Want to have a healthy bladder? Start now. Heather Shannon, MS, CNM, WHNP, MPH

How often do you think about going to the bathroom? Do you plan events around where the nearest bathroom is? Do you shy away from taking a long road trip or jumping on a trampoline? Have you stopped taking your favorite fitness class or stopped your morning run? Be honest. For many of us, when we were younger, urinating was no big deal. Right? In fact, teenagers will only urinate approximately three to four times per day. But as we get older, it is harder to ignore bladder signals or urges to go to the bathroom. If we do not act on it relatively soon, we find we end up having problems, such as incontinence (leaking urine). Many of us will experience unwanted incontinence with laughing, sneezing, exercising or losing urine at first sign of having to “go.” We might even develop a constant urge to urinate, which is a sign of an overactive bladder.

Because of these unwanted problems, women spend a lot of time thinking about ways to protect clothing and prevent leakage of urine that they will stop them from going to events or participating in activities. Thankfully, there are ways to treat many of the urinary problems women encounter, but of course, prevention is the best. In order get back to better bladder habits, it is important to understand how your bladder works and why it is important to listen to the signals. First, let us learn about our anatomy.

Where is your bladder?

Your bladder is in your pelvis, is located in front of your uterus, and is a hollow, muscular, balloon-shaped organ expands as it fills with urine. It receives urine from the kidneys through two tubes called the ureters. A normal bladder acts like a reservoir and can hold 1.5 to 2 cups (10-16 ounces) of urine for two to five hours. On average, women urinate every three to four hours and no more than twice at night. Of course, how often you urinate depends on what and how much you drink throughout the day and can be affected by certain medications. Lastly, the urethra is a single tube that carries urine from the bladder to the outside and is located above a woman’s vaginal opening, below the clitoris. The bladder will send you a signal as a sensation that you have to urinate called urge. Luckily, you can control the urge until you are able to get to a bathroom.

When it is time to urinate, your brain sends a signal to the opening of the urethra to relax and then to the bladder muscle to squeeze or contract causing urine to flow through the urethra. It is not okay to ignore the urge for long periods as this causes a weakening in the bladder muscle and decreases proper functioning. With the many missed opportunities to empty the bladder, you can develop urinary problems such as painful urge or more frequent urine leakage. This is why it is important to listen to your bladder signals to urinate whenever you have the urge when younger.

What can I do now to help limit bladder problems in the future?

First, think about how much liquids you are drinking every day. It used to be recommended to drink eight glasses of water a day, but that is no longer the case. The current recommendation is to drink when you are thirsty (American Urological Association, 2020). In addition to thinking about how much to drink, you should look at the types of beverages you are drinking i.e. soda, sports drinks, specialty coffees/teas or flavored water. Besides empty calories in many of these beverages, there is no nutritional value and many of them contain caffeine or artificial sweeteners that will increase your need to empty your bladder more often. Best option is to choose water above all others.

A healthy woman, at any age, should urinate when they have the urge, which is about every three to four hours. Holding your urine too long can increase risk of developing a weak bladder, cause urine leakage, and interfere with signals from the bladder to the brain. Having regular bowel movements (BM) daily or every other day is also very important to your bladder health. With constipation, you tend train with a BM which weakens your pelvic floor muscles and puts added strain on your bladder, causing urine leakage. In addition, obesity is linked to increased urinary urgency, frequency and leakage. Eating a healthy diet, getting regular exercise and maintaining a healthy weight will decrease your chances of developing these symptoms.

Now back to those missed activities. In order to reach or maintain optimal bladder health, you should drink water when you are thirsty, empty your bladder whenever you feel the urge (if not every three to four hours) and control for constipation. Of course, we cannot forget to maintain a healthy lifestyle that includes making good food and beverage choices, maintaining a healthy weight, and getting regular exercise. If you continue to have problems with leaking urine or going frequently, despite changes you’ve made, call your health care provider now. Don’t wait. Get back to the activities you want and enjoy! SWM