You're drifting off to sleep when suddenly you need to pee – despite having gone to the loo before you got into bed. If you need to urinate frequently throughout the day and you're getting up during the night, there could be a medical issue to blame.
See also: Natural ways to treat incontinence
See also: Coping with bladder problems
1. You have an overactive bladder
Needing to go to the toilet urgently could be a sign of an overactive bladder. This occurs when the bladder contracts without warning, even when not full, for no apparent reason.
While the cause is unknown, anxiety is believed to make the problem worse. Pelvic floor exercises, bladder training and medication may help. If you have OAB, it's recommended to reduce your fluid input by 25%, as long as you drink more than one litre of fluid a day.
Avoid drinks that can irritate the bladder, such as coffee, carbonated drinks, drinks containing aspartame, alcohol, and blackcurrant juice and citrus fruit juice.
2. You have urinary incontinence caused by childbirth
Urinary incontinence, where you have the occasional accident, is more common that you might realise, particularly for women who have given birth or had a hysterectomy.
Exercising, coughing and laughing can put pressure on the bladder, so that it loses its ability to hold in urine, causing you to have an accident. Pelvic floor exercises are a good way to strengthen the muscles and prevent the problem from occurring.
3. You have an enlarged prostate
Many men develop an enlarged prostate in later life, which puts pressure on the bladder and urethra, resulting in the need for more frequent urination. It can also cause difficulties starting urination, and problems fully emptying the bladder.
In some cases this is benign prostate enlargement (BPE), that isn't usually a serious threat to health. However, a need to urinate more frequently can also be a sign of prostate cancer – so it's important to see your doctor and get it checked out.
4. You are diabetic
Excessive thirst, along with a need to urinate more frequently, is one of the main symptoms of diabetes.
While type 2 diabetes is on the increase due to the obesity problem, it's possible for adults to develop type 1 diabetes in midlife – so don't presume that because you're not overweight, it can't be that.
If you're concerned, see your GP who can check your glucose levels.
5. You've had too much alcohol (or coffee)
Alcohol is a diuretic that causes the kidneys to expel much more fluid than you take in – which is why you need to go to the toilet so often when you drink. In fact, for every 1g of alcohol drunk, urine excretion increases by 10ml.
Alcohol also reduces the production of a hormone called vasopressin, which tells your kidneys to reabsorb water rather than flush it out through the bladder. With the body's natural signal switched off, the bladder is free to fill up with fluid.
Caffeine is another diuretic, so if you've been drinking more coffee than usual, you can expect more trips to the toilet. Drinking more water when you have alcohol, and switching to decaffeinated drinks may help.
6. You have an infection
Certain infections which affect the bladder, such as urinary tract infections, kidney infections and sexually transmitted infections can cause more frequent urination. If you experience a burning feeling when you go to the toilet, see your GP or visit your local GUM clinic.
While some urinary tract infections can clear up on their own within four to five days, you may require a course of antibiotics, so it's best seek medical advice.
7. You're drinking too much water
Finally, it could be that you're simply drinking more than usual. It's all well and good to up your fluid intake, but if you're drinking more than you need to, you'll obviously be making more trips to the bathroom.
If your free-flowing bladder is an issue at night, make sure you drink plenty throughout the day, but try not to drink much in the evening. Stick to water, milk or diluted juice and avoid caffeinated, carbonated or artificially sweetened drinks as these can irritate the bladder.