Over 30 million Americans suffer from an overactive bladder. 75% are women. Unfortunately, many women believe this is just a “normal” part of “getting older.” It is not. You don’t have to live like this.
Men can also have difficulty relaxing their bladder. Since men have a prostate, which can worsen an overactive bladder, it is important for men to have an evaluation with a urologist.
You’re probably asking yourself. “So how can I relax my bladder?”
At VirtuCare we’re here to help. Here are our top ten tips for relaxing an overactive bladder.
1. Keep a bladder journal
We have no idea how many times we went potty yesterday. Yet as urologists we expect our patients to remember how frequently they urinate.
You can’t improve what you don’t measure. By keeping a bladder journal, you will provide helpful data to our team of VirtuCare urologists to see if we can uncover a way to relax your bladder.
A good bladder journal will contain:
- Two columns: fluid in and fluid out
- Exact times of drinking fluids and urinating
- Accurate volume measurements
- Associated episodes of leakage
Click here to download a bladder journal with everything you’ll need.
2. Drink enough water (but not too much)
What goes in must come out. The average bladder holds 300-400 ml or about 12 oz of fluid. With a little 5th grade arithmetic we can calculate whether your issue is drinking too much fluid or whether you truly have an overactive bladder.
Let’s look at an example assuming:
- You drink 2L of water a day (2000 ml or about eight 8 oz glasses)
- Your bladder holds 300 ml when feeling full
- You sleep 8 hours a night and therefore are awake 16 hours a day
In this scenario you would be expected to urinate 6-7 times a day or once every 2 to 2.5 hours. This is a “normal situation”. If you start adding some of the bladder irritants as we cover below, then it’s no surprise why you have difficulty relaxing your bladder.
Back to the original question. How much water should you drink a day? For bladder health 2 L is a great starting point. When should this volume go up or down?
You may need to drink MORE water if:
- You exercise or sweat excessively
- Are dehydrated from certain medications (especially diuretics for high blood pressure)
- Drinking excessive caffeine, alcohol (see below)
You may need to drink LESS water if:
- You have kidney or heart troubles (be sure to consult your cardiologist or nephrologist)
- You have electrolyte abnormalities
- You are over age 75 and of a small stature
In general, we tell our patients that they are drinking the correct volume of water if their urine is light yellow to clear in color and they don’t feel thirsty all the time. People who are well hydrated usually don’t have dry skin or dry eyes either (unless these are side effects from a medication).
3. Perform timed voiding
Once we review your bladder journal, we can better help you relax your bladder.
It’s normal to urinate about every 2-3 hours. If you are going less often than this, then you DO NOT have an overactive bladder. You actually are doing quite well. If you have any episodes of leakage or severe urgency, this is easily fixed with going to the bathroom more often.
Timed voiding involves trying to urinate every 2 hours regardless of whether you feel the need to empty your bladder. The goal is to empty before those urges cause an emergency with your bladder.
What if you are urinating every 30-90 minutes? Assuming it’s not related to excess fluid, timed voiding can also be used to stretch out the time between bathroom trips.
Your urinary frequency trips may be a learned behaviour if:
- There is no bladder leakage
- You only have frequency during the day
- You wake up at most 1 time a night to urinate
In this situation trying to add 5 minutes in between your potty breaks can teach your bladder to “stretch out”. You can then increase this interval slowly over time.
We would not recommend this technique to relax your bladder if:
- You suffer from bladder leakage
- You’re drinking excess fluids
- You have frequent urinary tract infections
- You urinate frequently day and night
4. Avoid constipation
The bladder sits within the pelvis. This is a bowl-shaped area created by your pelvic bones (sacrum, ilium, pubis). The rectum and female organs are also housed in this area. There’s only so much room down there once the bladder and rectum start filling.
Infrequent and hard bowel movements can compress the bladder. This gives you an urge to urinate even when the bladder is relatively empty. A full rectum can also press on the nerves leading to the bladder. This can compromise normal bladder function.
Treating constipation will help you relax your bladder. Natural remedies such as an increase in fruits, vegetables, and whole grains in your diet is the first step. Next, you can add supplemental fiber to water or protein shakes. Lastly a trial of MiraLAX® (Polyethylene Glycol 3350) is a safe, gently over-the-counter treatment for constipation.
If you’re still having difficulties with these suggestions, an evaluation with a GI doctor (gastroenterologist) may uncover some other issues.
5. Perform Kegel exercises
Lining your bony pelvis is a series of muscles known as the pelvic floor. In order to urinate, the pelvic floor must be relaxed to allow the bladder muscle to contract without resistance.
