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Frequent Urination — What’s Normal, What’s Not

FrequentUrinationJacquie Eubanks RN BSN

Largely considered an inconvenient condition, frequent or urgent urination can affect both men and women. Sometimes referred to as overactive bladder, frequent urination is usually manageable, often by dealing with an underlying condition. During the day it’s not unusual to urinate every two to four hours dependent upon fluid consumption and hydration status. In general waking once or even twice during the night is considered within normal limits, although many can sleep through the night without having to go. If you are a healthy, non-pregnant adult having to urinate more than eight times daily, you may need to check in with your healthcare provider to eliminate any underlying causes.

Men and women who frequently wake during the night to urinate may wonder whether it’s a cause for concern. Known as nocturia, getting up multiple times several nights or more each week results in sleep disruption and becomes more common as we age. Symptoms can include frequent or excessive urination, as well as urgency and reduced urine. Getting up during the night can become a habit and may simply be the result of consuming caffeine, alcohol or other fluids within two to three hours before bedtime. Like frequent daytime urination, nocturia can have underlying minor or more serious causes, including  a urinary tract infection, diabetes, or prostate problems.

Frequent urination accompanied by increased thirst, weight loss, or increased appetite, as well as pain with urination, fever, signs of blood in the urine and a frequent urge to urinate with little output may all be cause for concern. As well, those aged 65 and older who get up more than twice nightly, should likely see their general practitioner.

Some common causes of incontinence

  • Certain medications, including those for high blood pressure, antihistamines, muscle relaxants, sedatives, narcotics and diuretics can cause urinary incontinence in men and women.
  • Alcohol and caffeinated beverages cause the body to produce more urine. Consumed in excess this can result in nighttime waking.
  • With aging, bladder capacity tends to dwindle. As we grow older, we tend to sleep less soundly, so we are more easily aroused by the urge to urinate.
  • To help avoid getting up during the night, those with edema, or lower leg swelling, should consider elevating the legs a few hours before bed. This allows fluid to redistribute into the bloodstream where it can be filtered by the kidneys and excreted. Lower leg edema should not be ignored, as it can be a sign of a weakened cardiovascular system.
  • Waking up with urinary urgency or burning with urination may be a symptom of a urinary tract infection.
  • An enlarged prostate can lead to a thickening of the bladder wall, which results in reduced bladder capacity and elasticity, and therefore increased frequency of urination day and night. Male incontinence is also associated with prostatitis, a painful inflammation of the prostate gland.
  • Increased urge and frequency is associated with disease processes that affect brain function, including dementia, Parkinson’s and stroke.
  • Diseases such as multiple sclerosis, diabetes, or Parkinson’s can damage the nerves that control the bladder.

What you can do:

  • If you are properly hydrated and have no issues with kidney function drinking several glasses of liquid in the evening will likely result in waking up at night.
  • To avoid sleep disruption due to fluid consumption, drink plenty of water during the day and limit fluids several hours before bed, especially alcohol and caffeinated drinks.
  • Elevate the legs or wear compression stockings to prevent fluid buildup.
  • A short afternoon nap can be helpful for those who wake frequently during the night. As well, lying down allows excess fluids to be absorbed into the bloodstream.
  • Changing the timing of prescription medications that increase urination may also help.
  • Loss of excess weight can help ease symptoms. Obesity can place extra pressure on the pelvic floor and bladder.
  • Weak pelvic floor muscles can result in incontinence. Strengthening the pelvic floor with Kegel exercises can help control or prevent urinary incontinence.
  • Timed voiding, in which one urinates on a schedule and slowly extends the time between trips, can help one regain control of an overactive bladder, especially when combined with other lifestyle changes and pelvic muscle exercises.
  • Prescription medications can help the bladder empty more fully during urination. Other drugs tighten muscles and can lessen leakage.

Professional Supplement Center offers these and other high quality products in support of urinary tract and overall health:

Urinary DefenseUrinary Defense® by Priority One®: This natural herbal blend provides nutritional support for urinary tract comfort and a healthy urinary system. The formula provides a patented cranberry extract containing active anthocyanins and natural cranberry fiber and is designed to deliver the nutrients to the lower gastrointestinal tract for enhanced absorption and utilization. Gluten, preservative, sweetener, flavor and phthalate free. Non-GMO formulation.

