It can be normal to wake up once or even twice during the night to wee, especially as we get older.

One in three adults over 30 makes at least two trips to the bathroom every night.

Waking up from sleep to urinate on a regular basis is called nocturia. It’s one of the most commonly reported bothersome urinary symptoms (others include urgency and poor stream).

So what causes nocturia, and how can it affect wellbeing?

A range of causes

Nocturia can be caused by a variety of medical conditions, such as heart or kidney problems, poorly controlled diabetes, bladder infections, an overactive bladder, or gastrointestinal issues. Other causes include pregnancy, medications and consumption of alcohol or caffeine before bed.

While nocturia causes disrupted sleep, the reverse is true as well. Having broken sleep, or insomnia, can also cause nocturia.

When we sleep, an antidiuretic hormone is released that slows down the rate at which our kidneys produce urine. If we lie awake at night, less of this hormone is released, meaning we continue to produce normal rates of urine. This can accelerate the rate at which we fill our bladder and need to get up during the night.

Stress, anxiety and watching television late into the night are common causes of insomnia.

Effects of nocturia on daily functioning

The recommended amount of sleep for adults is between seven and nine hours per night. The more times you have to get up in the night to go to the bathroom, the more this impacts sleep quantity and quality.

Decreased sleep can result in increased tiredness during the day, poor concentration, forgetfulness, changes in mood and impaired work performance.

If you’re missing out on quality sleep due to nighttime trips to the bathroom, this can affect your quality of life.

In more severe cases, nocturia has been compared to having a similar impact on quality of life as diabetes, high blood pressure, chest pain, and some forms of arthritis. Also, frequent disruptions to quality and quantity of sleep can have longer-term health impacts.

Nocturia not only upsets sleep, but also increases the risk of falls from moving around in the dark to go to the bathroom.

Further, it can affect sleep partners or others in the household who may be disturbed when you get out of bed.

Can you have a ‘small bladder’?

It’s a common misconception that your trips to the bathroom are correlated with the size of your bladder. It’s also unlikely your bladder is smaller relative to your other organs.

If you find you are having to wee more than your friends, this could be due to body size. A smaller person drinking the same amount of fluids as someone larger will simply need to go the bathroom more often.

If you find you are going to the bathroom quite a lot during the day and evening (more than eight times in 24 hours), this could be a symptom of an overactive bladder. This often presents as frequent and sudden urges to urinate.

If you are concerned about any lower urinary tract symptoms, it’s worth having a chat with your family GP.

There are some medications that can assist in the management of nocturia, and your doctor will also be able to help identify any underlying causes of needing to go to the toilet during the night.

A happy and healthy bladder

Here are some tips to maintain a happy and healthy bladder, and reduce the risk you’ll be up at night:

• make your sleep environment comfortable, with a suitable mattress and sheets to suit the temperature
• get to bed early, and limit screens, or activites before bed
• limit foods and drinks that irritate the bladder, such as coffee or alcohol, especially before bedtime
• sit in a relaxed position when urinating, and allow time for the bladder to completely empty
• practice pelvic floor muscle exercises
• drink an adequate amount of fluids during the day, and avoid becoming dehydrated
• maintain a healthy lifestyle, eat nutritious foods and do not do anything harmful to the body such as smoking or using illicit drugs
• review your medications, as the time you take some pharmaceuticals may affect urine production or sleep
• if you have swollen legs, raise them a few hours before bedtime to let the fluid drain.

Christian Moro, Associate Professor of Science & Medicine, Bond University and Charlotte Phelps, Senior Teaching Fellow, Medical Program, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

In a recent TikTok video, Australian media personality Abbie Chatfield shared she was starting a vaccine to protect against urinary tract infections (UTIs).

Huge news for the UTI girlies. I am starting a UTI vaccine tonight for the first time.

Chatfield suffers from recurrent UTIs and has turned to the Uromune vaccine, an emerging option for those seeking relief beyond antibiotics.

But Uromune is not a traditional vaccine injected to your arm. So what is it and how does it work?

First, what are UTIs?