Pelvic floor exercises, otherwise known as “Kegels”, help strengthen your pelvic floor in times of need. Although Kegels were traditionally performed to treat stress incontinence (the involuntary loss of urine during coughing, sneezing, exercise), there is some evidence that pelvic floor exercises can also help you relax your bladder.
How do you perform Kegel exercises? Here are some easy tips:
- Squeeze the muscles you would use to stop your urine stream. If you need to try it once or try while urinating that is OK but don’t do these repeatedly.
- Place a finger inside the vagina. If you are doing Kegels properly then you should feel your vagina tighten.
- Do not squeeze your abdomen or buttocks. When done properly, the only area that contracts is between the urethra and the anus.
- Perform 10 five-second contractions 2x per day. Breathe in relaxing your pelvic floor and breathe out while holding the contraction.
- This can be done while sitting at work, in the car or on the couch after a long day. Do NOT perform Kegels while urinating
- As your strength improves you can increase the length of each contraction to 10 seconds.
Once you’ve practised, now you’re ready for game time! The next time you feel a strong urge to urinate, squeeze your pelvic floor 5 times as strong as you can. This will reflexively relax your bladder and the urge to urinate should temporarily go away.
We’d still recommend finding a bathroom ASAP however. Pelvic floor exercises or Kegels will only help you relax your bladder temporarily.
6. Limit caffeine intake
Caffeine is one of nature’s diuretics or water pills. When you consume something with caffeine (coffee, soda, tea, energy drinks and chocolate . . . yes chocolate . . . sorry), your kidneys will produce more urine than if you drank the same volume of water.
Most of these beverages are also high in acid, so the urine that is produced irritates your bladder. It’s difficult to relax your bladder if you’re drinking several cups of coffee a day.
This is the point in the conversation where patients start negotiating.
“What about decaf?”
“Can I have one cup a day?”
“I’m not giving up my coffee!”
The answer is no caffeine is best. Any decrease in fluid volume and caffeine content will probably help.
At VirtuCare we believe in collaborative healthcare. We educate our patients and provide suggestions that will help. It’s up to you to decide. Would you rather relax your bladder or drink your caffeine? You choose.
7. Cut out sugar
Don’t be angry but you have to limit sugar as well. Sugary foods and drinks increase thirst. Therefore you increase your fluid intake.
If you’re diabetic, then poorly controlled blood sugars are often associated with frequency, urgency, burning with urination and an increased risk of bladder infections. Tight blood glucose control will help you relax your bladder.
8. Limit alcohol
Don’t kill the messenger but your evening cocktail is not helping the situation either. Like caffeine, alcohol is a diuretic. Alcoholic beverages tend to be high in acid, another bladder irritant, as well. Limiting your volume of alcohol aids in bladder relaxation.
We’ve had some patients report waking up less at night after drinking alcohol. Unfortunately this is not healthy. First and foremost, sleep after a large volume of alcohol is not restorative. It’s really more of being unconscious because alcohol is a depressant. As a result your bladder gets overexpanded and you’re too “knocked out” to wake up and urinate.
The first morning urination after an alcohol binge is usually associated with a slow stream because the bladder muscle was stretched out and weakened. You relaxed your bladder alright, but not in a healthy way.
9.Maintain a healthy weight
Abdominal fat puts pressure on your bladder. It’s difficult to relax your bladder if there’s 25 lbs of extra weight sitting on top of it. Weight loss will absolutely help.
The good news is that if you’ve followed some of the above suggestions (limit sugar, caffeine, alcohol), then you’re well on your way to a healthier weight. We’ve had patients lose 30 lbs in a month by quitting daily soda consumption.
If your extra weight is due to other habits then we’d be happy to discuss daily exercise goals (starting with walking 10,000 steps a day) and better dietary habits (have you tried intermittent fasting or time-restricted eating?).
10. Schedule a telemedicine visit with a VirtuCare urologist
Have you already tried these suggestions? Are you still asking yourself “how can I relax my bladder?” Then it’s time to call in the expert: a board-certified urologist.
An initial work-up can easily be performed from the comfort and safety of your home. A telemedicine consultation with a VirtuCare expert is not only more convenient, but you don’t have to ask your insurance company for permission. You pay a reasonable cash fee to get the care you deserve.
A thorough history and some simple tests can help rule out a UTI or blockage of the bladder. Sometimes a referral to a pelvic physical therapist can help improve your pelvic floor exercises. Maybe it’s time to consider an overactive bladder (OAB) medication because your bladder can’t relax despite your best efforts. Finally, if everything else has failed, we can refer you to a urologic surgeon who specializes in the treatment of an overactive bladder.
If we can’t help you relax your bladder then we will find an expert who can solve the problem!