What Is Polyuria (Excessive Urination)?

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Alexandra Dubinskaya, MD is a board-certified urogynecologist specializing in menopause and sexual health.

Increasing your fluid intake or drinking a lot of diuretic beverages, such as coffee or soda, may be why you are peeing so much. Several common health conditions may cause an increase in urine production and voiding as well. Polyuria is frequent urination in a 24-hour period with large amounts of urine each time.

An excessive urination volume is 2.5 liters (l) of urine or more per day. That's much higher than the average output of 800 milliliters (ml) to 2 l per day. Read on to learn about polyuria or why you might be peeing so much.

Symptoms of Polyuria

It's important to pay attention to whether you are actually peeing an unusually large amount of urine or simply feeling like you need to go more frequently. Polyuria means urinating more than 2.5 l of urine or more per day, which is different from frequently urinating at a normal volume.

Some people with polyuria only have increased urination at night (nocturnal polyuria). Polyuria is not the same as nocturia, or waking up in the night to urinate. Polyuria, however, is a common cause of nocturia.

Causes

Polyuria itself is not an illness but a symptom of several health concerns. It's necessary to figure out what's causing the increase in urine production to help manage polyuria. Why you are urinating at a higher-than-normal volume depends on the underlying cause.

Diabetes and excess fluid intake are some of the most common causes of polyuria. Excess urine output also tends to be common in older adults, especially women.

Diabetes

Uncontrolled diabetes is often the cause of polyuria. Diabetes is a chronic disease in which the pancreas cannot create enough insulin or use it correctly. Insulin is a hormone that helps your cells take in glucose (sugar).

The kidneys cannot process excess sugar in your blood and then reabsorbed back into the bloodstream. The sugar instead draws more water into your urine, leading to an increased urine output.

A rare form of diabetes, diabetes insipidus, may also be responsible for polyuria. Your blood sugar levels are normal, but the kidneys cannot properly concentrate urine. Diabetes insipidus also causes excessive thirst, which leads to extreme water intake, and a vasopressin deficiency. This antidiuretic hormone (ADH) promotes water conservation in the kidneys and helps balance fluids in your body.

Other Medical Conditions

Other medical conditions, although less common than diabetes, that might lead to polyuria include:

• Congestive heart failure (when the heart does not pump blood efficiently)
• Kidney disease or kidney failure
• Sickle cell anemia (a blood disorder in which sickle-shaped red blood cells do not move easily through the body)
• Varicose veins (enlarged, twisted veins)

Other Causes

Polyuria may also be a side effect or sign of:

• Certain medications (e.g., diuretics or lithium)
• Excess fluid consumption
• High or low calcium levels in the body
• Intake of alcohol and caffeine
• Pregnancy

Diagnosis

A diagnosis of polyuria usually starts with identifying the cause. A healthcare provider may ask about your diet and what medications you take.

A 24-hour voiding diary can help determine if you have polyuria, nocturia, or both. A healthcare provider might ask you to keep track of how much and what you drink, how often you urinate, and how much you urinate. The diagnosis will likely exclude polyuria, for example, if you urinate frequently throughout the day but produce an average or below-average urine output.

Other diagnostic tools include:

• 24-hour urine test: This test measures how much urine you produce in one day. You'll collect your urine in a container for 24 hours. A healthcare provider will analyze the samples for creatine and protein levels.
• Fluid deprivation test: A healthcare provider will ask you not to drink any liquids for several hours. You might have diabetes insipidus if you continue to urinate large amounts during that time.
• Osmolality tests: A healthcare provider may check your blood and urine for glucose, creatine, electrolyte, and urea levels. Urea is a waste product that your liver creates.
• Urinalysis: This test checks your urine for appearance, color, odor, and other characteristics.

Treatment

Polyuria itself does not come with its own treatment, and there are no specific medications to treat it. A healthcare provider will instead focus on helping you manage the underlying cause. You may need to wear compression stockings to improve blood flow and reduce swelling, for example, if the cause is varicose veins.

Other ways to control polyuria may include:

• Avoiding or limiting caffeine and alcohol
• Keeping track of your fluid intake
• Limiting your fluid intake before going to bed
• Managing your blood sugar

When To Contact a Healthcare Provider

You can typically treat polyuria at home by keeping track of your fluid intake and limiting caffeine and alcohol. Contact a healthcare provider if polyuria persists for several with no apparent cause. They can administer tests to help figure out what's causing excessive urine production.

A Quick Review

Having to urinate more frequently than normal and producing large amounts of urine can signal polyuria. An excessive urination volume is 2.5 l of urine or more per day. Sometimes, this may be the result of drinking more fluid. However, underlying health conditions may be the cause of abnormal voiding.

Diabetes, kidney disease, and sickle cell anemia are among the health conditions that may cause excessive urination. Other factors, such as certain medications, high or low calcium levels, or pregnancy, may also increase the amount you pee. If you have unusual symptoms related to urination, it's best to see a healthcare provider.

Health.com uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

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