How do I stop having to pee all the time?

September 26, 2011 8:58 AM

I'm sick of having to pee every hour. Help!

Male, mid 20s, feeling way too young to have this issue.

Beginning a year or so ago, I've had to pee every hour to 2 hours. It's insanely annoying and I'm not sure what to do about it. During the day, it averages around an hour and a half. At night, I'll regularly wake up 1 or 2 times to use the restroom. It's driving me nuts!

My GP first tried prescribing antibiotics to treat it as a UTI, because the dipstick test returned some conflicting results. Their dipstick test did not return positive results for diabetes. Upon the return of the test from the lab, I did not have a UTI. At that point, it was still a problem, so they referred me to a urologist.

I've done all the tests with the urologist, including a CT scan and an inside look at my bladder with a camera (forget the exact name of the process, but it wasn't comfortable!). I've been on Flomax and Vesicare, for several months each. Both of them caused constipation to the point that it was unbearable to continue taking them. Neither of them helped.

I recently participated in a blood test and medical management program through my employer. The blood test returned several data points, including cholesterol and blood sugar (I fasted for the test). All results were within the normal range.

As an additional point of data, around the same time as the problems began, I started to jog for fitness. In the last year or so, I've lost 15-20 pounds. I run regularly, usually everyday, and have completed several 5k runs. I'm running a 10k in two weeks. I eat well and get plenty of rest. I've never been in better shape my entire life except I have to pee every hour!

I've started to wonder if it's all in my head or if it could be a medical problem. I am usually very thirsty (sign of diabetes?), but I've always been like that. I'm also usually quite hungry, but I've been attributing to the daily exercise.

I think I'm prone to anxiety and stress, but I've never been treated. As you may be able to imagine, having to pee every hour makes one extremely anxious. I need to make sure I pee before meetings at work and have to take frequent breaks during long car or plane rides. At this point, my urologist seems to think it's all in my head. I don't disagree, but I'm also not sure what to do. The anxiety sort of builds on itself when I think I need to use the restroom.

I really want and need to figure this out. I'm scheduled to visit London with a friend in December, which has long been a dream of mine. I'm sick of having to get up twice in the middle of the night when I'm sleeping over at the GF's house. I'm sick of having to duck out of long meetings at work to use the restroom.

I'm planning on contacting my GP this week to discuss other options with them. What does the hive mind suggest? Should I be searching out a therapist? Do I need to request additional blood tests from my GP? Do I find another urologist to get a second opinion?

posted by pete to health & fitness (42 answers total)

When you started losing weight, did you switch to diet soda by chance? The chemicals in aspartame make me pee like crazy.
posted by kate blank at 9:05 AM on September 26, 2011 [2 favorites]

If they didn't do a prostate exam, get a prostate exam. An enlarged prostate can press on the bladder causing this, which means this might be the symptom of something worse.
posted by griphus at 9:12 AM on September 26, 2011 [3 favorites]

You're peeing too often? Stop doing that.

I know, it sounds ridiculous and you have probably already knee-jerked the same disgust I did when told that, but... It worked for me. Own your bladder! Tell it "no." Let it jerk about. Expect it to stop arguing with you in a month or two, if my experience is anything to go by (and I think that was the range the doctor who suggested it suggested, too). After all, nothing bad will happen if you simply don't go to the toilet. The physical irritability will pass. You can try the same thing people use when they are watching how much they eat, too -- "If I'm still hungry in twenty minutes, I'll eat" -- tell yourself that if you still need to pee in twenty minutes, you'll go.
posted by kmennie at 9:12 AM on September 26, 2011 [6 favorites]

Although it's less common in men and usually presents later, I know someone who was diagnosed with interstitial cystitis in his early 20s. It's a diagnosis of exclusion, and less treatable than if this really were being driven completely by anxiety, but something to consider.
posted by deludingmyself at 9:13 AM on September 26, 2011 [1 favorite]

How's your back? Peeing a lot is one symptom of having a tethered spinal cord. I have a slightly tethered cord (along with a Chiari Malformation) and I pee all the goddamned time. Go to a neurologist to get it checked out.
posted by phunniemee at 9:13 AM on September 26, 2011

How much, and what are you drinking? Has your kidney function been tested?
posted by MuChao at 9:14 AM on September 26, 2011

What other drugs are you taking? Certain meds can give you dry mouth which makes you really thirsty. Have you measured exactly how much water you're drinking.

