What is Nocturia?

Nocturia, the medical term for excessive urination at night, disrupts sleep and can significantly impact one’s quality of life. This condition, where individuals wake up multiple times to urinate, can result from various underlying health issues. While it's commonly associated with a high fluid intake before bedtime, its root causes can be more complex, ranging from urinary tract infections to more chronic conditions like diabetes or heart disease.

How does TCM view Nocturia?

Traditional Chinese Medicine (TCM) interprets nocturia through the lens of energy imbalances and disharmony within the body's organ systems. Unlike Western medicine that often targets the symptoms, TCM seeks to understand the deeper 'patterns' of disharmony causing nocturia.

Whether it stems from Kidney Yin or Yang Deficiency or Bladder Cold, each symptom provides a clue to the underlying TCM pattern, dictating a tailored treatment plan to restore balance.

Root Causes of Nocturia in TCM

In Traditional Chinese Medicine (TCM), nocturia is often attributed to the imbalance of the body's fundamental substances. Two primary patterns associated with nocturia are Kidney Yang Deficiency and Bladder Deficiency and Empty Cold.

Kidney Yang Deficiency manifests with symptoms beyond frequent nighttime urination, such as a sensation of cold, weak knees, and lower back pain. It is believed that when Kidney Yang is weak, the body's Fire or warmth necessary to transform and transport fluids efficiently becomes insufficient, leading to imbalances that cause nocturia.

Bladder Deficiency and Empty Cold suggest a lack of warmth and vitality within the Bladder, leading to its inability to retain urine. This condition may present with symptoms such as clear and copious urine, a feeling of coldness, and difficulty in initiating urination. Patients may also report fatigue, as their body's Qi is not warming and invigorating the Bladder function properly.

Explore below more details about what might cause Nocturia according to TCM.

  • By Syndrome
  • By Organ
  • Yang Deficiency
  • Qi Deficiency
  • Cold
  • Kidney
  • Spleen
  • Bladder
Detailed description of the cause

Yang Deficiency

Yang deficiency in TCM refers to a state where the body's Yang energy, which is responsible for warmth, activity, and function, is weakened or diminished. This pattern of disharmony often arises from chronic illness, aging, or inherent constitutional weakness. Symptoms of Yang deficiency are typically associated with cold and sluggishness, such as a feeling of coldness, cold extremities, pale complexion, low energy or fatigue, and a desire for warmth. Digestive issues like poor appetite, loose stools, and water retention can also be indicative of Yang deficiency.... see more

Yang Deficiency Patterns That Can Lead to Nocturia

Common Symptoms: Chills Generalized Fatigue General Weakness Diarrhea Erectile Dysfunction Premature Ejaculation Low Sex Drive Lower Back Pain

Pattern Name Relevant Symptoms Relevant Formulas
Kidney Yang Deficiency Night time urination, Lower back pain, Dizziness, Tinnitus, Weak and cold knees, Lower back coldness, Chills, Weak legs, Bright pale face, Generalized fatigue, General weakness, Leg edema, Female infertility, Diarrhea, Depression, Erectile dysfunction, Premature ejaculation, Oligospermia, Low sex drive, Pale and abudant urination... see more Ba Wei Di Huang Wan | You Gui Wan | Er Xian Tang | Shen Qi Wan | Wu Zi Yan Zong Wan | Tu Si Zi Wan
Yang Deficiency or Empty Yang Night time urination, Chills, General cold feeling, Pale urine, Undigested food in stools, General weakness, Abdominal pain relieved by pressure and warmth, Frequent urination, Polyuria, Nocturia, White vaginal discharge... see more Ba Wei Di Huang Wan | You Gui Wan
Kidney and Spleen Yang Deficiency Urination at night, Lower back pain, Weak and cold knees, Back cold sensation, Chills, Weak legs, Bright pale face, Erectile dysfunction, Premature ejaculation, Oligospermia, Watery ejaculate, Low sex drive, Generalized fatigue, General weakness, Clear urination, Nocturia, Apathy, Leg edema, Female infertility, Diarrhea, Depression, Lack of appetite, Slight abdominal distention, Desire to lie down... see more Li Zhong Wan
Detailed description of the cause

