Are you always waking up to pee in the middle of the night? Here are some possible causes — and what you can do.

Possible Causes: Aging, adrenal dysfunction, varicose veins, prediabetes or diabetes

“Peeing at night is age dependent,” says functional physician Thomas Sult, MD. Shifting hormone levels and structural changes in the bladder, among other issues, increase the likelihood of heading to the bathroom at least once during the night.

That said, if you routinely get up to go more than twice before dawn, no matter your age, consult a doctor. For men over 50, it could signal prostate troubles, says Sult — especially if urinating itself has become difficult. In women who have given birth, frequent urination can be a sign of bladder prolapse, another issue to discuss with your healthcare practitioner.

Sleep apnea can also trigger frequent nighttime urination, so if you ­experience any other symptoms of sleep apnea — like snoring, daytime fatigue, or insomnia — consider discussing it with your physician.

Undiagnosed diabetes can cause frequent urination during the day and night, because of the stress placed on the kidneys. And varicose veins can lead to midnight bathroom trips because “all the fluid [that had stagnated in your legs] comes back into your system and causes you to have to pee,” says Sult.

Finally, waking up to pee can be a sign of adrenal dysfunction. The adrenal system governs sleeping and waking, and if it’s off-kilter it may send a wake-up call at 3 a.m. Most of us assume we woke up because we had to go to the bathroom, but more likely, we feel like we have to go to the bathroom because we woke up. The body can normally “hold it” through a night of sleep.

What You Can Do: See your doctor if you suspect problems with your prostate (men) or bladder prolapse (women). Increased urination — like weight gain and wild swings in blood sugar — can also be a symptom of diabetes, so be sure to check that with your physician as well.

Chronic stress is taxing to the adrenal system, so prioritize self-care, and do what you can to get the support you need.