I am doubtful that anxiety would cause this problem, but it can exacerbate it. Maybe talk to a therapist?
posted by radioamy at 9:14 AM on September 26, 2011 [2 favorites]

Do you pee to "completion?" When you leave the bathroom, do you still feel like you have to pee, only not as much as when you entered? Do you ever feel like you have to pee but can't quite start?
posted by Obscure Reference at 9:16 AM on September 26, 2011

Oops, meant to link...tethered cord.
posted by phunniemee at 9:17 AM on September 26, 2011

What vitamins are you taking? Certain multis + my love of tea/water will make me go constantly.
posted by mrs. taters at 9:18 AM on September 26, 2011 [1 favorite]

How much, and what are you drinking?

Seconding this. Do you drink caffeine? A lot of water, soda or juice?

What colour is your pee?

I'd imagine your doctor would have asked all this in a first meeting. Still, never hurts to check.
posted by ODiV at 9:20 AM on September 26, 2011 [1 favorite]

As an additional point of data, around the same time as the problems began, I started to jog for fitness. In the last year or so, I've lost 15-20 pounds. I run regularly, usually everyday, and have completed several 5k runs. I'm running a 10k in two weeks. I eat well and get plenty of rest. I've never been in better shape my entire life

Gatorade/Powerade. You're drinking too much of it. Same thing happened to me when I started running and doing 5ks.
posted by cashman at 9:21 AM on September 26, 2011

After all, nothing bad will happen if you simply don't go to the toilet.

Um... UTIs? Weakened bladder (leading to incontinence)? Please don't follow advice of not going when you need to go.
posted by dayintoday at 9:24 AM on September 26, 2011 [1 favorite]

Wow, thanks so much for the replies.

To answer a couple of questions:

I only drink water and coffee. About 16oz of coffee each morning and then some herbal tea (blueberry) or water for the rest of the day. No soda, no alcohol, no sports drinks. I went coffee and caffeine free during the time that I was taking the Vesicare and Flomax and did not notice any difference.

I'm taking a small daily multivitamin. I do not notice a difference when I don't take it.

My urine is light yellow to clear during the day.

No back problems.

My kidney function has not been tested. What what would that look for exactly? To make sure it's filtering what it should filter?

kmennie, I've read a comment (probably yours) in a similar thread, and I agree. I will try that, although it's tough when I have a day of already stressful meetings scheduled.

On top of kmennie's comment, there are times during the day when time goes by quickly (I'm working on a project or spending time with friends) when I'll only need to go every 2 hours. Once in a while it peaks to 2.5 hours. Never more then that though.
posted by pete at 9:26 AM on September 26, 2011

You lost a lot of weight, so are you eating lower/better carbs than you used to? That has a big diuretic effect.
posted by Nattie at 9:26 AM on September 26, 2011

I have this same problem too but not at night. It's definitely a viscious cycle anxiety-wise.I take pills but I think more for the placebo effect. I would love to ignore it but not taking the risk in front of roomfulls of students or on crowded trains!! Some form of pill will probably work for you (there's many types) again even if it is only a placebo effect. Also I've had it for about 5 years and it is much less of a problem than it was initially so if your problem is similar to mine, at least it gets a bit better over time even if it hasn't disappeared entirely! Good luck and if you find a solution post it here and let us know!
posted by bquarters at 9:27 AM on September 26, 2011

Nattie, I am trying to eat less carbs or more whole wheat/whole foods/unprocessed sorta stuff.
posted by pete at 9:28 AM on September 26, 2011

Also, from what I've read online and discussed with my doctors, the going at night thing is what's confusing. It would stand to reason that at nighttime my body is waking me up because of a physiological reason and not a psychological one, right?
posted by pete at 9:30 AM on September 26, 2011

Get the latest copy of A headache in the pelvis by Dr. Wise.
posted by burlsube at 9:32 AM on September 26, 2011

It is possible to get into a peeing habit, as kmennie suggests. I probably go more often than I need to. If I wake up in the middle of the night, or if I'm leaving the house or about to work out, my brain goes "okay, time to pee" even though I don't strictly need to. (I often wake once or twice a night and I tend to just go through the ritual of going to the bathroom even though I probably don't have to.)

If you're peeing just for a few seconds - but don't have any physical problem peeing - and are completely empty when you're done, you might be peeing out of habit. Same goes if you have any specific pee-triggers, e.g. you always have to pee right before a car ride.

