also had an IVP Kidney X-ray which showed normal kidney function. I have a small fibroid outside my uterus which is pressing on my bladder ever so slightly. Could this be the cause of my frequent urination? I drink plenty of water, stay away from caffeine, chocolate, etc., drink cranberry juice, etc., with no success. I also get up every couple hours during the night. And, I do have a lot of urine, not just a trickle. I have no other problems with my menstrual cycle, etc. On a good day, I can go an hour or hour-and-a-half. Can you give me some advice or where to turn to next? Do I see a urologist or gynecologist? Help, I'm always looking for a bathroom.

Signed,
Urge to go!

Dear Urge to go!,

Wondering what might cause your frequent trips to the toilet? Urine the right place! As you noted, pressure on the bladder (such as from a uterine fibroid), infections, other health conditions, and use of caffeine can all lead to increased urination. It’s also possible that something as simple as the amount of liquid you consume or how much you’ve eaten can explain the situation. Frequent urination can manifest in two ways: an increase in the total volume of urine or increased frequency with a normal or decreased volume of urine each time. If you’re looking to investigate this issue further with a specialist, such as a urologist or gynecologist, a primary care provider may be able make the most appropriate recommendation as they can assess your symptoms and any tests that have already been conducted. Read on for some explanations of common causes of frequent urination that you can discuss in more detail with a health care provider who can help you assess what’s going on in your body.

Before diving in: where does urine come from? First, waste products and water in your bloodstream make their way to your kidneys. From there, newly formed urine exits through two tubes called the ureters into your bladder. Urine hangs out in your bladder until it swells and gets uncomfortably full. This usually happens when your bladder has about two cups of urine, roughly every two to five hours depending on how hydrated you are, or whether or not everything is functioning properly. From there, urine passes through the urethra (another tube) and out of the body.

Some causes of increased volume of urine (also known as polyuria) include:

  • Food and drink consumption: Drinking more liquids than your body needs can cause an increased production of urine. The amount of food you’ve eaten can also impact how much urine you produce, as can how much fluid you lose from sweating or breathing.
  • Diuretics: Alcohol, caffeine, certain medications (such as some blood pressure medications), and other substances can act as diuretics. Diuretics decrease the amount of fluid in your blood vessels which can leads to an increased volume of urine.
  • Diabetes mellitus: The group of diabetes conditions including Type 1 and Type 2 diabetes, diabetes mellitus is a chronic condition in which the body is unable to properly regulate the amount of sugar in the blood. Diabetes can be caused by too little insulin, resistance to insulin, or both, and can lead to increased urine production.
  • Diabetes insipidus: This is a condition in which large amounts of unconcentrated urine are excreted due to insufficient urine concentration by the kidneys.
  • Irregular calcium levels: Irregular calcium levels can strain the kidneys and cause excessive thirst and urination. There are a number of reasons calcium levels might be irregular such as taking excessive calcium or Vitamin D supplements, genetic factors, and certain health conditions.

Additionally, there are a number of reasons for increased frequency of urination (not necessarily with an increased volume of urine):

  • Urinary tract infection (UTI) or bladder infection: Inflammation or irritation of the bladder or urethra can cause the urge to go. The amount of urine produced each time is usually less than normal.
  • Overactive bladder (OAB) syndrome: Involuntary bladder contractions create a sensation of urgency regardless of the fullness of the bladder. There are many possible causes of OAB including, but not limited to, medication, constipation, or other health conditions.
  • Interstitial cystitis: A condition which may cause symptoms similar to chronic UTI (frequent urination, bladder/pelvic pain) but with no infection. Causes of interstitial cystitis are not well understood, but symptoms may flare up in response to certain triggers including menstruation, stress, certain foods, or sex.

While these are just some of the causes of increased urination, this list isn't exhaustive. Check out Mayo Clinic to read more about additional causes of frequent urination. If you’re urinating more than four to eight times per day, discussing the following questions with a health care provider can help them diagnose the issue: Does your frequent urination occur primarily during the daytime or throughout the night? Is there burning or pain as the urine comes out? How much fluid and what kinds of beverages are you drinking each day? Are you unusually thirsty when you have to urinate? Do you have other symptoms or issues — for example, fever or unusual weight loss? Are you experiencing any other chronic conditions or do you use any medications regularly? How much urine is there? Working with your provider may help you get more information about your frequent flyer status and hopefully, closer to finding some relief.

Here’s to P = problem solved soon,

Alice!

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