Qi Deficiency

Qi Deficiency in TCM is like running low on battery power. Qi is the vital energy that powers every function in your body. When there's a Qi Deficiency, it means your body doesn't have enough of this essential energy. This can make you feel tired all the time, weak, or even cause shortness of breath. It's similar to how you feel when you haven't had enough sleep or nutritious food. Your body just doesn't have the energy it needs to perform at its best. Unlike modern medicine, which often focuses on specific physical causes for fatigue and weakness, TCM views Qi Deficiency as an overall energy depletion that affects your entire well-being, and it seeks to replenish and balance this vital energy.... see more

Qi Deficiency Patterns That Can Lead to Nocturia

Common Symptoms: Dizziness Early Menstruation Pale Menstrual Flow Lower Back Pain Chills Thin Menstrual Blood Shortness Of Breath Palpitations

Pattern Name Relevant Symptoms Relevant Formulas
Kidney Qi Deficiency Urination at night, Hearing loss, Dizziness, Tinnitus, Back pain, Frequent urination, Nocturia, Premature ejaculation, Excessive menstruation... see more Qing E Wan
Spleen or Kidney Qi Deficiency Frequent night urination, Early menstruation, Pale menstrual flow, Lower back pain, Dizziness, Chills, Nocturia, Thin menstrual blood, Shortness of breath, Palpitations, Spontaneous sweat... see more Gui Pi Tang | Bu Zhong Yi Qi Tang | He Che Da Zao Wan
Detailed description of the cause

Cold

In TCM "Cold" as a pattern of disharmony refers to a specific type of imbalance within the body's systems, often linked to a deficiency or weakness. It's not about feeling physically cold or having a common cold, but rather a metaphorical description of certain symptoms and underlying conditions. When a TCM practitioner says someone suffers from "Cold," it usually implies that the body's Yang energy, which is warm and active, is insufficient or overpowered by Yin energy, which is cool and passive. Symptoms of Cold in TCM can include a general feeling of coldness, cold limbs, pale complexion, low energy, slow metabolism, and a preference for warmth. ... see more

Cold Patterns That Can Lead to Nocturia

Pattern Name Relevant Symptoms Relevant Formulas
Bladder Deficient and Cold Nocturia, Frequent urination, Pale and abudant urination, Urinary or fecal incontinence, Enuresis, Lower back pain, Dizziness, White urethral discharge, Chills... see more Sang Piao Xiao San | Suo Quan Wan
Detailed description of the cause

Kidney

In TCM the Kidneys are regarded as the body's most fundamental reservoir of Essence, known as Jing, which influences growth, reproduction, and aging. They are not just organs for filtering blood, but a holistic system governing vital life forces. When the Kidneys malfunction in TCM, it can manifest as a variety of health issues, such as chronic fatigue, reproductive problems, imbalances in fluid metabolism leading to edema or dryness, lower back pain, and a sense of fear or insecurity.... see more

Kidney Patterns That Can Lead to Nocturia

Common Symptoms: Lower Back Pain Dizziness Chills Generalized Fatigue General Weakness Premature Ejaculation Pale Menstrual Flow Thin Menstrual Blood

