Does Prednisone Make You Pee?
Prednisone is a prescription steroid medication that is used to treat a variety of inflammatory conditions. It is often prescribed for people with multiple sclerosis (MS) to help reduce inflammation and manage relapses. One common side effect of prednisone is frequent urination. Here is an in-depth look at why prednisone makes you pee more often.
How Prednisone Works
Prednisone is a corticosteroid, which means it mimics the effects of cortisol, a hormone naturally produced by the adrenal glands. It works by reducing inflammation and suppressing the immune system. For people with MS, prednisone helps manage acute relapses by reducing inflammation and nerve damage in the central nervous system.
Prednisone alters how the kidneys handle sodium and water. It causes the kidneys to excrete excess fluid and sodium from the body. This leads to increased urine production and frequency of urination. The higher salt and water output causes dehydration, which signals the brain to conserve water by limiting urine production. But prednisone counteracts this by promoting increased urine output.
Increased Urination Frequency
Frequent urination is a very common side effect of taking prednisone. Up to 60% of people taking prednisone report needing to urinate more often. Normally, the average person urinates between 4-8 times per day. On prednisone, urination can increase to up to 10-20 times per day in some individuals.
The onset of urinary frequency usually begins within a few days of starting steroid treatment. The degree of increased urination varies from person to person. It depends on the dosage of prednisone and the duration of treatment. Higher doses typically lead to increased frequency.
In most cases, frequent urination is mild and manageable. But it can disrupt sleep and become an annoyance during the day. Thankfully, the urinary effects of prednisone are reversible. Urination patterns generally return to normal within a few days of completing the course of steroids.
Increased Thirst and Fluid Intake
Prednisone causes fluid loss through increased urination. This leads to dehydration and a compensatory increase in thirst. People taking prednisone often feel thirstier and drink more fluids. This is the body's way of replacing the fluid lost through excessive peeing.
Drinking more liquids further contributes to the need to urinate frequently. The extra fluid intake eventually makes its way to the bladder for excretion. So increased fluid consumption can exacerbate frequent peeing caused by prednisone. It's important to stay well hydrated, but excess fluid intake close to bedtime can disrupt sleep.
Weakened Urinary Sphincters
Prednisone may also cause weakened urinary sphincters. The sphincters are muscles that control the flow of urine and contain it in the bladder. Weak sphincters make it more difficult to hold in urine. This can lead to leaks, accidents or an urgent need to pee.
People on prednisone may notice they have less control over their bladder and cannot "hold it" for as long as usual. Coughing, laughing, sneezing or other movements may trigger small amounts of urine leakage. Fortunately, sphincter control typically returns to normal after completing steroid treatment.
Increased Bladder Irritability
Some researchers believe prednisone may directly irritate the bladder wall. A sensitive, inflamed bladder wall sends signals to urinate more frequently. This bladder irritation, coupled with increased urine production, makes the urge to pee feel more urgent and frequent.
Bladder irritation from prednisone usually resolves after treatment ends. Your doctor may be able to prescribe bladder-soothing medicines if the irritation is severe.
Salt and Protein Loss
In addition to increased water output, prednisone also causes the kidneys to excrete more salt (sodium) in the urine. The loss of salt can stimulate thirst and leads to increased drinking. Attempting to replace the sodium loss encourages fluid intake, which leads back to more frequent urination.
Prednisone may also cause loss of protein through urine. Low protein levels signal the kidneys to produce more urine to expel waste products. This combination of salt, protein and fluid loss contributes to the increased need to pee.
Blood Glucose Changes
Prednisone often causes increased blood glucose levels. This steroid-induced diabetes can increase urine output. The kidneys will try to eliminate excess sugar through the urine, which drags water along with it by osmosis. This leads to increased urination.
People on prednisone who develop high blood sugar levels may need glucose monitoring and diabetes medications until steroid treatment is complete.
Tips to Manage Frequent Urination from Prednisone
Although increased urination can be annoying, there are things you can do to ease the frequency:
- Avoid drinking excess fluids, especially before bedtime
- Cut back on caffeinated or alcoholic drinks, which can irritate the bladder
- Kegel exercises can help strengthen the bladder sphincter
- Timed voiding, such as every 2-3 hours, may help "re-train" the bladder
- Wear absorbent pads if accidents are a concern
- Be understanding - frequency should resolve after prednisone is done
When to See Your Doctor
In most cases, frequent urination from prednisone is not serious. But see your doctor if you experience:
- Pain or burning during urination
- Blood in the urine
- Completely uncontrolled leakage
- Fever, back pain or abdominal pain
- Urinary frequency that doesn't improve after prednisone is stopped
These could be signs of a kidney infection or other issue that may require additional treatment. Urinary frequency from prednisone is normally temporary, but alert your doctor if the problem lingers.
The Bottom Line
Prednisone is likely to cause increased urination frequency as a side effect. This is due to its effects on salt, water and protein balance in the kidneys and inflammation in the bladder wall. Frequent urination from prednisone is usually manageable and resolves once steroid treatment is complete. Stay well hydrated, but avoid excess fluids close to bedtime. Report any severe or persisting urinary symptoms to your healthcare provider.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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