What's to know about frequent urination in women?
Frequent trips to the bathroom, not sleeping through the night, or refraining from going places for fear that they will leak urine, are often familiar to women who experience frequent urination.
Each person may urinate a different number of times per day depending on how much they drink and how well their kidneys work. According to the Cleveland Clinic, the average person should urinate somewhere between between six and eight times in a 24-hour period.
While an individual is occasionally likely go more frequently than that, daily incidences of urinating more than eight times may signal a concern for too-frequent urination.
Causes and risk factors
Sometimes, frequent urination is due to drinking too many drinks that are known to increase urine production or irritate the bladder. Examples include excess caffeine intake through coffee, tea, and certain soft drinks.
Frequent trips to the toilet can be caused by a variety of conditions, including excessive caffeine intake, bladder stones, and UTIs.
However, frequent urination may also be due to a number of medical conditions. Examples include:
- bladder stones
- interstitial cystitis, a chronic, inflammatory disorder of the bladder
- low estrogen levels
- overactive bladder
- urinary tract infection
- weak pelvic floor organs
Obesity is another factor. Excess weight can place extra pressure on the bladder. The result can be weaker pelvic floor muscles and a need to urinate more frequently.
Another risk factor for frequent urination is pregnancy. The growing uterus can place extra pressure on the bladder during pregnancy. As a result, a woman may have to go to the bathroom more frequently.
According to one study, an estimated 41.25 percent of pregnant women experience an increase in urinary frequency during pregnancy. Of these women, an estimated 68.8 percent report the increase in frequency causes them discomfort or distress.
Menopause can also affect bladder control. When women no longer have their periods, their bodies stop making estrogen. This hormone can impact the lining of the bladder and urethra. As a result, a woman may experience the need to urinate more frequently.
Another risk factor for frequent urination is a history of vaginal childbirth. Childbirth can weaken the pelvic floor muscles that hold the bladder in place.
Sometimes, however, frequent urination may be due to damage to the nerves in the bladder as well. Sometimes a woman does not experience problems with bladder control immediately after giving birth, but she may experience symptoms years later.
Symptoms and complications
Additional symptoms, such as pain or the inability to control one's bladder, can help the doctor identify the cause of the frequent urination.
A woman may have additional symptoms besides how often she urinates. This may give doctors a clue as to the potential cause of her frequent urination.
- a changing color to the urine, such as red, pink, or cola-colored
- experiencing a sudden, strong urge to urinate
- having trouble completely emptying the bladder
- leaking urine or losing control over one's bladder altogether
- pain or burning when urinating
Complications associated with urinary frequency often depend on the condition's underlying cause. For example, if a woman's frequent urination is due to a urinary tract infection, she could experience a severe and systemic infection if left untreated. This could damage her kidneys and cause narrowing of the urethras.
If urinary frequency occurs on its own with no immediately treatable illness, it can affect a woman's quality of life. A woman may not be able to sleep well due to having to wake up to go to the bathroom very often. She may also refrain from social events for fear of having to go to the bathroom too frequently.
These complications can all have an effect on a woman's sense of well-being.
When to see a doctor
If frequent urination is accompanied by symptoms of possible infection, women should see their doctor. Examples include fever, pain when urinating, and pink- or blood-tinged urine.
Painful urination or pelvic pains are also causes for concern, along with frequent urination. A woman should also see her doctor any time that she experiences symptoms that are uncomfortable to her or that interfere with her quality of life.
Often, there are lifestyle and medical means to treat frequent urination so that a woman does not have to suffer with the symptoms.
How is frequent urination diagnosed?
A doctor will start to diagnose potential underlying causes for frequent urination by asking questions about a woman's health history.
Examples of these questions may include:
- When did you first notice your symptoms starting?
- What makes your symptoms worse? Does anything make them better?
- What medications are you currently taking?
- What is your average daily food and drink intake?
- Do you have any symptoms when you urinate, such as pain, burning, or sensations that you are not emptying your bladder completely?
A doctor may take a urine sample for evaluation. A laboratory can identify the presence of white or red blood cells as well as other compounds that should not be present in urine that could indicate an underlying infection.
Other testing may include cystometry, or the measure of pressure in the bladder, or cystoscopy, which involves using special instruments to look inside the urethra and bladder.
Other diagnostic methods may depend upon a woman's specific symptoms.
Treatment and prevention
If a urinary tract infection is causing a woman's frequent urination, taking antibiotics to cure the infection may help.
Lifestyle changes like avoiding coffee and other caffeinated beverages may help reduce the frequency of trips to the bathroom.
Other treatments and preventive techniques for frequent urination that is not due to infection include:
- Lifestyle modifications: Avoiding foods and drinks known to irritate the bladder can help a woman experience fewer episodes of frequent urination. Examples include avoiding caffeine, alcohol, carbonated beverages, chocolate, artificial sweeteners, spicy foods, and foods that are tomato-based.
- Adjusting patterns of fluid intake: Avoiding drinking too much water before bedtime can reduce the likelihood of waking up at night to go to the bathroom, for example.
- Bladder retraining: Bladder retraining is another method to reduce the amount of times a woman goes to the bathroom per day. To accomplish this, she will void on a regular schedule instead of always waiting until she feels the need to urinate.
If possible, a woman should use techniques such as relaxation to see whether the need to urinate passes if she feels the need to go before the scheduled time. Women should not start a bladder-retraining schedule without discussing it with their doctor first.
In addition to these methods, doctors can prescribe medications that reduce bladder spasms and encourage relaxation of the bladder. This has the effect of reducing the urges to have to go to the bathroom.
Examples of medications used to treat urinary frequency include:
- imipramine (Tofranil)
- mirabegron (Myrbetriq)
- oxybutynin (Ditropan)
- tolterodine extended-release (Detrol)
Sometimes a doctor will recommend injections of botulinum toxin (BOTOX), which can reduce the incidence of bladder spasms. BOTOX can also relax the bladder so that it can become fuller before a woman has the urge to urinate.