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Waking up once or twice during the night to pee is annoying, especially for me if it happens around dawn, when the odds of falling back asleep are near zero. But one or two nocturnal bathroom trips are normal. It’s also natural to urinate a lot during the day. Exactly how often is a wee bit unclear, however.

“There isn’t just one answer regarding how often you should go №1,” says Cleveland Clinic urologist Petar Bajic, MD.

There are, however, warning signs that your pee frequency is related to an underlying health issue that needs attention:

• Regularly waking to urinate more than twice a night, a condition called nocturia
• Routinely tinkling more than eight or 10 times every 24 hours
• Having significant difficulty urinating or peeing very infrequently

Bajic also says that if your bathroom routine changes significantly — if you suddenly find yourself going a lot more or a lot less — or if your urine starts and continues to look or smell funky, you should seek medical attention right away.

Nocturia, by the way, is costly as well as annoying. A Rand Corporation study estimates it affects about 12.5% of people, lowering life satisfaction, increasing daytime fatigue, and cutting into worker productivity, costing the U.S. economy $44 billion a year.

A broader stream of pee problems can even signal a risk of early demise. For example, Finnish men 50 and older with severe urination problems are at greater risk of dying sooner than other men their age, a new study in the Journal of Urology finds. Here are the increased odds of premature death based on three symptoms:

• Weak stream or lots of straining: 20% more likely
• Too frequent daytime urination: 30% more likely
• Too frequent nighttime urination: 50% more likely

Your pee capacity may vary

Each person has their own “normal” pee capacity and frequency. Among the variables: We all have different bladder sizes, ranging from around 1.5 to 2.5 cups in capacity, and each of us has a different perception of what full feels like. Also, how much water we need daily varies based on body size, air temperature and humidity, physical activity, the amount of other liquids and foods we consume, and other factors.

And as we age, it’s common to gradually feel the urge to go more frequently, though serious increases should not be considered normal.

Interestingly, before age 50, more women suffer nocturia than men, but after age 60, the statistic flip-flops, and a higher percentage of men are prone to overly frequent nighttime urination.

Worth noting: Holding your pee in for a while, as you await a convenient place to evacuate your bladder, is not generally viewed as a problem. But holding it to the point of bursting, and doing so too often, raises the risk of urinary tract infections and can, over time, weaken your bladder and lead to incontinence, a lack of bladder control.

Serious problems to watch for

Among the serious urinary issues that should spur the urge to seek medical help:

Overactive bladder syndrome (OAB): The need to pee frequently can flow from many causes, including infections, nerve damage, diabetes, certain medications, or being overweight. Some of these may be easily treatable, according to the Cleveland Clinic. Postmenopausal women are more likely to have OAB.

Urinary incontinence: Peeing involuntarily while laughing, coughing, sneezing, or during physical activity — or just whenever, can occur anytime in life, but it’s more common in postmenopausal women.

Interstitial cystitis: This painful bladder condition, which affects mostly women but also men, increases the urge to urinate frequently.

Sudden increases in urination can signal anything from a urinary tract infection to a kidney stone.

Significant decreases in urination might indicate a prostate problem or obscrution of one or both ureters, the plumbing that carries urine from the kidney to the bladder.

Ways to prevent excess peeing

If frequent urination doesn’t seem to be a medical issue for you, but it’s annoying at times, I’ve collected a trickle of suggested remedies coming out of the Mayo Clinic, the Cleveland Clinic, the National Association for Continence, and the journal Menopause:

• Get regular physical activity and maintain healthy body weight.
• Women and men can strengthen their pelvic floor muscles, to gain better bladder control, with Kegel exercises.
• If your legs or ankles swell during the day, elevate them in the afternoon or try compression socks, so that excess water gets into your bloodstream, and then your urine, before bedtime.
• If you take any medications in the evening that might be diuretic (causing the kidneys to release more urine) ask your doctor or pharmacist if it’s OK to take them earlier in the day.
• Postmenopausal women might consider hormone therapy.

Finally, the most obvious and perhaps most difficult lifestyle change that could help many of us cut back on nighttime peeing: Don’t drink too much water or other liquid for several hours before bedtime, Harvard Medical School experts advise, “particularly if the drinks contain alcohol or caffeine.”

Well now, that’s a whole ’nother problem, isn’t it?

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