The Bladder Owner’s Guide: Insights Your Bladder Wishes You Knew

We have manuals for almost everything in life: our cars, our smartphones, even our toaster ovens. But what about our bodies? Specifically, let’s consider the bladder. As someone who has spent over two decades as a physical therapist specializing in female pelvic health, I’ve noticed that many women know more about their electronic gadgets than they do about their bladders. Often, the information passed down from mothers and grandmothers, while well-intentioned, lacks expertise.

Let’s start with the basics. The bladder is a hollow muscle, much like the heart. Its primary function is to store urine, which is produced by the kidneys and gradually fills the bladder. An average adult female bladder can hold about 2 cups of urine, and the first urge to urinate is typically felt when it’s about half full. This sensation signals that it’s time to start planning for a bathroom visit, although immediate action isn’t always necessary.

With a moderate urge, we can calmly walk to the bathroom, sit down, relax, and effortlessly empty our bladder with a strong stream of urine. There should be no need to strain to urinate. Healthy urine is light yellow (fluorescent if you’ve taken B vitamins and pinkish after consuming red beets) and should have minimal to no odor (unless influenced by certain foods like asparagus).

Now, let’s clear up some common misconceptions.

• Never pass up a bathroom: Emptying the bladder every time we pass a restroom, without waiting for a natural urge, can lead to an overly sensitive bladder that expects frequent emptying, or even a smaller bladder capacity.
• Ignoring the urge: On the flip side, holding off on bathroom breaks for too long can desensitize us to the urge to urinate and lead to an overextended bladder, which may not fully empty. This is sometimes referred to as “teachers’ bladder” or “nurses’ bladder.” Most adults should urinate around 5 to 7 times during the day, with no nighttime urination being typical for those under 65.
• Water intake: While hydration is essential, excessive water consumption can strain the bladder and increase the risk of urinary leakage. Fluid intake recommendations vary based on factors like climate, activity level, and body weight. A general guideline is to consume half your body weight in ounces of fluid per day, excluding alcoholic or caffeinated beverages.
• Public toilet seats: Fear of infections from public toilet seats can lead some to hover over them, but this can prevent the pelvic floor muscles from fully relaxing, hindering proper bladder emptying. Unless the toilet is unclean, it’s better to use a seat cover or sit directly on the seat.
• Postpartum urinary leakage: While common, urinary leakage after childbirth isn’t inevitable and can often be treated effectively by strengthening the pelvic floor muscles. Physical therapists specializing in pelvic health can provide evaluation and treatment for postpartum bladder symptoms.

If you’re experiencing bladder issues that concern you, consider discussing them with your primary care physician or consulting a physical therapist specializing in female pelvic health.