However, IANAD, and your bladder is nothing to fuck with. I wouldn't recommend trying to hold it if you're physically uncomfortable. If you've got a racehorse-quality stream every hour or two, or if you feel like you have to go but have trouble going, or any other sort of discomfort, it's likely physical and not mental.
posted by Metroid Baby at 9:34 AM on September 26, 2011 [1 favorite]

A family member was given kmennie's advice by a doctor after going through a similar battery of tests and it helped them too. A thing they were specifically told to cut down on was the "I may have to go to the bathroom in 20 minutes, so I'll go now" thing. Unless you're running a meeting, no one will care if you walk out for a minute to go later, if you really have to, and if you're in the habit of using the bathroom before a meeting just because, you're training your body to need to pee even more.
posted by tchemgrrl at 9:50 AM on September 26, 2011

I am the opposite. I am the guy who can drink 3 or 4 beers and not go pee. When I do go, whoa, do I go. I am with kmenenie. I think I trained myself to just not go and not be in pain about it. Once I go once, then I go often, so I just don't go once until I have a full and complete bladder. My friends are amazed and it is sort of a strange bar trick, but teaching yourself not to go even while drinking beers at a bar can be done. The one caveat is if I am sitting for a while, then I have to go. Not sure why.
posted by JohnnyGunn at 10:09 AM on September 26, 2011

Hmm... Ask your GP if he thinks that more fiber would help. It seems reasonable that would trap some of the excess liquid? If you don't like the powder, I'd think the capsules would do fine (or of course more from your food).

And I don't buy that it's physical because you're waking up at night. Anecdotally, it's quite possible to be very tired yet keep waking up through the night because of anxiety about remembering to wake up on time, or because you're anxious about something that keeps running through your head.

I'd try kmennie's advice, and I'd add in a behavioral component - you know how if you think you need to go but something interrupts you (a client phone call you need to take, etc) then it's almost like you stop needing to go for a bit? When you think you need to go, pause and do something else for a bit (first thing that came to mind was reciting a poem from memory in a language I'm proficient but not fluent in) and see if you interrupt your process enough. And on top of that, I'd do your best to stop stressing - so you have to get up and go three or four times on the way to London. In the big picture, yes, that's annoying, and it's annoying to have to get up from work and go, etc, but you can adapt (have adapted) to that.

All of that said, if your gut says to keep exploring it medically, then keep going.
posted by mrs. taters at 10:13 AM on September 26, 2011

I am usually very thirsty (sign of diabetes?), but I've always been like that. I'm also usually quite hungry, but I've been attributing to the daily exercise.

Those are all classic signs of diabetes. I know you had that one test that showed your fasting glucose in the normal range but I would ask your doctor for a hemoglobin A1C test which roughly measures your average blood glucose levels over the last 2-3 months.
posted by munchingzombie at 10:22 AM on September 26, 2011 [3 favorites]

I had the exact same problem when I was in graduate school. I thought for sure that it was my prostate (and even had it checked, uncomfortably), but it turned out to be a combination of too much caffeine and sodium in my diet. I limited myself to a single coffee a day and stopped eating my lunches at fast food places and was back to going only a couple times a day in no time.

16oz. is a lot of coffee to drink at once. Try cutting back or going out for a couple of weeks and see if that helps.
posted by Kevtaro at 10:22 AM on September 26, 2011

It may be worth doing the ins and outs. That is measuring what exactly you drink and when and logging it. Same for when you pee. This sort of data would be of a great help to a GP in either telling you if you are in the normal range or not.
But to be honest it sounds like you are normal to me.
posted by The Violet Cypher at 10:41 AM on September 26, 2011 [2 favorites]

Oh, and +1 to griphus' comment. If you haven't had your prostate checked yet, definitely start there. A family friend's son was diagnosed with prostate cancer at 27, so it isn't unheard of at your age.
posted by Kevtaro at 10:43 AM on September 26, 2011

Caffeine is definitely an issue for me. Try avoiding it for a bit and see if that helps.
posted by Awfki at 10:46 AM on September 26, 2011

IANAD:
I agree with munchingzombie. You can go to your local clinic for the A1C or purchase one online which can be cheaper than a copayment.
posted by BuffaloChickenWing at 11:00 AM on September 26, 2011

If you really like to drink water, and you're drinking more of it than most people would, then you will have to pee more often than most people would. I agree with The Violet Cypher, make notes of how much/often you're drinking, how often you're peeing, and check with the doctor if this is unreasonable. i.e. during a normal workday (but schedule to exclude any exercise/sweating time) total volume in divided by number of bathroom trips, should tell you the volume your bladder comfortably holds. If that number is really low, you can try to raise it by practice, and if that totally fails there may be some medical cause but clearly everyone else here is better at speculating than I am.
posted by aimedwander at 11:39 AM on September 26, 2011

Do you drink or eat anything with dyes? Artificial dyes and flavorings may irritate the bladder. What's in the blueberry tea? Vitamin C and cranberry juice are the stock answer for women who have UTI irritation; give it a try. Add some vitamin c, doesn't have to be a huge dose, and drink a couple of glasses of cranberry juice daily. It's generally good for you, though it has sugar, so it's kind of a no-lose proposition.
posted by theora55 at 12:42 PM on September 26, 2011

If you are both drinking a lot and urinating a lot, the House episode answer would be diabetes insipidus, which although called diabetes has little to do with your maintenance of blood glucose. N.B. that it can be difficult to distinguish from the more common psychological "habit polydipsia" or "habit drinking."
posted by hat at 12:55 PM on September 26, 2011

Four more ideas:

1. Do you consume a lot of salty foods? The number of times I need to pee in a day correlates directly with the amount of salt I consume, and it doesn't take much extra salt to notice the difference. Salty foods >> thirst >> drink more water >> PEE & PEE & PEE & ....