Bladder EaseBladder Ease™ by Vitanica®: Bladder Ease is designed to provide herbal and nutritional support for continuous, intermittent, or full bladder discomfort. Handpicked ingredients help to strengthen bladder walls and may support a healthier inflammatory response in the urinary tract. Free of preservatives, binders, artificial colorings and flavorings, sugar, lactose, salt, wheat, gluten, soybeans, dairy, eggs, peanuts, tree nuts, fish and shellfish. Vegan formulation.

AZO Bladder Control...AZO Bladder Control® with Go-Less® by AZO: Derived from naturally sourced pumpkin seed and soy germ extracts, this safe, drug-free proprietary formula helps reduce the urge to urinate and supports healthy control by sustaining the bladder muscle and pelvic floor. Free of gluten, yeast and artificial color and flavor.

Ultimate FloraMax...Ultimate FloraMax™ Total Woman Care 90 Billion by Advanced Naturals®: This high potency multi-strain probiotic formula is designed for support of women’s digestive, immune, vaginal and urinary tract health. Gluten, soy, dairy and artificial ingredient free.


Better Man HCPBetter Man HCP by Interceuticals®: Based on Traditional Chinese Medicine, this clinically tested, all natural men’s formula helps improve blood circulation, as well as modulate testosterone and neuromuscular functions in support of better bladder control, prostate health, stronger libido, increased energy and overall wellbeing.

Frequent nocturnal urination in older men is associated with arterial stiffness: The Nagayama study. https://www.ncbi.nlm.nih.gov/pubmed/31399710
Nocturnal Excretion in Healthy Older Women and Rationale for a Safer Approach to Sleep Disruption. https://www.ncbi.nlm.nih.gov/pubmed/31437310
Urination: Frequent Urination. https://my.clevelandclinic.org/health/diseases/15533-urination–frequent-urination
Medications that can cause urinary incontinence. https://www.health.harvard.edu/bladder-and-bowel/medications-that-can-cause-urinary-incontinence
Urinary Incontinence in Older Adults. https://www.nia.nih.gov/health/urinary-incontinence-older-adults

When You Gotta Go Right Now

GottaGoJacquie Eubanks RN BSN

Statistics show that as many as 33 million Americans have symptoms of a condition known as overactive bladder (OAB). However, the number of men and women with OAB symptoms may be much higher, as it appears many are too embarrassed to share their symptoms with their healthcare provider, or are unaware that OAB does not have to be accepted as a natural consequence of aging. Normal urinary frequency averages 6 – 7 times in a 24-hour period. Because everyone is different, frequency of 4 – 10 times can also be normal, if an individual is comfortable and has no symptoms of urgency or incontinence. If the bladder feels full but only a miniscule amount of urine is released, or there is burning or discomfort with urination, it can signal a bladder, kidney or urinary tract infection (UTI).

Frequent urination may be the result of caffeine, alcohol, and fluid intake, medications or side effects of medications, stress, UTIs, and certain chronic health conditions, such as diabetes, Parkinson’s, or multiple sclerosis. Although menopausal women and men with a history of prostate problems are at greater risk of OAB, the condition generally develops without cause or has causes that are not yet understood. In OAB, a partially filled bladder contracts suddenly resulting in the urge to urinate, and no cause is found for repeated and uncontrolled bladder contractions.

Symptoms of OAB that can vary in severity include:

  • Urgency, an intense, sudden and pressing need to urinate that cannot be put off
  • Frequency, having to urinate 8 or more times a day
  • Nocturia, waking up to use the bathroom more than once each night
  • Stress incontinence, along with urgency a leaking of urine that is not controllable

When OAB causes disrupted sleep, interferes with normal life, or prevents one from enjoying social engagements, it’s time to seek solutions. Barring diagnosis of a health problem, OAB is often initially addressed with lifestyle changes.

Try Kegel exercises. Strengthening the pelvic floor muscles that support the bladder and other internal organs helps with urinary incontinence. To identify the muscles, try to stop urination midstream. Once you have correctly identified the muscles, these exercises can be done discreetly just about any time. Repeatedly squeezing, holding for a count of five and then relaxing the muscles tones and strengthens the pelvic floor. For best results, start with an empty bladder, work toward holding for a count of 10, and aim for three sets of 10 repetitions daily. Kegel exercises are recommended for both men and women to help with urinary incontinence and to prevent potentially embarrassing leakage.

