“There are a lot of reasons for frequent trips to the bathroom,” says urologist Ardavan Akhavan, M.D., director of pediatric minimally invasive and robotic surgery and assistant professor of urology at New York Presbyterian-Weill Cornell Medical Center in New York City. “Your body could be producing a lot of urine from excessive fluid intake or you could have an underlying medical condition, like diabetes, or you could be reacting to a medication, like the ones used to treat high blood pressure.” Alcohol and caffeine could be to blame for needing to pee so much, as could an overactive or underactive bladder. Given the number of possible causes, Dr. Akhavan says, “it’s important to speak with your doctor if you are concerned about going too often.” These are a few factors your doctor will likely talk with you about.
Diuretics: Why coffee, tea, and soda make you pee more
If you have high blood pressure, you may be familiar with diuretics, a type of medication that helps get your body get rid of excess sodium and water. But there are plenty of foods and drinks that behave as diuretics as well—and if you’re not aware of them, they could cause you to unwittingly shed water through frequent urination. For instance, men who drink two cups of coffee a day are at a 72 percent higher risk for a leaky bladder and frequent urge to pee than those who skipped the joe, according to a study in The Journal of Urology. (Women’s coffee consumption has been linked to these symptoms as well.) It’s not the coffee itself, but the caffeine in the beans, a known stimulant, that has a diuretic effect. Caffeine speeds up your internal processes while blocking the absorption of salt into the bloodstream, resulting in an increase in urine production. For that reason, types of tea and cola (or other caffeinated soda) may also up your count for bathroom visits. So how many trips a day is OK? “Voiding up to eight times a day is considered normal,” says Ekene Enemchukwu, M.D., a pelvic reconstructive surgeon and assistant professor of urology at Stanford University Medical Center in Palo Alto, California. When it comes to caffeine, coffee is the biggest offender, with about 96 mg per eight-ounce cup (experts recommend no more than 400 mg per day). Can’t live without your daily jolt? Consider a smaller mug or try half-caf-half-decaf. Black tea has about 47 mg of caffeine per eight ounces, while green tea is about half that at 28 mg (and has multiple health benefits as well). Cola is just 22 mg per eight ounces, but keep in mind most cans are at least 12 ounces (and may carry additional health risks with them).
You could be drinking too much water (or not enough)
Well, here’s a no brainer: OD-ing on H20 can make you pee a lot. It’s not just the bathroom trips that are concerning though, it’s the fact that overdosing on water dilutes the salt content of your cells, a condition known as hyponatremia. Left unchecked, hyponatremia can cause cells to swell, setting off a dangerous chain of reactions that can make you ill. How do you know if you’re drinking too much? Along with the standard suggestion of aiming for eight 8-ounce glasses of water a day (more if you are very active), “we typically recommend most people urinate roughly every four hours,” says Dr. Akhavan. “We can differentiate urinary frequency with large urinary volumes by looking at the urine concentration.” If your pee is super-pale to clear, you’re likely drinking too much. A lemonade-like hue is what you’re going for here. “A urologist may also ask you to keep a ‘voiding diary,’ where you write down exactly when and how much you urinate over a few days, for your doctor to analyze,” he adds. So far, so good. Drink too much, pee too much. But … drink too little? Yes—in a roundabout way. Researchers at the University of Miami found that people who are dehydrated or drink less than 1.5 liters (roughly six cups) a day are at twice the risk for bladder infections, which in turn, make you feel like you urgently have to pee. You can tell if your need to go is infection-related because the quantity of urine will be small, dark in color and possibly smell funky. If that’s the case, see your doctor right away for treatment.
A UTI can make you pee a lot
Speaking of infections that make you have to pee, one of the most common types is called a urinary tract infection, or UTI. “Lower urinary tract infections cause inflammation of the bladder and can cause symptoms of needing to urinate frequently, as well as discomfort or burning with urination, a change in the odor and color of urine and lower abdominal pain,” says Dr. Enemchukwu. “This is usually caused by the inflammation of the bladder wall that makes even a small amount of urine irritating.” A UTI is usually diagnosed through a urine analysis, she says, and a urine culture test for the bacterial strain (typically E. coli) that caused the infection. UTIs, which produce urgent, painful urination and may induce lower back pain, can occur in multiple locations along the urinary tract, including your bladder, kidneys, ureter and urethra. Most commonly, they occur in the urethra—the part of the urinary tract that empties your bladder to the outside of your body when you pee. Although both men and women can get UTIs, they happen more frequently in women because the urethra and anus openings are closer together, raising the risk of fecal bacteria infection in the urethra (more information than you probably wanted, but there you have it).
Does pregnancy make you pee?
