Causes of Frequent Urination: What to Consider in Women and Men

Having to go to the toilet again and again can affect work, sleep and social life. Sometimes this is simply due to drinking a lot of tea or coffee, and sometimes it is caused by a condition that needs treatment. Below we summarise the main causes of frequent urination in women and men and the steps to follow.

How many times a day is it normal to pass urine?

There is no exact number; the amount you drink, the season and your habits are decisive. Most adults who drink enough pass urine 4–7 times during the day. Passing urine generally more than 8 times during the day, or going to the toilet so often that it bothers you, is considered “frequent urination”.

It is important to distinguish between two situations here:

• Frequent urination with small amounts: Mostly caused by the bladder or prostate.
• Frequent urination with large amounts: Drinking a lot of fluid, diabetes or water tablets (diuretics) come to mind.

What are the general causes of frequent urination?

Causes common to both women and men include:

• Too much fluid, caffeine and alcohol: Tea, coffee, energy drinks, fizzy drinks and alcohol increase urine production and stimulate the bladder.
• Urinary tract infection: Frequent urination comes with burning, a sudden feeling of urgency and sometimes blood in the urine. For details, see the urinary tract infection page.
• Overactive bladder: The main symptom is a sudden urge to pass urine that cannot be put off (urgency); sometimes people cannot reach the toilet in time and leak urine.
• Diabetes: When blood sugar rises, the amount of urine increases; thirst and a dry mouth come with it.
• Medicines: Water tablets (diuretics) used for high blood pressure and heart disease increase how often you pass urine.
• Stones close to the bladder: Stones where the ureter enters the bladder can cause frequent urination and a feeling of urgency.
• Constipation and anxiety: Chronic constipation can press on the bladder; stress and anxiety can also make the bladder more sensitive.
• Bladder pain syndrome (interstitial cystitis): Comes with pain that increases as the bladder fills, and frequent urination.

What causes frequent urination in women?

Because the urethra is short in women, urinary tract infections are more common. In addition:

• Pregnancy: The growing womb presses on the bladder; hormonal changes also increase how often you pass urine.
• Menopause: Lower oestrogen levels make the tissue of the urinary tract thinner; urgency and recurrent infections may increase.
• Pelvic organ prolapse: The bladder or womb sagging downwards can stop the bladder from emptying completely.
• Pelvic floor weakness after childbirth: Frequent urination and urinary incontinence can occur together.

What causes frequent urination in men?

In men, particularly after the age of 50, the most common cause to consider is benign prostate enlargement. The enlarging prostate narrows the urethra; the bladder cannot empty completely and soon fills again. This often comes with:

• A weaker urine flow, or passing urine in a stop-start way
• Delay in starting to pass urine, and straining
• A feeling of not having emptied the bladder completely
• Getting up at night to pass urine

For detailed information, see the enlarged prostate treatment page. In younger men, prostatitis (inflammation of the prostate), infections of the urethra and urethral stricture can also cause similar symptoms.

How is the cause of frequent urination found?

The assessment usually starts with simple steps:

1. Bladder diary: For a few days, you note down the drinks you have and the time and amount of each time you pass urine. This record is very valuable in telling whether the problem is due to too much fluid or to the bladder.
2. Urine test and, if necessary, culture: Checks for infection, blood and sugar.
3. Blood tests: Blood sugar and kidney function; PSA in men where appropriate.
4. Ultrasound scan: Measures the kidneys, the bladder, the size of the prostate in men, and the amount of urine left in the bladder after passing urine.
5. Uroflowmetry: A painless test that measures the speed of the urine flow; it is often used in men.

How do you keep a bladder diary?

A bladder diary (frequency-volume chart) is a simple but very valuable tool for understanding the cause of frequent urination. It is usually recommended to keep it for 3 days; including both a working day and a day off gives a more realistic picture.

What to record:

• The time of each time you pass urine and the amount, measured with a measuring jug
• The time, type (water, tea, coffee, etc.) and amount of every drink
• Whether you had a sudden feeling of urgency and, if so, any episodes of leaking
• The times you go to bed and get up in the morning

With this record, the total amount of urine per day, the volume passed each time and the proportion of urine produced at night can be calculated. For example, if only a small amount is passed each time, a problem with the bladder or prostate comes to the fore; if a very large amount of urine is passed throughout the day, causes such as drinking too much or diabetes are more likely. Bringing your diary to your appointment avoids unnecessary tests and makes it easier to tailor treatment to you.

What can you do at home for frequent urination?

Treatment depends on the cause, but for many people the following tips ease the symptoms:

• Cut down on caffeine, alcohol and fizzy drinks.
• Spread your fluid intake evenly across the day; avoid drinking a lot in the evening.
• Prevent constipation.
• Do bladder training (gradually increasing the time between toilet visits) and pelvic floor exercises as recommended by your doctor.
• Try to lose any excess weight.

Restricting fluids too much, however, is not recommended; concentrated urine can irritate the bladder even more.

When should you seek emergency care?

• If you cannot pass urine at all, or have swelling and pain in the lower abdomen
• If frequent urination comes with fever, shivering and pain in the side
• If there is visible blood or clots in the urine
• If excessive thirst, frequent urination and weakness have all increased rapidly

When should you see a urologist?

A urological examination is advisable if frequent urination is affecting your daily life, does not improve within a few weeks, or comes with burning, bleeding, incontinence, a weak urine flow or getting up often at night to urinate. Recurrent infections also need a detailed assessment.

Op. Dr. Mücahit Kabar sees patients in Bursa (Nilüfer), Turkey, at Özel Medicabil Nilüfer Hastanesi (weekdays 08:30–12:00, +90 444 8 112) and Özel Jimer Hastanesi (weekdays 13:00–17:00, +90 444 45 67). Appointments are booked through the hospitals’ online booking pages or appointment lines. Consultations are held in English or Turkish; the hospitals’ international patient departments can arrange interpreters for other languages. If you are travelling from abroad, you can send your questions and reports by WhatsApp to +90 541 622 54 82 before your visit. See the contact and appointment information for details.