Pattern Name Relevant Symptoms Relevant Formulas
Kidney Yang Deficiency Night time urination, Lower back pain, Dizziness, Tinnitus, Weak and cold knees, Lower back coldness, Chills, Weak legs, Bright pale face, Generalized fatigue, General weakness, Leg edema, Female infertility, Diarrhea, Depression, Erectile dysfunction, Premature ejaculation, Oligospermia, Low sex drive, Pale and abudant urination... see more Ba Wei Di Huang Wan | You Gui Wan | Er Xian Tang | Shen Qi Wan | Wu Zi Yan Zong Wan | Tu Si Zi Wan
Kidney and Spleen Yang Deficiency Urination at night, Lower back pain, Weak and cold knees, Back cold sensation, Chills, Weak legs, Bright pale face, Erectile dysfunction, Premature ejaculation, Oligospermia, Watery ejaculate, Low sex drive, Generalized fatigue, General weakness, Clear urination, Nocturia, Apathy, Leg edema, Female infertility, Diarrhea, Depression, Lack of appetite, Slight abdominal distention, Desire to lie down... see more Li Zhong Wan
Kidney Qi Deficiency Urination at night, Hearing loss, Dizziness, Tinnitus, Back pain, Frequent urination, Nocturia, Premature ejaculation, Excessive menstruation... see more Qing E Wan
Spleen or Kidney Qi Deficiency Frequent night urination, Early menstruation, Pale menstrual flow, Lower back pain, Dizziness, Chills, Nocturia, Thin menstrual blood, Shortness of breath, Palpitations, Spontaneous sweat... see more Gui Pi Tang | Bu Zhong Yi Qi Tang | He Che Da Zao Wan
Detailed description of the cause

Spleen

In TCM the Spleen plays a vital role in digestion and transformation, converting food into energy and nutrients, and overseeing the distribution of Qi and Blood. It's also crucial in maintaining the health of muscles and limbs and ensuring the blood remains within the vessels. When the Spleen malfunctions in TCM, it can lead to a variety of issues such as digestive disorders, fatigue, weak muscles, bloating, and a feeling of heaviness. It can also cause a pale complexion, poor appetite, and a tendency to bruise easily. Emotionally, a Spleen imbalance is often associated with excessive worry or overthinking, reflecting its role in the interplay between physical and mental health.... see more

Spleen Patterns That Can Lead to Nocturia

Common Symptoms: Lower Back Pain Chills Generalized Fatigue General Weakness Early Menstruation Pale Menstrual Flow Dizziness Thin Menstrual Blood

Pattern Name Relevant Symptoms Relevant Formulas
Kidney and Spleen Yang Deficiency Urination at night, Lower back pain, Weak and cold knees, Back cold sensation, Chills, Weak legs, Bright pale face, Erectile dysfunction, Premature ejaculation, Oligospermia, Watery ejaculate, Low sex drive, Generalized fatigue, General weakness, Clear urination, Nocturia, Apathy, Leg edema, Female infertility, Diarrhea, Depression, Lack of appetite, Slight abdominal distention, Desire to lie down... see more Li Zhong Wan
Spleen or Kidney Qi Deficiency Frequent night urination, Early menstruation, Pale menstrual flow, Lower back pain, Dizziness, Chills, Nocturia, Thin menstrual blood, Shortness of breath, Palpitations, Spontaneous sweat... see more Gui Pi Tang | Bu Zhong Yi Qi Tang | He Che Da Zao Wan
Detailed description of the cause

Bladder

In TCM the Bladder plays a crucial role beyond its basic function of storing and excreting urine. It is intimately connected with the Kidney system, helping to regulate the body's water balance and being a key component in the processing and elimination of fluids. The Bladder also influences the lower part of the body and the back. When it malfunctions or is imbalanced in TCM, it can lead to urinary issues like frequent urination, incontinence, or painful urination. Additionally, there may be problems related to its meridian pathway, such as lower back pain, stiffness, or weakness in the legs. The Bladder’s condition in TCM can also reflect emotional states, with imbalances potentially leading to feelings of fear or anxiety.... see more

Bladder Patterns That Can Lead to Nocturia

Pattern Name Relevant Symptoms Relevant Formulas
Bladder Deficient and Cold Nocturia, Frequent urination, Pale and abudant urination, Urinary or fecal incontinence, Enuresis, Lower back pain, Dizziness, White urethral discharge, Chills... see more Sang Piao Xiao San | Suo Quan Wan

TCM Herbal Formulas for Nocturia

For conditions like Kidney Yang Deficiency, TCM practitioners may recommend formulas like You Gui Wan, which is designed to warm and fortify the Kidney Yang, thereby improving its function. This formula often includes herbs such as Prepared aconite, which is known for its warming properties.

