Never squat on public loos and learn the ‘knack’ – 7 ways to train your bladder to be more patient and mistakes to avoid

Nothing makes a day out less enjoyable than worrying about the location of the closest restroom!

However, as we age, up to one in three women discover that they need to urinate more frequently than they formerly did, and many of them suffer from humiliating leaks.

The good news is that you don’t have to learn to live with an impatient bladder.

Regaining control and your freedom to move about is possible in a number of ways.

What caused your bladder to become so tense?

The bladder is similar to a balloon.

Urine, the liquid that remains after your kidneys have removed waste from your blood, fills it up.

Your bladder alerts your brain that it’s time to empty it when it fills up to about 100 to 150 ml of urine, which is roughly equivalent to three quarters of a can of carbonated beverages.

That feeling will intensify after it reaches about 200–300 ml.

The smooth muscle fibers in your bladder walls contract to force out the liquid when you actually use the restroom.

In order to allow urine to exit the body, the muscle surrounding the urethra, the tube, also relaxes at the same moment.

For a week, it’s common to desire to go six to eight times in a 24-hour period.

However, as we age, that number frequently begins to increase, with some women discovering that they must go twice as much.

Why do you start needing to go the loo more?

The decline in the female sex hormone oestrogen as menopause draws near is one explanation.

“This hormone helps keep the tissues of the organs, including the bladder and the pelvic floor muscles that help control it, strong and flexible,” says expert Katie Mann, a clinical specialist physiotherapist in the NHS.

“So, storage of urine and emptying of your bladder may not be as efficient as it used to be.”

Another function of estrogen is to maintain a constant amount of acidity in your bladder.

You are more susceptible to bacterial urinary tract infections when this begins to shift.

This may annoy it and cause it to feel satisfied when it isn’t.

Additionally, this causes your brain to become hyperactive by sending it conflicting signals about when you need to urinate.

Your muscles may have developed the habit of tensing up as you empty your bladder if you have experienced episodes of cystitis over the years and the hot, stinging urine that goes along with it.

“If you ve had lots of infections, then you can get into the habit of going more, and this can become your new norm ,” Katie adds.

“More than three episodes of confirmed infection in a twelve-month period should be investigated so speak with your GP.”

Do you sometimes spring a leak too?

In addition to wanting to go more frequently, some women may also find it difficult to control their urination or leak when they laugh, sneeze, or jump.

Why? If you have children, your pelvic floor—the hammock-shaped layer of muscle at the base of the pelvis that supports the uterus, intestines, and bladder—may have been compromised by the weight of carrying the baby, hormonal fluctuations, and the wear and tear of giving birth.

Should this begin to deteriorate, the weight of the other organs may exert pressure on the bladder, causing it to become compressed and reduce its capacity to hold pee.

Additionally, the muscles responsible for pulling the urethra open and closed could not function as well.

This helps to explain why studies show that women experience urine incontinence twice as frequently as males.

Prolapse, which occurs when the pelvic organs—such as the womb, bladder, or colon—no longer have the complete support of the pelvic muscles and ligaments and begin to descend, is another reason why your bladder may feel constricted.

According to Katie, if those organs are not properly nourished, they perform worse, which could make you feel the need to urinate more frequently.

“Prolapse is extremely prevalent, with 40% of women in the UK having some degree of it.

Additionally, you might notice that some pee may come out if you cough, sneeze, jump, or laugh.

“If you can t get to the loo quickly enough, some urine may escape and this is called urinary urge incontinence.”

Don t wait to fix an impatient bladder

Many women believe that having an impatient bladder is a fact of life.

According to women’s certified physiotherapist Christien Bird of the Whitehart Clinic in Surrey (whitehartclinic.co.uk), research indicates that only half of women seek care for it, and if they do, they wait five to seven years to speak with their doctor.

Katie, an expert, advises ladies not to wait for things to worsen.

She continues: “Research has found that incontinence is a significant reason why women are admitted to care homes in later life.”

7 ways to make your bladder more patient

1. Eliminate medical causes

Frequent urination may be a side effect of certain medications, such as opioid painkillers or high blood pressure medications.

It could also be a sign of diabetes, some neurological problems, or a urinary tract infection.

Thus, see your doctor first.

2. Reduce your intake of coffee and alcohol

The average British person now drinks two cups of coffee a day, a significant increase over the past decade.

However, coffee also acts as a diuretic, increasing the frequency of fluid elimination.

Additionally, studies have shown that the caffeine it contains tends to aggravate the intestinal walls more, causing them to spasm.

Limit your alcohol intake as well because it has the same effect.

3. Increase your water intake

According to Katie: “Lots of women who have irritated bladders will cut their fluid intake so they make less visits to the loo,” according to Katie.

“That s actually counterproductive because this can concentrate your urine and make the bladder more irritable.”

Get a water bottle you enjoy using, add flavorings like lemon or cucumber, or consume more items high in water, including soups and fruit, if you have trouble forming the habit.

4. Reduce your belly fat

Weight gain, particularly around the abdomen, increases strain on the pelvic floor, which supports your bladder.

According to research, reducing even 8% of your body weight—typically between 15 and 20 pounds—can help reduce bladder problems by up to 25%.

5. Grab the “knack”

Contracting your pelvic floor in advance can help you avoid losing urine if you know that you will jump, sneeze, or cough and that there is a possibility that some pee may seep out.

As Katie puts it: “This is called The Knack.”

6. Take a seat on it.

According to Katie, even though many of us dislike having our butts contact the seat in public restrooms, it’s crucial to avoid hovering since doing so prevents your pelvic floor from fully relaxing while you empty your bladder.

“Wait five to ten more seconds once you’re certain your urine flow is complete.

“Sitting relaxed for a short while longer can allow this to come out and improve the signals between your bladder and brain.”

6. Develop greater patience in your bladder

Your pelvic floor muscles, which surround your bladder, resemble a pocketbook with drawstrings that tighten when you pull on it.

But over time these can get out of balance; either weaker or tenser after childbirth, or they don t respond quickly enough.

Choosing the appropriate exercises, which are frequently several sets of squeezes and releases, can help you regain control over your bladder.

An exercise routine should be tailored to your individual need, so it s best to be referred to a specialist physio who can assess you first, give a tailored programme and monitor you, says Katie.

“Think of it as having a personal trainer for your pelvic floor!,” she continues.

7. Get an app or a gadget

One option is Squeezy app, designed by pelvic health specialists, which comes with an exercise plan and diary reminders.

Or you can go one step further, and get a gadget which you can insert into your vagina like a tampon and which will measure the strength of your squeezes, and which you can monitor on your phone, as you get stronger.

For example, you could try an Elvie trainer, which costs 169 atwww.elvie.com.

You may also be able to get one free on the NHS if you are receiving treatment.

And, if you re caught short

1. Tense your muscles

If you feel a sudden need to go, trysome pelvic floor contractions.

This may actually help you relax the bladder.

Katie says: “A strong pelvic floor muscle contraction has an inhibitory effect on a contracting bladder muscle, so calms it down.”

2. Try thinking about something else

Switching your attention away from the bladder by counting backwards or counting your steps as you walk to the loo.

Katie says: “When we feel we want to wee, urgency there is often a desire to clench your legs together or rush to the toilet.

“But it s often better to relax until after the initial strong sensation of urgency has passed.

“Then walk to the toilet at your normal pace.”

Find out more about bladder issues and what causes them at Pelvic Obstetric and Gynaecological Physiotherapy atthepogp.co.uk/resources/booklets

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