Frequent urination is defined as the need to urinate more often than a person normally would. It does not represent the quantity of urine. A person may pass a small amount of urine or more urine than usual. Frequent urination can occur during the day as well as at night. In some cases, the frequency of urination increases at night. It is medically termed as nocturia. Frequent urination may also be associated with dysuria (difficult micturition), polyuria (passing large amount of urine) and other conditions. Overall, it affects the general well-being, sleep and work life of the patient.
The causes of frequent urination in women include urinary tract infections, overreactive bladder, pregnancy, low estrogen level, vaginitis, post-partum period, sexually transmitted diseases etc. Frequent urination requires urgent medical attention if it is associated with back pain, fever, chills, vomiting, uncommon fatigue, bloody urine or discolored urine or abnormal vaginal discharge.
Normal Urinary Frequency
Everyone has a unique body and normal urinary frequency can also vary. On average, women urinate approximately 6 to 8 times a day, according to various studies. If a woman urinates more than 8 times a day, she may require medical attention to rule out the cause.
Causes of Frequent Urination in Women
Let’s start a discussion on the most causes of frequent urination in women:
Excess Fluid Intake
The most common question that your doctor asks you how much fluids do you take a day. Fluid intake affects urination. The simple principle is more you drink more you urinate. Generally, if you take caffeinated beverages in excess amounts, then you may likely to have more urination a day than usual. The following things can be a cause of frequent urination:
- Alcohol
- Caffeine-containing products
- Certain medicines
- Artificial sweeteners
- Soft drinks
- Energy drinks
- Soda water
- Chocolate
- Black lentil (Black gram)
- Vinegar
- Lime
- Lemons
- Apple juice
- Orange juice
- Grapefruit juice
- Pineapple juice
Any product that contains any of above ingredients can cause frequent urination.
A person with a moderate activity requires around eight glasses of water daily. So, the total consumption of water should be around 64 ounces (1800 ml) per day. However, the fluid requirement can be different for everyone depending on the level of daily activities, season and other factors. If a person does more physical work that causes sweating, then water intake can be more than usual. If a person lives a sedentary lifestyle, then water requirement may be less than the recommended.
Urinary Tract Infection (UTI)
Urinary Tract Infection (UTI) is the most common cause of increased urinary frequency in women. It affects 50 to 60 percent of women in their lifetime. One in three women by the age of 24 experience severe UTI that require treatment with antibiotics. The increased risk of urinary tract infection in women is due to shorter urethra from where bacteria travel to the urinary tract and cause infection. The most common symptoms include frequent urination and burning sensation during urination.
The common causes of UTI include:
- Less water intake.
- Holding urine for a longer period.
- Poor hygiene of private parts. Poor hygiene can increase the risk of E. Coli bacteria to enter the urethra and cause UTI.
- Vaginal inflammation and irritation.
- Sexual intercourse.
- Pregnancy – due to some structural changes in the urinary system during pregnancy.
- Diabetes
Overactive Bladder
Overactive bladder can also cause frequent urination. Around 17% of women experience overactive bladder (OAB) over the age of 18. Approximately, 15 million adult women have frequent urination due to OAB in the US. Some women with OAB can also have urge incontinence. Other symptoms include urine leakage and nocturia (increased urination at night).
Low Estrogen & Menopause
Low estrogen levels in women can also cause increased urinary frequency. The pathophysiology involves the thinning of the urethra and increased the sensitivity of the bladder due to low estrogen. Thin urethra also becomes more prone to urinary tract infections.
Menopausal women also experience frequent urination and urgency. In such cases, women experience frequent urination at night. Low estrogen level during menopause is the underlying cause of frequent urination.
Vaginal Infections
Vaginal infections cause abnormal discharge from the vagina. The thick discharge also sticks to walls of the vagina. It results in bad odor, burning, itching, irritation and urinary symptoms. The urinary symptoms include dysuria (difficult urination) or increased frequency of urination in some women.
The common causes of vaginal infections are:
- Yeast infections: It is the most common cause of vaginal inflammation and infection. It is caused by several species of candida fungus, especially Candida albicans. However, candida is naturally present in the vagina, but in small numbers. It does not cause any harm. The balance of yeast species is maintained by lactobacilli bacteria that also live in the vagina. When its numbers decrease vagina, it leads to bacterial yeast imbalance. It results in two infections – yeast infection and bacterial vaginosis. When yeast starts to grow in number, it leads to infection causing discharge of thick and white fluid, itching, redness and inflammation of vulva and vagina.
- Bacterial vaginosis: The low level of lactobacilli bacteria in the vagina also results in bacterial vaginosis causing invasion of other harmful bacteria. Gardnerella bacteria are the most common cause of bacterial vaginosis. Its symptoms include discharge of clear and slippery whitish discharge and fishy odor.
- Trichomoniasis (trichomonas vaginitis): It is a sexually transmitted disease (STD). It is caused by trichomonas vaginalis, a single-celled parasite. It is passed from one partner to another during sexual intercourse. It is characterized by itching, irritation, burning, swelling and inflammation of vulva. The discharge in trichomonas vaginitis is greenish, yellow or gray in color. It also causes burning sensation and pain during urination and increases the frequency of urination.
Pregnancy
Frequent urination is an early sign of pregnancy that usually occurs during the first trimester. It also occurs during the third trimester of pregnancy. In the first trimester, it starts appearing around 6 weeks of the pregnancy. There are three major causes of increased frequency of urination during pregnancy:
- Hormonal Changes: Changes in hormonal levels during pregnancy increase blood flow to the kidneys. Kidneys receive 35 to 60% more blood flow in pregnant women than normal women. The extra blood flow increases the urine output by around 25% after conceiving a baby. The urine output starts increasing after the 6th week of pregnancy. It is higher in 9 to 16 weeks and then becomes normal.
- Increased Body Fluids: The fluid volume increases during pregnancy. Circulating blood volume increases by 50% in the body during pregnancy than before. So, kidneys have to do some extra work to process the blood. The extra filtration of fluid also increases urine output and leads to frequent urination.
- Growing Uterus: In the third trimester, uterus grows to accommodate the developing baby, which puts pressure on the urinary bladder. The increased pressure on the bladder causes frequent urination. It is not necessary that pregnant women have excess urine in the bladder or bladder is full. It is caused by pressure that results in an increased urge of urination. Some pregnant women also have leakage of the urine when they cough or sneeze due to the same cause.
References
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