In cases of Bladder Deficiency and Empty Cold, Sang Piao Xiao San may be suggested to stabilize and bind the Essence, thus helping in reducing nocturnal emissions and frequent urination. Its key ingredient, Praying Mantis Egg-Cases, is typically used for its properties to secure the Kidneys and Bladder.

For Kidney Qi Deficiency, where symptoms may include a dribbling urine stream and a feeling of incomplete emptying of the bladder, formulas like Jin Suo Gu Jing Wan may be utilized. It aims to secure the Kidney Qi and consolidate the Essence, often including ingredients like Lotus Seed and Euryale Seed known for their astringent qualities.

Explore below some TCM herbal formulas used to address nocturia, organized by cause and by formula type.

  • By Cause
  • By Formula Type
  • Yang Deficiency
  • Qi Deficiency
  • Cold
  • Formulas that warm yang and tonify
  • Formulas that tonify yin and yang
  • Formulas that secure essence and stop enuresis
  • Formulas that tonify qi and blood
  • Formulas that tonify qi
  • Formulas that nourish yin and tonify
  • Formulas that warm the middle and dispel cold

All Formulas Recommended for Nocturia Caused by Yang Deficiency

Formula Patterns Suitable For
Ba Wei Di Huang Wan Kidney Yang Deficiency, Yang Deficiency or Empty Yang
You Gui Wan Kidney Yang Deficiency, Yang Deficiency or Empty Yang
Er Xian Tang Kidney Yang Deficiency
Shen Qi Wan Kidney Yang Deficiency
Wu Zi Yan Zong Wan Kidney Yang Deficiency
Tu Si Zi Wan Kidney Yang Deficiency
Li Zhong Wan Kidney and Spleen Yang Deficiency

All Formulas Recommended for Nocturia Caused by Qi Deficiency

Formula Patterns Suitable For
Gui Pi Tang Spleen or Kidney Qi Deficiency
Bu Zhong Yi Qi Tang Spleen or Kidney Qi Deficiency
He Che Da Zao Wan Spleen or Kidney Qi Deficiency
Qing E Wan Kidney Qi Deficiency

All Formulas Recommended for Nocturia Caused by Cold

Formula Patterns Suitable For
Sang Piao Xiao San Bladder Deficient and Cold
Suo Quan Wan Bladder Deficient and Cold

All "formulas that warm yang and tonify" recommended for nocturia

Formula Patterns Suitable For (if applicable)
You Gui Wan Kidney Yang Deficiency, Yang Deficiency or Empty Yang
Shen Qi Wan Kidney Yang Deficiency
Wu Zi Yan Zong Wan Kidney Yang Deficiency
Tu Si Zi Wan Kidney Yang Deficiency
Qing E Wan Kidney Qi Deficiency

All "formulas that tonify yin and yang" recommended for nocturia

Formula Patterns Suitable For (if applicable)
He Che Da Zao Wan Spleen or Kidney Qi Deficiency
Er Xian Tang Kidney Yang Deficiency

All "formulas that secure essence and stop enuresis" recommended for nocturia

Formula Patterns Suitable For (if applicable)
Sang Piao Xiao San Bladder Deficient and Cold
Suo Quan Wan Bladder Deficient and Cold

Acupoints for Nocturia

In TCM, specific acupoints are targeted to address nocturia. Shenshu (BL-23) is used for Kidney Yang Deficiency to strengthen renal function. For Bladder Deficiency and Empty Cold, Guilai (ST-29) is employed to warm the Bladder. To counter Kidney Qi Deficiency, Fuliu (KID-7) is selected to bolster the Kidney's Qi reception. These points aim to rebalance the body’s Yin and Yang, and harmonize the flow of Qi, thereby mitigating nocturnal urination issues.

Explore below some acupoints used to address nocturia, organized by meridian.

  • By Meridian
  • Stomach Channel
  • Bladder Channel
Guilai ST-29

Guilai ST-29

4 cun below the umbilicus, 2 cun lateral to the anterior midline.

Shenshu BL-23

Shenshu BL-23

1.5 cun lateral to the lower border of the spinous process of the 2nd lumber vertebra (L2).