How often we go to the bathroom is usually something we don’t think about until it becomes a problem. If you are experiencing urinary frequency and feel like you are always looking for a toilet, it may be time to make a change. I have tools to help you stay free of bladder worries!
This topic came up with a friend of mine who is a postpartum mom. Like most of my friends they are curious about what I do as a Pelvic Health Physical Therapist and eager to learn more about their bodies and good self-care. She shyly asked the question because I was talking about how I often see new mom’s who continue with bladder frequency well after they have delivered their babies.
And here’s the reason why.
When you are pregnant the weight of the baby squishes the bladder down to a very small size. This is why during pregnancy most women are going to the bathroom a lot and that is considered normal. Nothing we can do about it, the baby takes up a lot of space and our bladder can’t fill like it used to.
After the baby is delivered there is a time when you will need to empty more because of breastfeeding. There is a very real need for more hydration to meet the needs of milk production and as a result most mom’s who are nursing are emptying more as a result. Once breastfeeding has stopped however, the number of bathroom trips should gradually decrease over time. At this point it’s time to allow the bladder to fill just like it did prior to pregnancy.
So how does the bladder filling process work?
The job of the bladder is to constantly accept the urine created by the kidneys and once it reaches half full to gently give us the signal (urge) to empty. Because the bladder talks to the brain and vice versa, we can develop habits related to emptying that may or may not have anything to do with how much liquid is in the bladder itself. If we are in the habit of peeing at certain times the feeling that we need to empty or urgency may continue.
This is why mom’s often continue to pee frequently during the day, or get up at night, even after they have stopped breastfeeding. What was once a necessary act of emptying is now a habit that continues, often without conscious awareness. The first step in shifting this pattern is reflecting on what’s happening and deciding to take a closer look.
How do I figure out how much I’m peeing?
The easiest way of determining how often you empty is to take a few days, both midweek and weekend and write down every time you use the bathroom. To make this easy I have included the Bladder Journal I use, including step-by-step instructions.
The Bladder Journal includes an area to monitor fluid and food intake as well. Some foods are more fluid-dense than others (think soups and watermelon) and it is important to take those foods in consideration when you are looking at hydration. I also have a place to monitor the intensity of urgency, which is good to look at if you’re thinking that a certain beverage may be causing an increase in bladder urges
It’s uncomfortable to fill my bladder at times, am I hurting myself?
No, not at all. Your bladder is meant to hold 300 to 400ml of urine which is equivalent to 10 to 13.5 fluid ounces or 1.25 to 1.75 cups of liquid. That’s a lot of liquid! It can actually hold a bit more if needed, and the worst that can happen if you continue to hold off urination, is that you will leak.
If you want to measure how much you’re peeing you can, but another good way to measure is to count the number of seconds it takes for you to empty. A good satisfying pee is at least 8 seconds at a minimum and ideally more.
Many of my clients find it uncomfortable to fill their bladder at first, because it’s a new feeling. When this happens I encourage them to relax their abdominal muscles, and allow the belly to expand outward slightly. This will help to decrease inner abdominal pressure and give your bladder the go-ahead to fill.
Positive self-talk is important.
It’s also important to include what I call ‘positive self-talk’ when you feel the discomfort. This is much like reciting a mantra to yourself along the lines of;
- This is only my bladder filling.
- I’m happy my bladder is doing its job.
- Or nothing to worry about, it’s just my bladder.
Positive self-talk is important because worry or anxiety about the feeling of bladder filling will likely make things more uncomfortable. Remember if you are worried about something, your brain will tend to focus on that worry and amplify whatever you are feeling. Over time the discomfort of bladder filling will fade to the background, as your body gets used to a ‘new normal’.
So what is the normal number of times to go to the bathroom during the day?
If you are an adult female then going to the bathroom should happen roughly every 3 hours, that’s about 6-8 times per day. This is a range because our bladder emptying can depend on how long you are awake, and your fluid intake. Don’t expect the amount of fluid in to equal the amount of fluid out. Our bodies lose fluid due to perspiration when we move, and respiration when we breathe.
Given these variables, I advise moms to aim for going every 2-3 hours at first, working up to going every 3 hours or more as you can. As a Pelvic Health Physio I realize this can be challenging at first, especially if frequent urination is a long standing habit.
Go slow with any transition in bathroom habits and mark your progress by using the Bladder Journal provided in the link here. As with any behavior change you may have your good days and bad days. Be kind to yourself and remember the idea is ‘practice not perfection’ when making changes in behaviors.
This is exactly what my friend did, she used the Bladder Journal to quickly assess her bladder frequency and realized she had gotten into a habit of emptying a lot! She had been going to the bathroom frequently for so long, it just seemed like ‘normal’ to her. Armed with this new information, she looked at her urination frequency and decided she definitely could cut out a few bathroom breaks during the day.
Now she’s going less often and finds that she doesn’t have to look for a toilet constantly during the day.
Freedom from bladder worries! 
If you found this helpful, share it with a friend or pin it to your self-care board!
Tami Lines is a licensed Physical Therapist with certifications in Pelvic Rehabilitation and Women’s Health Coaching. She is the founder of Pelvic-Health-Matters. Tami has over 15 years of experience with expertise in bladder Health, and pelvic floor muscle dysfunction for adolescent and adult women. She is also a mom of two wonderful young adults working their way through college.
Referrence:
Lukacz ES, Whitcomb EL, Lawrence JM, et al. Urinary frequency in community-dwelling women: what is normal? Am J Obstet Gynecol. 2009; 200:552 el-7.
