Peeing Too Much Can Be a Sign of Something More Serious—Here's What to Know


If you're emptying your bladder more often than usual, there could be a simple reason: maybe you've increased your fluid intake recently or have been drinking lots of diuretic beverages, such as caffeinated coffee or soda.

But once you've ruled out the obvious causes and lifestyle habits, it's worth asking yourself if your increased urination could be medically related; there are several common health conditions that can cause an uptick in urine production and voiding (and some less-than-common ones as well).

What-is-Polyuria-AdobeStock_303740549 What-is-Polyuria-AdobeStock_303740549 . That's much higher than the average of output of 800 milliliters to 2 liters per day, reports the US National Library of Medicine.

You should note that polyuria is similar to nocturia, but it's not the same. For one, people with nocturia only have symptoms at night, says Cleveland Clinic, but people with polyuria usually have daytime and nighttime symptoms.

More importantly, though, is the difference in the root cause or source of the increased urination. With polyuria, your body is actually producing an excess amount of urine, which causes the increased urination, Cleveland Clinic explains. With nocturia, however, your body is not overproducing urine—you just have the urge to go more frequently (this can happen for a variety of reasons, most often incomplete voiding due to enlarged prostate and overactive bladder).

And there's one more wrinkle: Some people with polyuria only have increased urination at night, says Dr. Ramin. It's called nocturnal polyuria.

RELATED: Why Do I Pee So Much at Night? 3 Reasons Why You're Always Running to the Bathroom

What causes polyuria?

Because polyuria isn't just urinary frequency, or feeling an urge to go more frequently, it's necessary to figure out what's causing the increase in urine production in order to manage your polyuria.

Most of the time, says Dr. Ramin, uncontrolled diabetes mellitus, both type 1 and type 2, is the culprit.

"If a person all of a sudden develops increased urination, it's important to see if they have uncontrolled diabetes," he explains. "It may be difficult for a layperson to determine whether they have urinary frequency versus polyuria [which is why you should see a doctor]."

The high occurrence of polyuria in people with diabetes comes down to glucose. According to the research organization JDRF, excess sugar in your blood can't be processed by the kidneys and reabsorbed back into the bloodstream; instead, it draws more water into your urine and promotes excess urine production.

There is another kind of diabetes, diabetes insipidus, that is also often responsible for polyuria, explains the National Institute of Diabetes and Digestive and Kidney Diseases. It can cause both excessive thirst, which leads to extreme water intake, and a deficiency of something called vasopressin, an antidiuretic hormone (ADH) that promotes water conservation in your kidneys.

According to Merck Manual and other experts, some health conditions associated with polyuria include:

Polyuria is also more common in older adults, especially women, says Mark Ellerkmann, MD, director of the Urogynecology Center at Mercy Medical Center in Baltimore. "ADH makes your kidneys make less urine; it's secreted so you're not up all night peeing," he explains. "But as you get older, you secrete less."

RELATED: What to Know About Overactive Bladder, Including Causes, Symptoms, and Treatment Options

What are the symptoms of polyuria?

In many cases, you may experience what Dr. Ramin calls an acute onset of polyuria: "From a symptom standpoint, this means a person has been doing okay and then all of a sudden they're urinating more often in the daytime, more than ever before."

Again, it's important to pay attention to whether you're actually voiding an unusually large amount of urine or simply feeling like you need to go more frequently. If you're using the bathroom several times per hour but only urinating a small amount each time, it's more likely to be urinary frequency or nocturia.

Increased voiding is the number one symptom of polyuria, though the excessive urination can cause its own sub-symptoms as well, including excessive thirst (if you're urinating a lot, you'll feel more thirsty than usual) and nighttime wakings to urinate.

RELATED: What Is Nocturia? Why Getting Up to Pee Multiple Times a Night May Signal a Problem

How is polyuria diagnosed?

Drs. Ellerkmann and Ramin say a diagnosis of polyuria begins with identifying the source of the problem—polyuria versus urinary frequency, an important distinction for determining treatment. In this case, the most important diagnostic tool is information.

Dr. Ellerkmann says the results of a urine frequency-volume chart, or 24-hour voiding diary, can help determine if you have urinary frequency or nocturia due to low-volume voiding, polyuria due to an excess volume of urine, or both. For instance, if you are urinating frequently throughout the day but only producing an average or below-average amount of urine, the diagnosis will likely exclude polyuria.

On the other hand, if you're urinating frequently and it's adding up to more than the average amount, that's a good sign for your doctor that you're dealing with a high volume of urine, not just a high frequency.

There is another way, Dr. Ellerkmann says, your doctor may try to distinguish between the frequency versus volume of your voiding: "Measuring post-void residual urine [in the bladder] by catheterization or bladder ultrasound can be helpful in diagnosing bladder obstruction and urinary retention."

In other words, your doctor may ask you to undergo diagnostic testing in-office or at a hospital or clinic that involves measuring the amount of urine left in your bladder after you void. Less than 75 milliliters is considered normal, per Dr. Ellerkmannn, but residual urine totaling 200 milliliters or more is considered abnormal (and might prompt a polyuria diagnosis).

RELATED: What Is Nocturnal Polyuria? Possible Causes, Symptoms, and Treatment Options

How is polyuria treated?

Polyuria itself doesn't come with its own treatment plan and there are no specific medications to treat polyuria. Instead, you and your doctor will focus on better managing the condition or conditions causing polyuria.

"The treatment is mostly driven by the root cause of the problem," says Dr. Ramin. "You determine the underlying cause and address any uncontrolled conditions, like diabetes or congestive heart failure."

For example, says Dr. Ellerkmann, when you combine the prevalence of varicose veins in older women with the changes in ADH production, you end up with many older women producing extra urine—especially at night. "You build up swelling in your lower legs, go to bed, and put your legs up, and then your body tries to mobilize all that fluid back into your vascular tree."

This process, he adds, involves producing more urine in the kidneys and causing more frequent voiding. In the case of varicose veins, the"treatment" for polyuria would involve managing your edema; this might include wearing compression stockings during the day to improve your circulation and reduce swelling.

If your doctor feels that medication might be a necessary component of your treatment, there are drugs given to people with related conditions, like overactive bladder or enlarged prostate, which may help. Still, with polyuria, the best treatment involves finding out why your body is producing so much urine in the first place and focusing that treatment on the source of the problem.

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