Have you heard someone say ‘I have a small bladder, that’s why I need to use the toilet often’? Well, here’s a fact: we all have the same bladder size. Certain people may urinate more often, which makes them feel like they have a small bladder, but the more likely culprit of incontinence issues is weak pelvic floor muscles, infection, or nerve damage.

What’s a normal bladder pattern?

5 to 8 times per 24 hours is considered normal. If you’re younger, you should be voiding at 3–4 hour intervals. If you’re over 65 years old, it’s considered normal to urinate at 2 hour intervals.

Waking up in the middle of the night to urinate

Is that normal to wake up in the middle of the night to pee? Nocturia is a condition in which you wake up during the night because of a need to urinate, often leading to other issues like fall risks, poor sleep quality or poor hydration to avoid the situation.

If you’re over 65, it’s considered normal to wake up 1–2 times to urinate. If you’re below 65, you should be able to sleep through the night without waking up to urinate (or at most, once a night if you’ve had a lot to drink or taken diuretics like alcohol or caffeine — but it shouldn’t be frequent).

How much should you urinate?

Your bladder holds 400–600ml of fluids, and each time you urinate, you release all of that except 5-100 ml of urine, called post-void residual. All your urine should flow in a consistent stream, with the morning void the longest where you release 240–360ml, and the rest of the day 180–300ml each time.

Normal Bladder Control does not leak when you sneeze
Photo by Florian Klauer on Unsplash

Is it normal to ‘leak’?

No. Normal bladder control means you’re able to take your time to get to the bathroom, hold your pee while you sit through a meeting, movie or listen to your spouse babble.

While it is common, it is not normal to leak urine when you laugh, cough, sneeze, run, squat — no matter how much or little the amount of leak is.

Urinary Control Disorder (UCD) is more common than we think.

Females are 2x more likely to experience UCD. In fact, UCD affects 40% of females worldwide. The prevalence of UCD is 67% higher after childbirth. However, men are not exempted, with 11-22% of men experiencing UCD. The risk for UCD increases with age across genders — 1 in 2 over the age of 65 would face a bladder control problem.

Other causes of urinary incontinence include:

  • Overweight. Being overweight puts pressure on the bladder, which can weaken the muscles over time. A weak bladder cannot hold as much urine.
  • Constipation. Problems with bladder control can happen to people with chronic constipation. Constipation, or straining to have a bowel movement, can put stress or pressure on the bladder and pelvic floor muscles. This weakens the muscles and can cause UCD, urinary incontinence or urinary leakage.
  • Chronic Cough. Long-term coughing cause one to put extra stress on your bladder, stretching the muscles of the pelvic floor and possibly making tiny tears in the muscles that cause UCD.
  • Nerve damage. Damaged nerves may send signals to the bladder at the wrong time or not at all. Childbirth and health problems such as diabetes and multiple sclerosis can cause nerve damage in the bladder, urethra, or pelvic floor muscles.
  • Surgery. Any surgery that involves the reproductive organs, such as a hysterectomy or prostate surgery, can damage the supporting pelvic floor muscles to cause UCD.

Only 45% seek help

Perhaps because it’s an issue of embarrassment, only 45% seek help for UCD. Women often don’t talk about symptoms of urinary incontinence, overactive bladder or pelvic organ prolapse, believing these conditions to be a normal part of aging or childbearing.

Start taking care of your pelvic floor.

Your pelvic floor is working 24/7 to support your bladder, colon, rectum and sexual organs. Like brushing your teeth to prevent tooth decay, you should exercise the pelvic floor to avoid aging process of your pelvic floor muscles.

You can engage a pelvic health physical therapist to learn exercises that could help strengthen/stretch the pelvic floor. Or use the help of electromagnetic therapy to create bigger muscle contractions, better muscle memory and muscle hypertrophy — like weightlifting to let your muscle tissues expand and grow.

Places like Orchard Clinic combine advanced medical technology with physical therapy to treat UCD — in a manner that’s fast, safe and effective. It’s never too late to start working your pelvic floor.

This article was first posted on medium.com

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