Adjust your fluid intake. You need to drink a proper amount of fluid daily to maintain healthy bladder function. Ideally, urine should be almost clear or very light yellow. For some, this will mean reducing fluid intake, and for others, increasing intake. When you don’t take in enough liquids, it can lead to darkly colored concentrated urine and result in bladder irritation. In this case, it’s best to slowly increase fluid intake to reduce the irritation, as well as sensitivity. If you are getting up several times each night, you may need to cut back on fluids, especially in the evening. Minimize bladder irritants, including caffeine, alcohol, artificial sweeteners, and carbonated drinks.

Consider bladder training.  Lengthening the time between trips to the restroom can help to increase the amount of fluid the bladder can hold and diminish the sense of urgency. Regularly performing pelvic exercises can greatly increase the chance of success. Bladder training is not easy but ultimately, it can get you on a regular schedule of 3 – 4 hours between visits. Begin by suppressing the urge for 5 minutes or as long as you can. Continue to incrementally increase the time you can wait. After 6 -12 weeks, you should notice progress, but keep practicing!

Supplement with Pumpkin Seed Oil. Studies have shown that orally administered pumpkin seed oil extracted from Cucurbita pepo significantly reduced urinary dysfunction in OAB within 6 – 12 weeks. Pumpkin seed oil is rich in vitamins, linoleic acid, oleic acid and microelements. Clinical trials involving 2000 men with benign prostate hypertrophy (BPH) showed considerably improved urinary dysfunction with no undesired side effects.

And of course, exercise. Studies show that middle-aged women who are physically active are less likely to develop incontinence. Exercise and a healthy diet that supports weight loss and maintenance helps to relieve incontinence, as carrying extra weight puts undue pressure on the bladder. For some, it might be best to avoid high impact exercise or weight lifting. Walking and swimming are good exercises for both men and women with symptoms of OAB. Avoiding caffeinated beverages for several hours before exercising is helpful, but do continue hydrate with water.

Professional Supplement Center carries these and other high quality supplements to support a healthy urinary tract and overall health:

Urgent LessUrgent-Less™ by Priority One: This product provides highly stabilized Go-Less® pumpkin seed oil extracted from Cucurbita pepo in support of improved urinary function. Contains soy.


U-TractU-Tract® by Progressive Labs: This powdered formula provides D-mannose, a naturally occurring simple sugar that supports urinary tract health. D-mannose helps to prevent urinary tract infections by coating bacteria that stick to urinary tract walls, allowing bacteria to be washed away. Excreted through the kidneys, very little D-mannose is metabolized, preventing interference with blood sugar regulation. U-Tract Caps™ also available.

Flow-LessFlow-Less by Allergy Research Group: This blended formula provides pumpkin seed extract and soy isoflavones to support healthy bladder function and reduce occasional urinary urgency, allowing for more restful sleep.


AZO Bladder Control...AZO Bladder Control with Go-Less® by AZO: This naturally sourced blend of Go-Less® pumpkin seed and soy germ extracts provides a safe and drug-free way to reduce the urge to urinate. Specific ingredients support bladder control function and help to limit nighttime trips to the bathroom. This product should be taken for minimum of 30 days to realize the full benefits. Gluten and yeast free, Non-GMO formulation.

Bladder Support, Q.Bladder Support, Q. by Quantum Nutrition Labs: This popular botanical product provides powerful, broad-spectrum nutritional support for bladder and urinary tract health and function. Gluten and lactose free, vegan formulation.

Urology Care Foundation. Official Foundation of the American Urological Association. http://urologyhealth.org/urologic-conditions/overactive-bladder-(oab)
New guidelines recommend Kegels, other lifestyle treatments for urinary incontinence in women. http://www.health.harvard.edu/blog/new-recommend-kegels-and-other-treatments-for-incontinence-women-201409177438
What is normal urinary frequency? https://www.bladderandbowel.org/bladder/bladder-conditions-and-symptoms/frequency/
Overactive Bladder Syndrome. https://patient.info/health/overactive-bladder-syndrome
What Are Kegel Exercises? http://www.healthline.com/health/kegel-exercises#overview1
Bladder Training. https://www.ucsfhealth.org/education/bladder_training/
Pumpkin Seed Oil Extract From Cucurbita maxim Improves Urinary Disorder in Human Overactive Bladder. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4032845/