As a pelvic floor therapist, I often receive questions from patients about what is “normal” when it comes to bladder and bowel habits. Well, there are no firm rules, but here are some general rules of thumb to keep in mind when nature calls.
- Most adults urinate about 6-9 times each day and 0-1 times each night.
- The average adult bladder holds about 2 cups of urine during the day (~350 mL) and up to 4 cups at night (~800 mL).
- Most people have an urge to urinate when there is about 200 mL of fluid in the bladder (about a cup).
- There is always a small amount of urine retained in the bladder – this is called the post-void residual. For adults <65, this amount is typically about 50 mL adults 65 and older typically retain about 100 mL.
You go less frequently than average:
- You may not be sufficiently hydrated. Make sure you are drinking at least 8 – 8oz glasses of water each day. That’s 64 oz of water (sorry, coffee doesn’t count and neither does sparkling water). It seems like a lot, but when you drink a few ounces of water every hour, you can quickly meet your goal. A helpful, but not completely accurate way to tell if you are hydrated is by judging by the color of your urine. Pale yellow is usually what you’re aiming for.
- You may be ignoring the urge when you first have one. In general, I expect that my patients will be going to the bathroom about every 2-3 hours minimum. If you are going longer than this between visits to the restroom, this may be a factor.
Image borrowed from: https://healthjade.com/urine-color/
You go more frequently than average:
- Drinking and eating things that irritate the bladder or have diuretic properties (e.g. soda, caffeine, alcohol) can increase urinary frequency. Try cutting back on these and note if there is a difference in your urinary frequency.
- You could be going to the restroom before your bladder is truly full. Remember that just because you can urinate doesn’t mean you have to. Due to that residual volume mentioned earlier, you will almost always be able to urinate if you try. Doing this on a regular basis though can lead to a positive feedback loop in the brain that leads to even greater frequency.
- Check your medications. Sometimes urinary frequency can be a side effect of certain medications especially medications like diuretics for high blood pressure. Some patients help get around the frequency (and urgency) symptoms from diuretics by taking these medications at night. It may increase night time frequency however. Before you make any changes with your medication, consult with your doctor that prescribed it to you.
- Urinary frequency can be a symptom of a UTI. Some other common UTI symptoms include: urinary urgency, burning with urination, pain or pressure in your low back or abdomen and cloudy, dark, or foul-smelling urine. If you suspect you might have a UTI, go see your doctor!
If you aren’t sure what your frequency is or if you are urinating a sufficient amount, you can try tracking for a day or two. Personally, I don’t want to carry around a measuring cup to pee in. Instead, estimate volume by counting the number of seconds you have a strong, continuous urine stream. Urinating for about 8 seconds is roughly equivalent to 200 ml of urine – when you should first feel the urge to urinate anyway. You can also make a quick tally or right down the times that you urinate throughout the day.
One final thought, if you are having urinary leakage of even a few drops this is not “normal”. Common? Extremely. Normal? No. There is something that can be done for this that does not involve wearing pads or avoiding activities that you love to do. If you have leakage at any time, see a pelvic floor therapist to help address this. Your pelvic floor therapist will likely want to talk to you about the things I covered above and want to know specific times when the leakage occurs. Consider keeping track for a day or two before you go to your appointment. This will help you be informed and empowered by knowing what your body is doing and provide rich objective information that will best help your therapist help you.
It’s important to bear in mind that norms are based on averages and averages include people on both ends of the spectrum – high and low. If you don’t fall perfectly into the ranges I listed above, don’t freak out. It’s always good to have an idea of what your norm is. This can help you easily recognize when something is off and nip potential problems in the bud! Having healthy habits now is also a great way to experience better health later.
Check back next week for all about healthy bowel habits in Part 2.
Thanks for reading!
Heather Draper, PT, DPT
Heather Draper is a physical therapist with Functionize Health & Physical Therapy. She specializes in treating patients with a variety of pelvic health conditions as well as low back, hip and SI pain. She earned her doctorate in physical therapy from the University of North Georgia where she participated in research related to diastasis recti causes, effects and treatment. Heather’s email is firstname.lastname@example.org. For more information visit www.functionizehealth.com.