UTIs are caused by bacteria entering the urinary system. This system includes the kidneys, bladder, ureters (thin tubes connecting the kidneys to the bladder), and the urethra (the tube through which urine leaves the body).

The most common culprit is Escherichia coli (E. coli), a type of bacteria normally found in the intestines.

While most types of E. coli are harmless in the gut, it can cause infection if it enters the urinary tract. UTIs are particularly prevalent in women due to their shorter urethras, which make it easier for bacteria to reach the bladder.

Roughly 50% of women will experience at least one UTI in their lifetime, and up to half of those will have a recurrence within six months.

The symptoms of a UTI typically include a burning sensation when you wee, frequent urges to go even when the bladder is empty, cloudy or strong-smelling urine, and pain or discomfort in the lower abdomen or back. If left untreated, a UTI can escalate into a kidney infection, which can require more intensive treatment.

While antibiotics are the go-to treatment for UTIs, the rise of antibiotic resistance and the fact many people experience frequent reinfections has sparked more interest in preventive options, including vaccines.

What is Uromune?

Uromune is a bit different to traditional vaccines that are injected into the muscle. It’s a sublingual spray, which means you spray it under your tongue. Uromune is generally used daily for three months.

It contains inactivated forms of four bacteria that are responsible for most UTIs, including E. coli. By introducing these bacteria in a controlled way, it helps your immune system learn to recognise and fight them off before they cause an infection. It can be classified as an immunotherapy.

A recent study involving 1,104 women found the Uromune vaccine was 91.7% effective at reducing recurrent UTIs after three months, with effectiveness dropping to 57.6% after 12 months.

These results suggest Uromune could provide significant (though time-limited) relief for women dealing with frequent UTIs, however peer-reviewed research remains limited.

Any side effects of Uromune are usually mild and may include dry mouth, slight stomach discomfort, and nausea. These side effects typically go away on their own and very few people stop treatment because of them. In rare cases, some people may experience an allergic reaction.

How can I access it?

In Australia, Uromune has not received full approval from the Therapeutic Goods Administration (TGA), and so it’s not something you can just go and pick up from the pharmacy.

However, Uromune can be accessed via the TGA’s Special Access Scheme or the Authorised Prescriber pathway. This means a GP or specialist can apply for approval to prescribe Uromune for patients with recurrent UTIs. Once the patient has a form from their doctor documenting this approval, they can order the vaccine directly from the manufacturer.

Uromune is not covered under the Pharmaceutical Benefits Scheme, meaning patients must cover the full cost out-of-pocket. The cost of a treatment program is around A$320.

Uromune is similarly available through special access programs in places like the United Kingdom and Europe.

Other options in the pipeline

In addition to Uromune, scientists are exploring other promising UTI vaccines.

Uro-Vaxom is an established immunomodulator, a substance that helps regulate or modify the immune system’s response to bacteria. It’s derived from E. coli proteins and has shown success in reducing UTI recurrences in several studies. Uro-Vaxom is typically prescribed as a daily oral capsule taken for 90 days.

FimCH, another vaccine in development, targets something called the adhesin protein that helps E. coli attach to urinary tract cells. FimCH is typically administered through an injection and early clinical trials have shown promising results.

Meanwhile, StroVac, which is already approved in Germany, contains inactivated strains of bacteria such as E. coli and provides protection for up to 12 months, requiring a booster dose after that. This injection works by stimulating the immune system in the bladder, offering temporary protection against recurrent infections.

These vaccines show promise, but challenges like achieving long-term immunity remain. Research is ongoing to improve these options.

No magic bullet, but there’s reason for optimism

While vaccines such as Uromune may not be an accessible or perfect solution for everyone, they offer real hope for people tired of recurring UTIs and endless rounds of antibiotics.

Although the road to long-term relief might still be a bit bumpy, it’s exciting to see innovative treatments like these giving people more options to take control of their health.

Iris Lim, Assistant Professor in Biomedical Science, Bond University

This article is republished from The Conversation under a Creative Commons license. Read the original article.