Waking up to use the bathroom—a condition called nocturia—becomes a nightly ritual for many men as they age. But there is something that can help: strength training. 

Hear me out.

  Nocturia occurs when the body produces too much urine at night—often about 20 to 30 percent of what a person produces during a regular 24-hour period. The result: You have to wake up from a sound sleep to empty your bladder. 

Nocturia is more common as you age. Almost 69 percent of men older than age 40 have nocturia at least once per night, and up to 62 percent have two episodes. 

Age is not the only culprit. There are many causes of nocturia, such as excessive fluid intake and taking a diuretic (water pills) to treat high blood pressure. In fact, taking multiple blood pressure drugs can lead to more nocturia events than taking a single medication, according to recent research. 

Other conditions associated with a higher risk for nocturia are heart disease, a high body mass index (BMI), a measure of being overweight, and diabetes. 

But for many men, nocturia often results from an enlarged prostate or an overactive bladder (OAB). With OAB, you have uncontrolled spasms of the bladder muscle, which makes you have to urinate when your bladder is not full.

Nocturia also can be its own thing—for some odd reason, excess urination occurs mainly at night, irrespective of OAB or an enlarged prostate.

Nocturia is not just annoying; it can interfere with many aspects of a man’s health, especially sleep quality. Some research has suggested that about 43 percent of nocturia sufferers have trouble getting back to sleep after their bathroom trip. This can lead to daytime drowsiness, irritability, and difficulty concentrating. There is also a risk of falling during your nighttime journey to the toilet.

All these problems are perhaps why nocturia is associated with a higher risk of early death among men older than age 60. 

So what can you do about nocturia?  

If nocturia has become more frequent, let your doctor know. While I always first look for alternative methods for urological conditions, I find alpha-blockers may help to relax the bladder neck and prostate. Popular alpha-blocker drugs include Tamsulosin (Flomax), Alfuzosin (Uroxatral), and Silodosin (Rapaflo) with very little side effects.

As a doctor who treats urinary problems primarily with natural approaches, I find alpha-blockers to have more reward than risk.

Your doctor can also determine if your nocturia is related to weight gain or signs of heart disease, and suggest appropriate treatment. Making simple lifestyle changes also can help.

For instance, restrict fluids two to four hours before bedtime and take any diuretics about six hours before.

Yet, another way to fight nocturia (and urinary leakage) is to increase your strength, suggests a study in the November 2019 issue of the Journal of Urology.  

 Here, researchers examined almost 1,300 men. They measured their body and bone mass and grip and leg strength. The group then filled out questionnaires about current urinary problems. More than half had regular nocturia, and almost one-quarter had incontinence. 

After a three-year follow-up, those with a higher BMI struggled with nocturia. Men with lower grip and leg strength also were more likely to suffer from regular urinary incontinence. (Muscle weakness also reflects weakness in the urinary sphincter—the muscle that holds urine in the bladder.) In fact, even a 5 percent decline in strength over the three years was associated with a higher risk of new or worsening incontinence. 

In simple language, muscle weakness and excess body fat mean more peeing problems, especially at night. 

Strength is essential in so many aspects of a man’s health.

This is why I always advocate my patients and anyone going through prostate cancer treatment and management to step up their strength-training workouts. Aerobic exercise is not enough.

Besides building muscle, strength training builds stronger bones that are less likely to fracture or break after a tumble. Plus, other research has shown that regular strength training can drive weight loss and lower your risk of heart disease. 

So join a gym or buy some weights to use at home, or better yet, hire a trainer if you can to set up an individualized program. Nocturia or urinary leakage is not something you have to endure.

Take strength training as your medicine.