If you feel like you are constantly looking for the nearest bathroom, planning your day around where the bathrooms are, or waking up multiple times at night to pee, it may be time to take a closer look at what’s going on with your bladder. Bladder urgency and frequency are common, but needing to go all the time is not something you simply have to accept as part of getting older.
Overactive bladder is a term used when you have a sudden, difficult-to-control urge to urinate, usually with increased frequency and sometimes nighttime urination. It can affect women at different stages of life, but it becomes particularly common during midlife and after menopause.
One of the tricky things about bladder urgency is that your bladder can get used to being emptied before it is actually full. Think about how often you pee “just in case” before leaving the house, before a workout, or before getting into the car. It can seem like a good way to prevent an emergency, but constantly emptying your bladder at the first sensation of fullness can actually reinforce the habit of going more frequently.
Your drinks can also play a role. Caffeine, carbonated drinks, and other bladder irritants can make urgency and frequency worse for some women. That doesn’t mean you have to give up your morning coffee forever. Instead, paying attention to what you drink and how your bladder responds can help you figure out what may be contributing to your symptoms.
And then there is the pelvic floor.
It might seem like bladder urgency automatically means your pelvic floor is weak, but that isn’t always the case. A pelvic floor that is constantly tense or working overtime can also contribute to urgency and frequency. Your pelvic floor needs to be able to contract when you need it, but it also needs to relax when you don’t.
This is where bladder retraining can be helpful.
Bladder retraining is essentially teaching your bladder and your brain to respond differently to the urge to urinate. Instead of immediately running to the bathroom every time you feel an urge, you can gradually work on increasing the amount of time between bathroom trips. This should be done gradually and based on your symptoms rather than forcing yourself to hold your urine for uncomfortable periods of time.
You can also learn urge-suppression techniques to help you manage that sudden “I need to go RIGHT NOW” feeling. Depending on the situation, this might include slowing down, taking a few controlled breaths, relaxing your pelvic floor, and using gentle pelvic floor contractions to help settle the urgency. The goal isn’t to ignore your bladder. It’s to give yourself enough time to respond instead of feeling like your bladder is always in charge.
One of the easiest ways to start understanding your bladder habits is with a bladder diary. For three days, you can keep track of when you drink, what you’re drinking, when you urinate, how strong the urge was, and whether you experienced leakage or nighttime trips.
A three-day bladder diary can reveal patterns that are difficult to notice when you’re simply going about your day. You may realize you’re going to the bathroom every hour, drinking several cups of coffee before noon, waking up twice every night, or automatically urinating “just in case” before almost every activity.
That information can be incredibly helpful when you’re trying to figure out what your bladder actually needs.
If urgency, frequency, or nighttime bathroom trips are interfering with your sleep, work, exercise, travel, or daily life, you don’t have to just plan your life around the nearest bathroom. A pelvic floor physical therapist can help you look at your bladder habits, pelvic floor function, fluid intake, and other factors that may be contributing to your symptoms.
Start by downloading the three-day bladder diary and see what your bladder is telling you. It may give you more information than you realize.
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Looking to optimize your well being with pelvic floor physical therapy? Reach out to us at Pelvic Health Center in Madison, NJ to set up an evaluation and treatment! Feel free to call us at 908-443-9880 or email us at [email protected]. We are in-network with several insurance plans and can help you confirm your benefits before your evaluation.