The Leak on Leakage: What Bladder Habits are ‘Normal’ and What’s Not.
It’s happened to us all.
You’re in the car, on a boat, in the middle of a presentation, at a concert, or during a workout class. Your bladder is saying go, but your brain is saying no.
You immediately begin planning mode: is there a bathroom nearby? If not, where could you find one? How far away is it? How long will you have to wait? Can you make it in time?
Meanwhile your pelvic floor is hard at work, contracting muscles to keep urine in until you’ve safely made your way to a toilet.
The sensation of a full bladder starts as a whisper and intensifies to a loud consuming scream.
It’s go time.
You finally make your way to a bathroom, do the pee dance while unfastening your pants, cursing the manufacturers for making such difficult buttons, and giving yourself a pep talk to keep it together. Finally, ahhhhh, the sense of relief when you’re in the clear. The pelvic floor muscles can release to empty your full bladder.
Bravo! Another splendid performance by your brain, bladder, and pelvic floor.
It’s a tale as old as time, but one we experience without much understanding or place much thought to…unless it concludes with a leaky ending.
A healthy bladder holds approximately 2 cups of fluid, that’s about the size of a Starbucks Grande. This means that on average a person voids 6-8 times a day or every 2-4 hours. Healthy pelvic floor muscles should be able to contract to prevent any leakage, and lengthen to fully release. Voiding urine should be effortless, there should be zero straining to initiate, to maintain a constant stream, or to conclude. These muscles function to support unexpected movements, such as coughing, sneezing, or laughing, as well as high impact activities including running, jumping on a trampoline, or lifting weights without urine leakage.
Continence is complex, and incontinence gets a bad rep. But let’s bring out the facts, because it can be an isolating experience due to feelings of shame or resigning to false beliefs that these issues are 'part of womanhood.’
You are not alone.
1 in 3 women still pee their pants 12 years after giving birth (Study of 4,000 women, BJOG)
25% of high school female athletes have at least occasional urinary leakage (Journal of Human Kinetics, 2014)
More than 33 million adults in the US have Overactive Bladder (Urology Care Foundation)
1 in 4 women over the age of 18 experience episodes of involuntary urinary leakage. (National Association of Incontinence)
Urinary Incontinence doesn’t just happen after menopause. It doesn’t just happen postpartum. It can occur at any age, and can occur with all genders. It also isn’t a one size fits all situation. There are a few types of incontinence.
Types of Incontinence
Urge Incontinence: Loss of urine of any amount after a sudden need to urinate.
Stress Incontinence: Leakage of urine of any amount caused by coughing, sneezing, or high impact activities that put pressure on the bladder.
Mixed Incontinence: A combination of both stress and urge incontinence.
What Can Effect Bladder Health?
Bladder Irritants:
There are foods and drinks that can make your bladder a bit cranky, urging you to make more frequent trips to the bathroom. These can include…
highly spiced foods (curry, chai, peppers)
carbonated beverages (soda, seltzers)
alcohol
coffee
citrus
artificial sweeteners
even some medications
If anyone reading this is anything like me, you are not about to give up a glass of wine with dinner or your morning coffee…and that’s okay. It’s about learning to strike a balance by drinking plenty of water to dilute these irritants for a happier bladder environment.
How to Support Your Bladder:
There are some lifestyle changes you can make to help with bladder issues. First, you may find it helpful to get to know you patterns better by keeping a journal on when and how often you go, what you eat and drink, and medications you take. Some other ways to support your bladder are…
Quit smoking
Make healthy food choices
Engage in some form of physically active routine
Learning to properly kegel and reverse kegel (activate and release your pelvic floor muscles)
Drink enough fluids, especially water
Prevent/avoid constipation
Hydration:
The National Academies of Sciences, Engineering, and Medicine determined that an adequate daily fluid intake is about 15.5 cups of fluids for men and about 11.5 cups a day for women.
Now I understand that “fluids” is vague. However, after reading the lengthy list of bladder irritants (see above), it makes sense that if someone reports they drink plenty of fluids living off of coffee, beer, and sweet tea, they still may not have a happy bladder.
The body requires water.
Considerations For the Next Time You Take A Tinkle
At least a 6-second stream
Sit, don’t squat: Be in a relaxed position so your muscles can fully release
Take your time: Take enough time to fully empty your bladder
Stop going ‘just in case’: it trains your bladder to go when it’s not full yet
Quick Take Home Tips
For Frequency/Urge:
5-8 quick kegels
Changing your positioning or environment
Breathe slowly: Calms the
Release excess tension: unclench your jaw, drop your shoulders away from your ears
For Stress Incontinence:
Squeeze before you sneeze: perform a kegel when you feel a sneeze coming
Exhale with exertion: exhale as you stand, lift, or exert force
Posture: Head over heart—heart above hips—hips above heels
Give these tips and trick a go! Keep in mind that every body is different, and each person’s bladder requires different things. A pelvic floor therapist can assess muscle tone, coordination, posture, habits, and routines to help improve bladder functioning. Reach out to a local pelvic floor therapist to address your individual needs.