Life Changing Facts about Bladder Health

Nearly 29 million American women live with untreated stress urinary incontinence. So, we think that information and practical tips for bladder health should be just as common. If you want to know why urinary leaking happens and what to start doing about it, this is for you.

First, some basics. The bladder is a pear-sized organ sitting right near your pubic bone, in the very low center of your abdomen. The bladder muscle is called the detrusor. As the bladder gradually fills up, the detrusor muscle stretches and the bladder grows in size to comfortably hold about 2 cups of urine. At some point, the stretch will cause the urge to pee. If you hold it, the urge will gradually increase. During this time, the pelvic floor gets the cue to tighten so that pee doesn’t leak out of the body. And when it’s time to go (aka you’re on the toilet), the bladder muscle squeezes and the pelvic floor relaxes to let the urine pass out of the body. The bladder and pelvic floor are in a feedback loop with each other. We do have some control over this, but much of this system is automatic. Outside influences, like hydration, diet, and stress can affect this system. For example, high sugar or caffeine can increase urinary urgency and frequency beyond a normal amount.

A normal bladder pattern looks like this:

- Void every 2-4 hours
- Easy voiding - starts naturally, fully empties, strong stream, no strain or pain
- Nighttime voiding: once per night if age 65+, otherwise none
- A full void, meaning it takes at least about 8 seconds to void (this is a very general way to determine if you’re filling up a normal amount before having to go)

Unhealthy bladder patterns can look like this:

- Voiding more or less than every 2-4 hours, and more than once per night
- Going “just in case”, like before leaving the house, even if there is no urge to go
- Leaking / incontinence
- Urgency with external triggers like hearing running water, nearing the toilet, etc.
- Thin, spraying, painful, or strained stream
- A stream that starts and stops

So why does leaking happen? Many people immediately think of weak pelvic floor muscles or pelvic organ prolapse. Although these two conditions can contribute to urinary incontinence, there are many other possibilities. For example, food or beverages that stimulate urinary urgency; diabetes; certain medications; hormone changes associated with menopause; scar tissue in the abdomen or pelvic floor; and habits that have created more frequent voiding.

Some of these causes will need professional management from a healthcare provider. However, there are some things any person can do today to help improve and protect their bladder health, and reduce their risk of leaking:

- Drink plenty of water each day. Your bladder system needs good hydration!
- Assess your diet - is there a relationship between something you consume (especially sugar, caffeine, alcohol, citrus, and dairy) that increases urgency or leaking?
- Retrain healthy habits, like voiding on a schedule if you’re going too much or too little, and discontinuing going ‘just in case’
- Partake in daily exercise (walking, stretching)
- Manage anxiety and stress - options include deep breathing, meditation, gentle exercise, time outdoors, hobbies, and/or professional support as needed
- See your physician for a hormone assessment, particularly if you’re peri-menopausal or in the first year postpartum
- Participate in a pelvic floor program for strength and coordination (pelvic floor physical therapy)
- Use support tools as necessary to support the pelvic organs (like a pessary) or to support the vaginal tissue health (like a vaginal moisturizer)

In some cases, like pain or physical injury associated with leaking, or leaking related to medications or a disease process, it will be important to see a medical provider. Start by contacting your primary care physician or a pelvic health physical therapist near you.

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​** Note: this content serves as educational only. It does not constitute medical evaluation, treatment, or advice. Please consult with your medical provider(s) as needed, before partaking in changes to your medical, fitness, or health care practices.