Certain people just need to pee more frequently than others. Ever since high school, I’ve known that I’m one of these people. That means always being vaguely stressed about where the closest bathroom is, and spending a lot of time debating whether or not to have another sip of water before getting into bed. For my frequent-peer friend Tony, it means getting an aisle seat on every flight, and, if he drinks beer before a movie, spending “more mental energy planning a good time to take a leak than following the plot.” It’s not a huge deal, but it’s annoying; and I can’t help but wonder: why?
The average person pees six or seven times a day, though anywhere between four and ten is considered normal. But for those with “urinary frequency”—the unsatisfyingly banal medical term for peeing a lot—the number is much higher. This can be due to any one of a long list of conditions that affect the urinary tract, from bladder stones to an enlarged prostate to diabetes.
Unfortunately, when there isn't a diagnosable condition in the mix (there was not one for me), it can be tough to pinpoint a clear-cut answer to why some people feel the urge to pee more often than others. Still, we do know some things about what might be behind my need to pause a 56-minute episode of Narcos: Mexico more than once to use the bathroom. “Everything affects your bladder—what you eat, what you drink, stress levels, even the weather,” says Michael Ingber, a New Jersey-based urologist. Here are a few potential causes.
Your body makes more pee than other people’s bodies do
Usually when someone has to pee a lot, it’s because they feel like they have to go all the time, even when their bladder is pretty empty. But for those with polyuria, your body actually produces more urine—up to five times the adult average of three liters a day. Certain external factors, like being diabetic, taking certain prescription drugs, or drinking tons and tons of water could cause a person to make more urine.
Stress knocks over a long line of physiological dominos, some of which make you need to pee. First off, stress and anxiety can cause the limbic system (which controls our “fight or flight” response) to override brain signals that usually curb our desire to urinate. Plus stress raises cortisol levels, which can inhibit antidiuretic hormones (ADH), creating the need to pee more. See, ADH normally increases the amount of liquid reabsorbed by the body, so without it, less liquid is reabsorbed and more urine accumulates. “There are several studies which confirm that stress plays a role in worsening urinary frequency,” Ingber says.
You’re eating something that’s messing with your bladder
We all know that certain foods can upset your stomach or esophagus, but apparently the bladder has food sensitivities too. In general, the biggest culprits are spicy and acidic foods, though the Cleveland Clinic provides a comprehensive list that includes pickled herring and strawberries (not together, that would be gross). “Just like these foods can irritate your mouth, they can also irritate your bladder and make you feel the need to pee,” says Anita Ackerman, a New Jersey-based urologist.
You’re drinking the wrong things—or just too much
Though “breaking the seal” may be a myth, it’s true that alcohol irritates the bladder and causes a more frequent need to take a leak. As you probably already know, caffeine can have the same effect, due to its diuretic qualities. And lest you need reminding, drinking more than your normal amount of anything is bound to make you need to go more.
When you feel cold, your body constricts the blood vessels in your limbs and extremities to shift more blood to your core. This increase in blood puts pressure on the area, which your body then normalizes by evacuating excess fluids. (That means pee, in case it wasn’t clear.)
Weirdly, not drinking enough can also make you need to pee. This is because the more concentrated your urine is (think that dark yellow color), the more irritating it is to the bladder, Ackerman tells me, and the more your body will want to get rid of it.
You’re taking certain meds
Take a pill for one problem, then all of a sudden you’re dealing with another one, amirite? It’s true, taking prescriptions drugs can often feel like a game of side-effect whack-a-mole, and needing to pee a lot is one of those moles. High blood pressure medication, anti-anxiety and antidepressant meds, and certain antibiotics can all be culprits.
It’s all in your head
“I find in my practice that some people psychologically feel the need to urinate more frequently,” Ackerman says. “These people may have no underlying pathology for why they pee so much.” This could be due to a history of UTIs or incontinence, a lower threshold for discomfort, or even boredom.
Your bladder is overactive
“Overactive bladder” is a sort of catch-all term for when your bladder contracts involuntarily, making you think you need to pee when you don’t—but the reasons for those contractions are poorly understood. Anything from diabetes to SSRIs to too much caffeine could be linked to it.
Your bladder is small
Size does matter. A small bladder is an excuse almost all frequent pee-ers have cited at some point, though most of us probably had no idea it was true, or even a possibility. While most people’s bladders hold about two cups of fluid, some people’s anatomy might be such that they can hold significantly less. “If someone is born with a smaller bladder, they simply cannot hold as much urine as people who have a larger bladder,” Ackerman says.
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There’s also the issue of nocturia, or excessive nighttime peeing, which is defined as getting up to use the bathroom more than once each night (#itme). Nocturia can be caused by any of the factors above, as well as sleep apnea, which releases an enzyme called atrial natriuretic peptide that causes the kidney to increase urine output, according to Ackerman.
No matter when you're peeing, or why, there are some things experts recommend you do to mitigate the issue:
Track your habits
Tracking what you eat and drink, and how often you pee, can help you see if there’s a clear pattern—or maybe realize that you’re actually peeing a normal amount.
Track what you’re consuming
This is sort of obvious, but try cutting down on the the bladder-irritating or diuretic items you consume (yes, that means less coffee and booze).
Figure out a way to reduce your stress
“When dealing with young people with [urinary frequency] complaints, we often work on stress relief—for example, with guided imagery,” Ingber says. Guided imagery is a technique used in meditation for stress and pain management that involves someone trained in meditation/hypnosis telling the patient to picture her or himself in a calming, tranquil scenario, and then asking them to imagine the pelvic muscles relaxing.
Train your bladder
If you pee every time you feel the slightest urge, your body becomes accustomed to that. Train it to do the opposite through “timed voiding”—go pee every 30 minutes for a day or two, whether you need to or not; then increase the interval by 15 minutes every day. This could help your bladder both increase its capacity and become comfortable with the sensation of holding urine. As Ackerman explains it, “Resisting the urge to urinate and allowing the bladder to fill can lengthen time between voids.”
Or, you can just accept it and move on with your life. These days, I’m pregnant, so my frequent need to pee is suddenly normal—and since I don’t feel weird about it anymore, it doesn’t bother me at all. For me, turns out that the only issue with urinary frequency was a vague embarrassment. Now that I’ve experienced the joy of a shame-free pee, I plan to do so as often as my tiny bladder desires.
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