In happier news, sometimes peeing a lot has nothing to do with infections and illness, and everything to do with a baby on board! “Urinary frequency can be experienced during pregnancy,” confirms Dr. Enemchukwu. “Early in pregnancy, the fetus is still very small, so urinary symptoms are thought to be hormone-mediated. However, as the uterus enlarges, women may experience increased urinary frequency, urgency and even stress urinary incontinence where you have leaking with coughing, sneezing or activity.” This is likely caused by the growing baby, which puts pressure on the bladder. Convenient, it’s not—especially if your workstation is nowhere near a bathroom—but it’s a small price to pay for your little one, especially if you’ve been trying to get pregnant for a while.
Constipation can make you pee.
How’s that for a non sequitur? But here’s the thing: In the land of internal organs, your bowels and bladder are next-door neighbors. And when you’re constipated (maybe you changed up your schedule, or you’re trying a new diet), your bloated bowels can push on the bladder or urethra, causing spasms or irritation that trigger the need to go. “Constipation can cause weak stream, intermittency (stop and go urinary stream), loss of bladder control and painful urination,” says Dr. Enemchukwu. Along with over-the-counter and prescription meds, there are plenty of natural at-home remedies for constipation that can help you get things running regularly again. For men, along with backed-up bowels, an enlarged prostate may be another culprit that’s putting pressure on the urethra and blocking the downstream flow. This pressure sends a signal to the bladder that it’s time to start the pee process, even when there’s only a small amount of urine in the bladder. Soon, guys find themselves hitting the head twice as often as before. The good news: It’s relatively common and easy to treat. “If the problem is a blockage, typically a medication called an alpha-blocker will work by relaxing the bladder neck and prostate,” says Dr. Akhavan. “Other medications called 5-alpha-reductase inhibitors work by shrinking the prostate.”
Anxiety can make you pee?
Ever notice how the urge to go increases exponentially when it’s your turn to take center stage? Like giving a toast at your friend’s wedding, standing on the start line before a road race or logging onto Zoom to make a company presentation—without fail, you have to go. Stumped as to why? Turns out, the scientists are, too. “There are multiple theories that attempt to explain the link between overactive bladder and anxiety—although they are mostly based on animal studies,” says Dr. Enemchukwu. “The thought is that anxiety and bladder function share a common neurologic pathway, known as the serotonergic pathway, or a hormonal pathway (the hypothalamic-pituitary-adrenal (HPA) axis and corticotropin-releasing factor).” Usually, the messages that transmit along these pathways remain independent of each other, but during times of stress and anxiety, signals may get crossed up. Other theories about why anxiety makes you want to pee have to do with your bladder’s design: In normal times, it contracts to help you go. But when you’re anxious, muscles all over your body tense up, including your bladder. Because your brain usually associates this contraction with a signal that you’re trying to pee, it sets off a chain of reactions, culminating in an urgent need to urinate at the most inconvenient of times. Anxiety is a universal human experience, but there are ways you can help yourself relax. Research shows that cognitive behavioral therapy can successfully teach people coping skills in stressful situations. Yoga and meditation can also bring some people relief. Or you can download apps that teach you everything from deep breathing techniques to practical ways to worry less.
You could have an overactive bladder
Well yeah, you’re thinking. We’ve already established I have to pee a lot. But overactive bladder isn’t just a general catch-all phrase—it’s an actual specific condition. “This is a disorder where the bladder squeezes too much, leading to the sensation of having to go to the bathroom too often,” says Dr. Akhavan. Unlike having a small bladder, which is rare, overactive bladder (OAB) affects 12 to 16 percent of the U.S. population, says Dr. Enemchukwu. You’re more likely to develop it as you get older, and women are slightly more likely to get it than men. These frequent urges to pee can lead to pelvic discomfort or pressure and even incontinence, she says. While there are several possible causes of OAB, including lack of exercise and increased stress, diet is a prime suspect for this disorder, as certain foods may irritate the bladder, causing it to contract. Potential irritants include:
alcoholartificial sweetenerscaffeinecarbonated fluidschocolatecitrustobacco
In general, says Dr. Enemchukwu, overactive bladder is treated with a progressive approach:
Behavioral therapies: This may include cutting out bladder irritants, ensuring daily soft bowel movements, exercise/meditation/mindfulness to address anxiety/stress and bladder training.Medications: These include anticholinergic drugs, beta 3 agonists, or possibly combination therapy (anticholinergic + beta 3 agonists).Pelvic floor physical therapy: Exercises that train your muscles around the bladder and urethra to contract and relax.Advanced therapies: Options include bladder Botox injections, sacral neuromodulation implants (electrical impulses that stimulate the sacral nerve to try and improve communication between the bladder and brain) and percutaneous tibial nerve stimulation (electrical current used to stimulate nerves in the bladder and pelvic floor to change their pattern of activity).
