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  • Karen Crudden

URGENCY

Running to the toilet? sometimes don’t make it in time? Peeing more than 7 times a day? getting up more than once a night? Running water, seeing the toilet or key in the door bring on that sudden bladder urge? These symptoms can indicate overactive bladder / urgency urinary incontinence and you’re not alone, affecting up to 43% of people.

Let’s discuss some of the reasons around why you might experience such symptoms. In majority of cases simple lifestyle changes and guidance from a pelvic health physiotherapist can make all the difference before exploring medication or surgical options.

Fluid

One of the biggest culprits is caffeine, and I know we love a good cup of tea or 10! Caffeine has been shown to be a bladder irritant, as well as artificial sweeteners, fizzy drinks, alcohol, green tea and acidic fruit juices. Not everyone will experience urgency with these drinks, but if you do try switching to decaf, or reducing bladder irritant drinks for a few weeks.

The same goes for fluid amount, many people drink 4-5L a day and feel thirsty (I think you need to get a diabetes check!) were others restrict their fluid intake due to fear of accidently leaking. Both can lead to urgency for different reasons. The recommended fluid intake are 2.1L/day for females and 2.5L/day for adult males.

Pelvic floor muscles

The pelvic floor muscles are the floor of the pelvis, think of them as muscles in the shape of a bowl they give support to the pelvic organs and help to stop pee or poo from coming out when we don’t want it too. If these muscles are weak (due to pregnancy, vaginal birth, chronic cough, chronic constipation or being overweight) allows the bladder to be the boss. We really don’t want them to be, it’s like putting your 2-year-old toddler in charge, they go through all the emotions in 5 minutes and play up at the worse times. By strengthening the pelvic floor muscles this will increase the upward support to your pelvic organs and help put you back in charge.

On the flip side just like the rest of the body the pelvic floor muscles can hold tension. Pelvic floor muscle tightness can play into bladder urgency, frequency, difficulty with passing urine or pain with intercourse, tampons or vaginal examinations. Carrying out pelvic floor exercises will only make symptoms worse, and pelvic floor relaxation is recommended.

Postmenopause

Our vaginas and bladders love oestrogen, when your postmenopause oestrogen levels drop significantly and continue drop. The inside walls of the bladder, and the surrounding vaginal tissues become more sensitive and thinner (just like the rest of our body ages, the pelvic organs and muscles are not exempt). This is a time were pelvic floor issues can start to arise for women, they might start to experience symptoms of prolapse, leaking with cough or sneeze and urgency with the bladder or bowel. Pelvic floor trauma can go unnoticed for a long time until postmenopause, even more reason why we need to be doing on to the rehab postnatal.

Mental health

Research shows people with OAB report higher anxiety and negative psychological wellbeing this alone can contribute to poor treatment outcomes. Poor well-being puts our bodies alarm system on high alert 24/7 feeding into bladder urgency. We don’t know 100% if this is a result of coping with OAB or a factor for developing OAB, but we do know improving poor mental health will improve your overall quality of life and potentially calm that disruptive bladder.

Seeing a health professional ensures appropriate treatment for you.


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