Urinary urgency and frequency - what is “normal”?
Do you feel like you are always needing to make a pit stop by the bathroom when you’re out? Or maybe you notice you are making frequent trips to the bathroom at work?
Do you always go before you leave your house? Is this a habit, or are you worried if you’re out you may have a sudden urge and not have a bathroom nearby?
Urinary urgency and frequency are common, and they are sometimes considered “normal”, especially in the postpartum population. Moms will hear things like “that’s the cost of being a mom - peeing your pants, having to pee all the time, or not being able to hold it for very long”. (if you’re interested in learning more about fixing postpartum urinary incontinence, check out this blog post).
I’m here to tell you that no matter how many kids you’ve had, how far postpartum you are, or even if you feel like you have “always had to pee a lot, even as a kid”, this is something we can work to improve!
So what is “normal”?
Typically you should be peeing once every 2-4 hours, or about 4-8x/day. You should also be getting out of bed no more than once a night to pee. The urge to pee should never take you by surprise, or make you feel like you have to run to the bathroom to avoid an accident.
If you are urinating more frequently than the norms listed above, here are some tips to try.
Stop “just in case” peeing. Just because the bathroom is right there, doesn’t mean you should use it! If you don’t feel an urge to pee, hold off. If you are frequently emptying your bladder “just in case”, you actually train your bladder that it needs to be emptied before it is full. Over time, this can increase urinary frequency. (Of course if you are about to be in the car for several hours or won’t have access to a bathroom for long periods of time for any reason, it is OK to go. You just don’t want to make it a habit to empty your bladder when it is not full!).
Suppress the urge (see tips below). Reducing the intensity of urge can help reduce frequency, helping you get closer to the 2-4 hour goal.
Sip water throughout the day to stay hydrated. Optimizing your hydration will help with urinary frequency. Being dehydrated can actually irritate your bladder, and if you drink all of your water for the day in just a couple sittings it may increase your frequency. Sipping water throughout the day helps you stay hydrated and allows your body to process fluids at a normal rate.
Consider bladder irritants. Some foods and beverages can irritate your bladder and increase urinary urgency and frequency. The food and drinks listed below have been found to be common bladder irritants, however you may be able to tolerate some or all of these without any issues. It is great to be aware of what might be irritating your bladder so you can notice patterns and make changes as needed. Common bladder irritants include:
citrus
alcohol
caffeine/coffee (bonus tip: try drinking 8 ounces of water before and after your cup of coffee to see if it helps)
chocolate
acidic foods
Do you feel a sudden urge to pee and have to rush to the bathroom? If you are experiencing urgency, here are some tips to try.
Identify triggers. Sometimes things such as hearing running water, putting your key in the door, or even parking your car in your driveway can make you feel like you need to go right now. Your brain has learned that it is time to go when these triggers happen, so it starts to cue you to rush to the bathroom. Identifying these triggers and being prepared with urge suppression techniques can help to break this cycle.
Consider bladder irritants (see above). Bladder irritants can increase both urgency and frequency, so pay attention to the food and drinks listed above and see if you notice any patterns.
Suppress the urge. By staying calm and suppressing the initial urge, you can start to retrain your brain and bladder to give calmer cues when you have to go. You can also retrain your bladder not to cue you until it is actually full (not 50% full, 75% full, etc). Here are a few urge suppression techniques to try.
Sit down. A little pressure on your perineum can help to reduce the urge.
Calf raises and/or toe curls. Your feet share some neurological connections with your bladder, so curling your toes or doing calf raises can help suppress urgency. It also helps to distract your brain from the urge.
Diaphragmatic breathing. Taking a few deep breaths can help to calm your nervous system and reduce urge. Breathe into your diaphragm by breathing through your nose and feeling your ribs expand 360 degrees.
Distraction. Try some of the techniques above to distract your mind from the urges. After you suppress the initial urge, when you feel a second urge walk calmly to the bathroom.
The final tip to address urinary urgency and frequency: work with a pelvic floor PT! These tips are a great place to start, but working with a pelvic PT can help you determine how your pelvic floor muscles might be involved, troubleshoot working through triggers and bladder irritants, and address other symptoms that often go along with urinary urgency and frequency. To learn more about all of the pelvic floor conditions and symptoms we treat, click here.
Questions? Reach out to us any time at info@absolutekineticspt.com.
Blog post written by Dr. Alexis Hutchison, PT, DPT, OCS