Urinary tract infections are the best known and most common cause of urinary frequency. They usually start very suddenly and also tend to cause stinging and burning, but sometimes there is no pain. With sudden onset frequent urination it's important to see a doctor right away, as untreated UTIs can spread to the kidneys. The onset of diabetes can also cause frequent toilet visits.
Possible Causes
- urinary tract infection
- kidney problems
- interstitial cystitis
- diabetes
- diabetes insipidus
- multiple sclerosis
- chronic fatigue syndrome/myalgic encephalomyelitis (CFS/ME)
- fibromyalgia
- hyperthyroidism
- candida (yeast overgrowth)
- some STDs like gonorrhea
- anxiety/stress
- benign prostate hyperplasia (BPH) in men
- pregnancy
- diuretic drugs (such as some blood pressure drugs) and lithium
- drinking too much water (polydipsia)
Urinary frequency is associated with many chronic illnesses, especially neurological illnesses. It is well-known to be a symptom of multiple sclerosis, but many doctors don't know it's also very common in fibromyalgia and CFS/ME. The latter are also often associated with interstitial cystitis, a chronic bladder condition that causes frequency, urgency and often severe pain.
The cause of interstitial cystitis isn't known, but the symptoms are thought to stem from inflammation in the bladder, with possible connections to allergies or autoimmunity. In most people with urinary frequency, however, the problem is spasms of the bladder or sometimes excessive urine production (polyuria).
In benign prostate hyperplasia the enlarged prostate can cause frequent trips to the bathroom. This is very common in older men. Similar symptoms can occur during pregnancy in women, when the uterus presses on the bladder.
Sometimes no cause is found. This conditions has many names which are mostly synonymous: irritable bladder, overactive bladder or idiopathic bladder spasm. When the problem occurs at night it is called nocturia. Some, but not all, people with these problems also suffer from incontinence.
Treatment
Anticholinergic drugs can reduce urinary frequency. They decrease the action of the neurotransmitter acetylcholine, which can cause bladder contractions. There are several anticholinergics meant specifically for bladder overactivity. Oxybutynin (Ditropan) is the most commonly used, but trospium (Sanctura), solifenacin (VESIcare) and darifenacin (Enablex) may have fewer side effects. Oxybutynin is also available as an extended release patch.
Tricyclic antidepressants have several potentially useful properties. Imipramine (Tofranil) is most commonly used for this purpose. They can also reduce pain caused by interstitial cystitis. Unfortunately side effects are common. Antidepressants that increase the levels of norepinephrine (noradrenaline) also reduce the need to urinate. Duloxetine (Cymbalta/Yentreve) is approved for stress urinary incontinence in some countries.
Other medications that may reduce urinary frequency include antihistamines (hydroxyzine (Atarax/Vistaril) is particularly used in interstitial cystitis), beta blockers, alpha blockers, stimulants and the muscle relaxant baclofen (Lioresal).
Vasopressin (also known as antidiuretic hormone) is a hormone that controls the amount of urine produced. A severe deficiency of ADH is known as diabetes insipidus. Some people with excessive urinary frequency may have a milder deficiency. Desmopressin (DDAVP), a synthetic equivalent of vasopressin, can be used as a treatment. It is sometimes used in children who suffer from enuresis (bedwetting).
Alcohol, caffeine, cranberry juice, vitamin C and some B complex vitamins have diuretic properties. Some people have noticed that avoidance of sodas, citrus fruit and acidic foods in general helps reduce bladder irritation. Unfortunately there are no herbal remedies or supplements that have shown efficacy in reducing bladder overactivity, though saw palmetto may help prostate problems.