2. I notice the same thing if I spend a lot of time in an unusually dry environment, like a shopping mall. Is the air in your home and/or workplace very dry, leading you to drink more? If you're sure you're getting enough fluid but still feel thirsty, chewing gum or hard candy can relieve the thirst without sending you to the WC.

3. I pee a lot, because I drink a lot, because I have the autoimmune disease Sjogren's syndrome, which causes dry mouth and dry eyes. Many more women have this than men, so your doctors may not think to look for it. Not at all likely, but worth checking.

4. The drug Cymbalta (duloxetine) is primarily an antidepressant (SSNRI variety). One of its possible side effects is urinary retention; in Europe, it's approved for treatment of some urinary problems, but the US FDA rejected approval for that use here. I believe that urologists here sometimes use it off-label for that purpose, but it's controversial. It seems to be quite safe and well tolerated, and maybe it would even improve the anxiety situation. Could be worth considering.
posted by Corvid at 1:42 PM on September 26, 2011

Check out a new book: Teach Us To Sit Still by Tim Parks. Reviewed fairly recently in the New York Times. Basically, anxious men tense up the muscles in the area, this irritates the prostate and can cause symptoms like what you are describing. Young men can and do get the condition. Like you, he had the tests and came up negative but was motivated/uncomfortable/frustrated enough to dig into the research and try to find things that worked. The author struggled with the problem, tried various things and found some relief in specific relaxation/meditation.
posted by PickeringPete at 3:02 PM on September 26, 2011

If cranberry juice upsets your stomach like it does mine, you can buy cranberry capsules in the vitamin aisle at your pharmacy. My doctor said they're as good as the juice.
posted by IndigoRain at 3:10 PM on September 26, 2011

Nthing monitoring your water intake.

Many people these days (some for reasons listed above) drink too much water. Are you grazing on water all day? Do you always have a glass on your desk and bottle when you travel? Could you be drinking too much out of habit?

Or do you only having a glass when you're truly thirsty?

Try cutting back and see how you feel.
posted by asuprenant at 3:26 PM on September 26, 2011

To followup: IANAD, but if your urine is clear to light yellow, you may be intaking too much water. My acupuncturist, FWIW, tells me that medium yellow is an indication of balanced water consumption.
posted by asuprenant at 3:27 PM on September 26, 2011

Um... UTIs? Weakened bladder (leading to incontinence)? Please don't follow advice of not going when you need to go.

I meant, I thought rather obviously, that nothing bad will happen when you do not respond to the urge of a spasmodic bladder that was emptied only an hour ago. Routinely not urinating, bad. But trying to condition the voiding reflex by ignoring false signals that the need to pee is urgent? Good.
posted by kmennie at 7:20 PM on September 26, 2011

just wanted to suggest that you try other overactive bladder medications aside from Vesicare. The Flomax is for your prostate so I'm not sure why that was used, although I'm sure your urologist had a rationale for it. There are several other medications in the same class as Vesicare, like Ditropan for example, that might not cause as much constipation and might work for you. Or, if one of these medications (an "anticholinergic" type medication) works for you but causes constipation, you could just take laxatives at the same time and just consider it the pric eyou have to pay for not needing to pee every hour.

best of luck.
posted by treehorn+bunny at 10:34 PM on September 26, 2011

My friend had this and it turned out to be a hernia. Did they examine you standing up as well?
posted by superfish at 3:17 AM on September 27, 2011

Thanks again everyone. I'll be calling my GP to make an appointment and discuss all of the options with them.

To be honest, I'm going to try and whole "telling myself don't go!" thing and see how it works. I think I was actually able to distract myself last night and this morning long enough to wait 2 hours or so, which is good for me. Also going to try cutting down and eliminating the coffee.

To answer a few more questions, my urologist did preform a prostate exam and it was while I was standing up (ugh).
posted by pete at 7:09 AM on September 27, 2011

I agree with pp's suggestion of reading "A headache in the pelvis".
Your problem sounds exactly like what my husband experienced about a year ago. He, too suffers from anxiety.
Worrying about the symptom caused it to get worse >>and prolonged the agony. When he was finally able to realize it wasn't something serious it went away! So, as Frankie says, relax :)
posted by PrettyKnitty at 2:30 PM on September 27, 2011