Waking at Night to Pass Urine: Causes and When to See a Doctor

Getting up once in the night is common. Getting up three or four times can wreck your sleep. Many men over 40 assume “it must be my prostate”. Sometimes that is right, and often it is not. Here is how a pharmacist would work out the cause.

Why do you wake at night to pass urine?

These are the common reasons, and more than one can apply at once:

• Drinking late. Large drinks close to bedtime, and caffeine or alcohol in the evening, all increase night-time urine.
• An enlarged prostate. The prostate often grows with age. It can press on the tube that carries urine out and stop the bladder emptying fully, so you need to go more often.
• Diabetes. High blood sugar irritates the bladder and makes the body pass more urine.
• Sleep apnoea, heart or kidney problems. These can all lead to more urine being made at night.
• Medicines. Water tablets for high blood pressure are a common example.
• An overactive bladder or a urinary infection.
• Ageing. Levels of the hormone that slows night-time urine production fall as we get older.

What to try first

• Have your last drink earlier in the evening, for example 8 pm instead of 10 pm. Keep drinking enough over the whole day.
• Cut back on caffeine and alcohol in the evening.
• Keep a bladder diary for a few days, noting the times you go and how much. Your doctor can use it to find the cause faster.

When to see a doctor

Make an appointment if you wake more than once or twice a night and it bothers you, or if you also notice a weak stream, dribbling, a feeling that your bladder has not emptied, extra thirst or tiredness, or loud snoring with pauses in breathing.

Get urgent medical care if you cannot pass urine, see blood in your urine, or have pain or fever with your symptoms.

A doctor may test your urine and blood, check your prostate, and talk to you about whether a PSA blood test is right for you. An enlarged prostate is not cancer, but the symptoms can overlap with other conditions, so it needs checking.

What does the evidence say about prostate supplements?

Saw palmetto is the best-known ingredient, so it has been studied the most. A Cochrane review of 27 trials with 4,656 men found that saw palmetto on its own gives little or no benefit for urinary symptoms. When it was combined with other plant ingredients, there was little to no difference in symptoms or quality of life.

Other ingredients have less evidence behind them. An older Cochrane review of beta-sitosterol reported short-term improvements in some urinary measures, but the trials were small and the long-term effects are unknown. Pygeum has a similar story of older, small studies.

So a supplement is at best an extra to consider after assessment. It should never delay a check-up or replace a prescribed medicine.

Where PROSTAVIVE fits

If a doctor has checked you and you want to review a supplement with your pharmacist, this is the NutriQure option.

Because individual doses are not disclosed, we cannot compare this blend with the doses used in studies. No trial of the finished formula has been supplied, so we do not claim that it will lower PSA, shrink the prostate or ease your symptoms. Ask a pharmacist to check it against any prostate medicines, blood thinners or diabetes medicines you take, and never stop a prescribed medicine to try it.

Frequently asked questions

Is getting up twice a night normal?

Waking once is common and becomes more common with age. If you wake more often, or it bothers you, speak to a doctor.

Does an enlarged prostate mean cancer?

No. An enlarged prostate is not cancer, but the symptoms can overlap with other conditions, so get it assessed.

Should I cut down on fluids?

Move your drinks earlier in the day and limit caffeine and alcohol in the evening, but keep drinking enough overall.

Will PROSTAVIVE lower my PSA or shrink my prostate?

No such outcome is established for this product. Follow your doctor’s testing and treatment plan.

Can I take it with prostate medicines?

Ask your doctor or pharmacist to review the full formula first, and do not replace prescribed treatment.

Keep reading

• Browse the NutriQure supplement range
• More pharmacist-written articles
• Ask NutriQure for product information

References

1. Cochrane. Serenoa repens (saw palmetto) for benign prostatic hyperplasia. Plain-language summary
2. American Family Physician (AAFP). Cochrane summary: saw palmetto for lower urinary tract symptoms due to BPH. aafp.org
3. Beta-sitosterols for benign prostatic hyperplasia (Cochrane review). PubMed
4. Guy’s and St Thomas’ NHS Foundation Trust. Nocturia: getting up at night to pee. guysandstthomas.nhs.uk
5. Urology Care Foundation. Nocturia. urologyhealth.org
6. NHS. Enlarged prostate. nhs.uk

This article is general information, not medical advice. Supplements do not diagnose, treat, cure or prevent any disease. Speak to your doctor or pharmacist before starting a supplement.