Why interstitial cystitis makes you pee
You may never have heard of it, but interstitial cystitis affects up to 12 million Americans, according to the Interstitial Cystitis Association, with women outnumbering men by a ratio of about three to one. “This is a potentially debilitating disorder also known as bladder pain syndrome, where people can feel chronic suprapubic pain, burning, frequency and urgency in the absence of an infection,” says Dr. Akhavan. The cause of interstitial cystitis is not clear, and your doctor may make the diagnosis only after ruling out other urinary bladder issues. Along with an urgent and frequent need to go (in extreme cases, people with interstitial cystitis need to go 60 times a day), pain that worsens when you drink or eat, and gets better after you urinate, is a telltale symptom of this disorder. If you have interstitial cystitis, your doc may suggest OTC or prescription meds, along with alternative therapies. As a last resort, surgery may be an option.
Peeing a lot could be a sign of diabetes
A quick science lesson: The cells in your body rely on a sugar called glucose for energy. In order for glucose to get into your cells, it pairs up with something called insulin. In people with type 1 or type 2 diabetes, the body either doesn’t make insulin or can’t use it efficiently to get the glucose into your cells. Instead, the glucose hangs out in your bloodstream then heads for your kidneys to be excreted. Your kidneys, recognizing an excessively large amount of glucose, signal to your body that they need more water to dispose of the sugar. Hence, your need to pee goes up. “In the kidneys, high sugar levels can lead to glucose spilling into the urine,” says Dr. Akhavan. “This can affect the balance of urine production, by pulling more water into the urine stream, causing excessive urine production.” Complications associated with diabetes may also play a role in increasing your need to pee. “In people with something called diabetic neuropathy, the nerves coming to and from the bladder can be damaged,” he says. “This can affect someone’s ability to feel like they have a full bladder or damage their ability to empty their bladder all the way.” While type 1 diabetes almost always requires medicine to manage, type 2 diabetes can sometimes be reversed by keeping track of your diet, exercise and lifestyle habits.
Pelvic floor exercises can strengthen your bladder
If you’ve been dealing with issues of frequent urination for a while, you might think it’s just how you are, or maybe it’s something that happens as you get older. But there are plenty of things you can do, from taking medication to making changes to your diet, that can improve your situation. A good place to start? Putting your pelvic floor muscles on a fitness program. That’s right—the muscles responsible for holding in your pee can sometimes get a little lazy, and the right exercises can get things back on track. “You cannot strengthen the bladder itself, but you can exercise and strengthen your pelvic floor muscles with kegel exercises,” says Dr. Enemchukwu. “This can help improve bladder control.” Specifically, a type of pelvic floor physical therapy known as bladder training can be helpful, she says: “This teaches you how to ignore your bladder when it gives you false signals by using distraction and quick flicks, a type kegel exercise.” Ultimately, dealing with the constant urge to pee is annoying, but unlikely to be life threatening. Moreover, it’s something your doctor hears a lot, so you can feel confident in the treatment advice you get. “Issues with urinary frequency can affect up to half the population,” says Dr. Akhavan. “So it is an extremely common—and treatable—issue.” Up next, What is the Anti-Inflammatory Diet and What Foods Can You Eat On It?
Sources
Ardavan Akhavan, M.D., urologist, director of pediatric minimally invasive and robotic surgery and assistant professor of urology at New York Presbyterian-Weill Cornell Medical Center in New York CityEkene Enemchukwu, M.D., pelvic reconstructive surgeon and assistant professor of urology at Stanford University Medical Center in Palo Alto, CaliforniaMayo Clinic: “Diuretics.”The Journal of Urology: “Caffeine Intake and Its Association with Urinary Incontinence in United States Men: Results from National Health and Nutrition Examination Surveys 2005–2006 and 2007–2008.”International Urogynecology Journal: “Caffeine and Urinary Incontinence in US Women.”U.S. National Library of Medicine: “Caffeine.”Mayo Clinic: “Nutrition and Healthy Eating: Caffeine Content for Coffee, Tea, Soda, and More.”Mayo Clinic: “Hyponatremia.”Urology Care Foundation: “Urinary Tract Infection in Adults.”U.S. National Library of Medicine: “Urinary Tract Infection in Adults.”Frontiers in Psychiatry: “The Effect of Cognitive Behavioral Therapy on Depression, Anxiety, and Stress in Patients With COVID-19: A Randomized Controlled Trial.”Interstitial Cystitis Association: “Interstitial Cystitis Association.”Centers for Disease Control and Prevention: “What Is Interstitial Cystitis?”Interstitial Cystitis Association: “Surgical Procedures.”Urology Care Foundation: “Diabetes and Its Impact on Your Urinary and Sexual Health.”National Association for Continence: “What Is Overactive Bladder?”
