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Urination is a vital human function and often occurs without much fanfare or thought – but age, sex, medications and a host of other factors can influence how you use the bathroom. Because there can be so much variation, patients must not ignore what seems out of the norm for their bodies, says Dr Vannita Simma-Chiang, a board-certified urologist and associate professor at the Icahn School of Medicine at Mount Sinai in New York.
“If something seems strange to you, one of the best things you can do is just go in and chat with a medical professional about it,” says Simma-Chiang.
Issues may stem from different phases of the bladder, such as urine storage, excretion and what remains afterward, explains Dr Aqsa Khan, a board-certified urologist at the Mayo Clinic in Phoenix, Arizona.
“I often describe myself to patients as a kind of human plumber,” says Khan. “When the plumbing is good in our homes, we don’t think twice about it. But when something goes wrong, it can be terribly problematic.”
Here are the healthful habits experts recommend for managing urinary health.
Check the color of your urine
Hydration is essential for overall health, including digestion, metabolism and cognitive function. When you’re dehydrated, urine is more concentrated, which can irritate the bladder and increase the risk of urinary tract infections.
You may have heard that you should drink eight to 10 glasses of water a day. But the amount one needs is widely debated. Simma-Chiang says urine color is a better indicator of your hydration levels. “It will tell you a lot about your health,” she says.
You want your urine to be a light yellow. Dark yellow suggests you’re dehydrated, and clear means you’re consuming too much water, she explains. If there’s any visible blood in your urine, you need to speak with your healthcare provider.
Don’t hold it in excessively
The general rule is to urinate at least once every three to four hours. If you ignore the need to urinate, eventually your brain may start to ignore the signals that it’s time to go. Over time, ignoring bladder signals can also cause the bladder to increase in size, making it less efficient.
Some people are more likely to experience this because of demanding work duties. Doctors, nurses, police officers, firefighters and teachers are often vulnerable, says Simma-Chiang.
Frequently holding in urine also increases your risk of a urinary tract infection, explains Simma-Chiang. Urination flushes out bacteria; when you hold urine in for a long time, it’s easier for bacteria to multiply.
Any kind of pain associated with urination – when holding in urine, while urinating or after – should not be ignored, says Dr Rosanne Leipzig, professor emeritus of geriatrics and palliative medicine at the Icahn School of Medicine at Mount Sinai and author of Honest Aging. Simple testing can reveal whether there’s an issue, such as an infection.
Don’t push too hard or hover over the seat
“One of the biggest problems I see with patients is that they push to get every single little drop out,” says Simma-Chiang.
Putting that much pressure on the pelvic floor can weaken this group of muscles in the long term, she explains. Peeing “just in case” isn’t necessarily a bad thing to do on occasion, but doing it so often that nothing comes out is inadvisable, as consistent pushing can also strain the muscles. Many hover over a toilet seat to avoid contact, but this can put too much pressure on the pelvic floor.
It’s best to relax and urinate as much as you can. If there’s a bit left, that’s fine. “You don’t have to be obsessed with getting to zero,” says Simma-Chiang.
Monitor for frequent trips to the bathroom
Certain medical conditions, like bladder stones or diabetes, might cause someone to urinate more than once every three to four hours. Specific bladder-irritating foods and drinks can lead to frequent peeing as well. If you’re concerned about how often you need to pee, consult a healthcare provider.
But if you’re overall healthy and urine comes out easily, “it’s probably fine to go as often as you want,” says Khan. If you feel the need to use the restroom more than eight times per day, and this is normal for you, it’s unlikely that this frequent urination is damaging your bladder.
However, habitual urination can be an issue if it’s affecting your quality of life. Khan has seen it “take a toll” on individuals and become a source of anxiety. For example, some people who need to urinate often may avoid working at their office or taking trips away from home. “It can be paralyzing,” she says.
People experiencing anxiety about frequent urination should start by speaking with their healthcare provider to be evaluated for any physical health issues, explains Khan. If everything checks out and anxiety persists, bladder training might be an option. This is a form of behavior therapy that can involve increasing the intervals between urinations, and techniques like breath work and mindfulness
For example, the immediate urge to urinate can be experienced “as a wave”, says Leipzig. When people need to learn to control their impulse to urinate, that feeling of need can go away if “you wait it out and distract yourself”, she explains.
Good bowel health is critical
“A lot of people don’t realize that bowel and bladder health are very interconnected,” says Simma-Chiang.
For example, people who have frequent constipation are prone to overactive bladder syndrome, says Khan. They might have difficulty emptying their bladders, incontinence or recurrent urinary tract infections.
Staying hydrated is a strong foundation for bladder and bowel health. The right amount of water can vary for each individual, but a good rule of thumb is to drink when you’re thirsty rather than aim for a target amount.
Eat fiber-rich foods and avoid bladder irritants
Because bowel and bladder health are connected, eating foods that support bowel health – high-fiber options like fruits and vegetables – is always recommended, says Simma-Chiang.
Fiber-rich foods also lower the risk of diabetes, which is helpful because diabetes can eventually lead to bladder problems like incontinence, explains Khan.
If you’re experiencing urination issues, Simma-Chiang recommends cutting back on bladder irritants like coffee, soda and wine. Chocolate, citrus fruits, artificial sweeteners, uncooked onions, spicy foods and processed foods with artificial flavors can also irritate the bladder, says Leipzig.
Some research suggests that men who eat more red meat are at a higher risk of an enlarged prostate. This condition is associated with various bladder issues, including incomplete emptying, a weaker flow and the frequent urge to urinate. While a weaker stream may seem like something you can ignore, Leipzig encourages men who experience this to speak with a healthcare provider.
Consider pelvic floor exercises
At times, when urination is painful, that could indicate an infection, explains Khan. But pain might also signal a problem with the pelvic floor.
“Many gastroenterologists are sending their patients to pelvic floor therapy because the pelvic floor is not relaxing in a way that allows for the easy passage of stool contents,” says Khan.
The pelvic floor is a group of muscles that runs from the pubic bone to the tailbone, and supports pelvic organs such as the bladder. It can also support the vagina and uterus, or the prostate.
Pelvic floor exercises can help with urinary incontinence, or the involuntary leakage of urine. Exercises can include Kegels, engaging the pelvic floor when lifting weights, bridge lifts, squats and diaphragmatic breathing. Because it’s so easy to do Kegels incorrectly, experts recommend speaking with your medical provider or physical therapist before you begin.
Labor and delivery can cause straining and tearing of pelvic floor muscles. If you’re considering pregnancy, it can be helpful to start these strengthening exercises before becoming pregnant, says Khan.
During menopause, hormonal changes can weaken the pelvic floor muscles. Because a decline in estrogen can lead to bladder issues, Khan also emphasizes the importance of timely, postmenopausal topical vaginal estrogen therapy.
Male pelvic floor issues can manifest as incontinence, erectile dysfunction and chronic pain. Among men, excess stress, cycling, heavy lifting and constipation can lead to an over-clenching of the pelvic muscles.
