Welcome to Ask Doctor Zac, a weekly column from News.com.au. This week Dr Zac Turner talks all things pee.
Question: Hi Dr Zac, ever since lockdowns and all this chaos began, I have been more in tune with my body. In particular, my bathroom breaks as I work from home. I've noticed over the last two years that I frequently pee throughout the day – I'm talking upwards of fifteen times a day easily. Is this normal? Is there such a thing as a small bladder?
I've just gotten an email from my employer letting me know that we will be heading back into the office and all I can think about it is my colleagues counting in their heads how often I go to the bathroom. Surely there is a way to train my bladder to pee less? – Rosie, Bankstown, NSW.
Answer: I've always found it an honour when I've reached a point in doctor and patient, or even friend relationships, where people feel they can talk about things that are personal. And here we have this week's column on the wonderful world of wee (and other bathroom activities).
I encourage everyone to start thinking about the "motion of their ocean" and not get embarrassed about taking a look afterwards and taking note.
Being a body advocate I will always advocate for people to listen to their body's more, and watching our wee habits is one great way to have a deeper look into our health.
How often you urinate during the day and night, the colour of your urine, and whether you can hold it all in, are all clues to deciphering the code of your own health.
If you really are worried, I recommend you keep a "pee-diary". Every time you go number one, keep a log of the time it occurred, what colour it was, how much there was and if it smelt at all. You also need to record everything you drink, and the amount.
With your doctor, you can piece together the clues to see if anything is going wrong inside your body.
What colour should pee be?
I can't stress enough you: are what you eat and drink, and the colour, texture and frequency of your bathroom activities is the best gossip of your health. Darker colours such as amber or brown indicate you might be dehydrated or drank too much caffeine. Whereas green like toxic waste can mean you're excreting unabsorbed nutrients and vitamins (just like after a glass of Berocca), or painful urinating can mean you've got an infection. You want your urine to look and smell just like water!
How often should you pee?
Now on to your question about pee frequency. How often you urinate is a great indicator of your body's overall level of hydration. A healthy person may urinate anywhere from four to 10 times in a day. The average, however, is usually between six and seven times.
But don't be alarmed if you don't fit into these numbers. It's not out of the ordinary to urinate more or less on any given day. The key to remember is that what you put into your body eventually must come out. Do you drink a couple coffees a day, and/or religiously refill your water bottle a few times a day? That will cause you to pee more because other than sweating, it's the only way out. Although pets such as dogs can lose a lot of fluid from their mouths … though excessive salivation for humans is a topic for another day!
Frequent urination can, however, be a sign of a serious condition which is why I recommend you speak to your doctor if it persists. It could be a number of things including a bladder infection, prostate problems or a heart condition. So while everyone is individual changes to your regularity should be something you note and record for yourself and doctor.
If you are a woman, the need to urinate frequently also may be a sign of poorly supported pelvic organs, such as the bladder. Elderly people tend to urinate more frequently at night as they age.
Another wee habit to be aware of is incontinence, which is the involuntary loss of urine. There are two main types: stress incontinence and urge incontinence.
Some female readers might be aware of stress incontinence, which is when someone leaks urine when coughing, laughing, sneezing or exercising strenuously. A number of things cause this but the two main ones are weak urethras and pelvic floor muscles (most often post childbirth due to the amount of change and stretch that occurs), and obesity.
Stress incontinence can often be treated and prevented with regular exercises, sometimes medications, and if they or a combination aren't entirely successful, then surgery.
Urge incontinence is when the bladder is an eager beaver, and it will leak urine just as the person reaches the toilet. It's also described as an overactive bladder, and what happens is that the muscle around the organ which pushes out the urine simply begins to squeeze prematurely, or unfortunately in some instances, at the wrong time.
How to train your bladder to pee less
Now, believe it or not, a healthy bladder that is poorly potty trained can in fact be whipped back into good shape and behaviour. With some Dr Zac tips and tricks, you can aim to extend your time between wees, even to over four hours (and for some people who need to go hourly or more this is life enabling).
Just remember don't hold in any longer than is comfortable, excess urine build up in your bladder can lead to urinary tract infections and potentially stretch and damage your bladder.
Remember, bladder training is a mind-body approach that helps your brain and bladder learn to tolerate the presence of more urine before creating the urge to get rid of it.
It sounds stupid, but a great way to train your bladder is to distract it. Listen to music, repeat a mantra, read something or make a phone call to someone who will understand you are training your bladder. The idea is to take your mind off peeing, and eventually it can reduce the urge.
Sitting down all day in front of your desk can put pressure on your bladder. By shifting your position, taking the steps or doing a stretch such as leaning forward slightly can take the pressure off the stomach and bladder and reduce the need to go go go.
Choose an interval of peeing. Based on your typical interval of urination, begin adding 15 minutes to it. If you pee every thirty minutes, make it every forty-five. And slowly over several months with the above techniques, you can increase the intervals all the way up to four hours.
It seems like work but teaching your bladder good habits early can enable you to avoid many of the issues that happen later in life.
Happy peeing, Rosie!
• Dr Zac Turner has a Bachelor of Medicine and Bachelor of Surgery from the University of Sydney. He is both a medical practitioner and a co-owner of telehealth service Concierge Doctors and is also a qualified and experienced biomedical scientist.