Feel like you have the urge to pee all the time? Getting bladder urges at night that keep you from getting a good night’s rest? If you are nodding your head in agreement read on, I have tips to put you back in control! Let me explain…
Urinary urgency, frequency, and frequent nighttime urges are all indicators of bladder dysfunction called Overactive Bladder (OAB). The most recent studies indicate it affects at least 17% of all women and becomes more common as we grow older. However, many researchers feel this number is vastly underreported.
What is an Overactive Bladder?
Women who have an overactive bladder experience urgency even when their bladder is not full. This means they are constantly looking for a bathroom, also called ‘toilet mapping’ or ‘toilet scanning’. They often make the trip to the bathroom with very little coming out. As frustrating as this is, the most disturbing aspect of OAB is its effect on your quality of life.
The constant worry about bathroom availability means that you become reluctant to participate in social activities, take trips, or exercise. If left untreated this condition can progress to include bladder leaks related to not making it to a toilet in time.
The additional burden of having to wear a pad only adds to the psychological distress. Not to mention the stress of dealing with your bladder issues while sleep-deprived due to bladder urges at night. This is why there is a high correlation between anxiety, shame, frustration, depression, and social isolation.
As a Pelvic Health physical therapist (physio) this bladder dysfunction is one of the most common reasons clients are sent to me for treatment. Clients often share with me that their underlying fear is that this condition will not go away and that they will have to live with it for the rest of their lives.
My response is absolutely NOT!
To understand an overactive bladder you first must understand what makes your bladder happy.
Your bladder is a round muscular organ designed to stretch and hold urine. It actually has pressure receptors in the bladder wall just for this purpose. Your bladder operates in two phases; the filling phase and the emptying phase.
In the filling phase, your bladder is happiest when it has a chance to store urine and tells you how the filling is going by sending you physical messages called bladder urges. The first urge your bladder sends you is when your bladder is half-full. This is meant as a gentle reminder of how the filling process is going.
The first urge is a suggestion, NOT a command to empty your bladder!
If you decide to act on the first urge and make the trip to the toilet, your bladder never has a chance to stretch and fill properly. By repeatedly acting on the first urge or emptying ‘just in case’, your bladder never has the chance to do its job.
The lack of stretch slowly, gradually leads to small bladder capacity and urge signaling that starts at an ever smaller amount of pee. This means you get the next urge sooner, and the cycle repeats itself.
As your bladder becomes more sensitive to smaller amounts of urine, your brain starts to spend more time thinking about peeing. The attention on toileting reinforces the behavior and you end up with stronger urgency and bladder urge triggers like ‘running water’ or ‘hand on the door knob’ when coming home from the store.
Before long, your bladder is in control and you feel at the mercy of bladder urgency.
How do you stop your bladder from controlling you?
Here are five of my top tips for dealing with an overactive bladder to put YOU back in charge!
Stop going to the bathroom ‘just in case’.
Preemptive voiding or emptying your bladder ‘just in case’ may have started with the best of intentions but is it not helping your bladder symptoms. It is a good idea to empty your bladder before leaving your home for a long car ride, or before going to bed. However, this does NOT mean you have to empty out every time you leave your home.
The time between trips to the bathroom should be around two to three hours. If you recently went, hold off for a while and wait. Your bladder will have a chance to stretch and do its job, and your bladder capacity will improve.
Want more information on this topic? Check out my blog!
Don’t rush your time on the toilet!
If you’ve adopted the habit of hurrying to urinate, which includes pushing your pee out, you are NOT doing your bladder any favors. Rushing to urinate does not allow the pelvic floor muscles to fully relax. As a result, you can get incomplete bladder emptying which will send you back to the toilet sooner.
Instead, take your time on the toilet, relax your pelvic floor muscles, and take deep breaths to help with emptying. Avoid pushing your pee out by holding your breath or contracting your abdominal muscles. Pushing or straining to pee will only make your pelvic floor muscles weaker, and this in turn will make your bladder symptoms worse.
Want more specifics on how to empty your bladder better? Check out my free printable on the toileting here!
Drink plenty of water!
It may seem counterintuitive to the person going to the bathroom a lot, but withholding fluids is NOT the way to deal with bladder issues. One way or another, your kidneys are going to produce urine. Drinking less water or other fluids will only serve to dehydrate your body and concentrate your urine.
Concentrated urine is a bladder irritant and will send you to the toilet sooner. Instead, drink small amounts of water throughout your day, and monitor your hydration level by looking a the color of your urine. It should be a light yellow or straw color and have no unpleasant odors. Want more specifics on this subject?
Check out my blog on exactly how much fluid to consume in a day!
Avoid consuming bladder irritants!
Exactly what you drink does matter to your bladder. Fluids such as soda, carbonated water, tea, coffee, juices, and alcoholic beverages all have acids in them and can be irritating to your bladder. This is especially true if you are dehydrated and then consume a highly acidic fluid.
Add more plain water during your day. Improving your general hydration level will reduce the effect of high acid liquids and create a calmer bladder and a calmer you. In this case, the ‘solution is dilution’, which is the subject of this blog.
Use your pelvic floor muscles for bladder urge suppression!
Utilizing the strength of your pelvic floor muscles is one of the main strategies I use when treating my clients. Your pelvic floor muscles and your urethral sphincter work together to hold back your pee. Activating your pelvic floor muscles not only helps keep your urethra shut but also sends a signal to your bladder to relax, and hold more urine.
Five to ten quick squeezes of your pelvic floor muscles signals your bladder to relax and diminish urgency. This very useful technique called ‘bladder urge suppression’ can be used to delay peeing or get the bladder urgency to go away completely.
It is an invaluable tool to have in your bladder control toolbox to deal with bladder urgency. I highly recommend you check out my free printable using the link here.
Bladder control issues are common but NOT normal.
Gaining insights into why your bladder is behaving the way it is is critical. If you’re not sure how often you’re going or what your triggers are, I have free printable bladder journal for you to monitor your symptoms. My link for the bladder journal is here.
Insights gained from bladder diaries can lead to simple changes in behavior or routines that will make a big difference in how your bladder is feeling. Having a lot of tools in your bladder health toolbox is an important step in putting you back in charge. Freedom!
Be sure and share this with a friend or leave a comment below!
Happy Bladder wishes!
~ Tami
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.com. 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.
References:
Willis-Gray MG, Dieter AA, Geller EJ. Evaluation and management of overactive bladder: strategies for optimizing care. Res Rep Urol. 2016 Jul 27;8:113-22. doi: 10.2147/RRU.S93636. PMID: 27556018; PMCID: PMC4968994.
Monteiro S, Riccetto C, Araújo A, Galo L, Brito N, Botelho S. Efficacy of pelvic floor muscle training in women with overactive bladder syndrome: a systematic review. Int Urogynecol J. 2018 Nov;29(11):1565-1573. doi: 10.1007/s00192-018-3602-x. Epub 2018 Apr 11. PMID: 29644384.
Burgio KL, Newman DK, Rosenberg MT, Sampselle C. Impact of behaviour and lifestyle on bladder health. Int J Clin Pract. 2013 Jun;67(6):495-504. doi: 10.1111/ijcp.12143. PMID: 23679903.
