If you feel like you’re constantly having the urge to pee, you may ask yourself… Why do I have such a small bladder? This feeling often occurs after drinking coffee or alcohol, in cold weather, or gradually over time.
So why is my bladder so small? Let’s discuss what it means to have a small bladder and what you can do about it.
What does it mean to have a “small bladder”?
Urinary urgency is the feeling of a strong need to pee, often thought of as having a “small bladder”. This sensation can occur even when the bladder isn’t full. This often comes with an involuntary leakage of urine, also known as urge incontinence.
Not everyone with a small bladder or the frequent urge to pee will experience urinary incontinence, but many do. Urinary incontinence occurs when a person experiences sudden urges to urinate that are uncontrolled or can’t be stopped. These urges often happen without warning. This can cause a little or a lot of urine leakage before they have time to reach the toilet.
Your pelvic floor muscles can help not only control the urge to pee, but also help with leakage should it occur.
What causes urinary urgency?
I sometimes relate understanding bladder control to getting in tune with hunger cues.
Listening to our bodies (internal hunger cues) vs. external thinking can be challenging.
For example: “When’s the last time we ate/drank? What did we eat/drink? When will our next chance to eat/drink be? Why am I getting a hunger cue (is it real hunger vs. a trigger: taste/stress/emotional/etc.)?”
When we check internal and external cues we can better decide if we want to give into it or ignore it.
Internal urinary urge cues:
- How full your bladder is
- How concentrated the urine in your bladder is. Is it irritating the bladder and causing an urge sooner than full?
- Something puts pressure on your bladder. Think from a baby growing, pushing, kicking or external from tight clothing like belts.
External thinking:
- Volume: Most bladders (not pregnant) can hold up to 1.5-2 cups during the day and up to 4 cups at night
- Urge sensation: Most urges begin to start when your bladder is about 60-70% full
- Frequency: Take into consideration bladder volume and quality hydration. Most people will void every 2-4 hours, or roughly 6-8x per day (more when you’re pregnant), and 0-2 times at night.
- Hydration: What did you drink and how much? Larger volumes of fluid (more than 2 cups between voids) or bladder irritants? Anything besides water can increase risk of overactive bladder – like coffee, soda, tea, alcohol, fizzy drinks, spicy foods, and more. This can make you feel an urge sooner.
Consider urge triggers
Is there something external happening that might cause your urge to be sooner or more intense than the actual fullness of your bladder? Common urge triggers are:
- Running water
- Being in water
- Arriving home
- Putting your key in the door
- Seeing the toilet/bathroom
- Leaving the house and a “just in case” urge
All this is to say we drink fluids and we pee. Sometimes we urinate when a bathroom or break is available and sometimes we do it because there’s an urge. But how often do we actually think about balancing between internal cues and the external thought processing? Doing so will help you decide if you should or shouldn’t go.
What are urge suppression techniques?
What happens if you experience strong urges and are running to the bathroom to make it in time? Consider trying some urge suppression techniques.
- Distract yourself by counting backwards from 100 by 7s, scrolling on your phone, making a call, or making a grocery or to-do list. Taking your mind off the sensation can help.
- Wiggle your toes, do calf raises, or walk around on your tippy-toes. This may sound goofy, but your toes and bladder are close in the brain. Moving your feet and toes can cool down your bladder.
- Take big deep breaths. This helps quiet your nervous system, which can help decrease the urgency.
- Perform 5-7 kegel contractions. Activating your pelvic floor muscles can actually help your bladder urges calm down.
The idea is to decrease the intensity of the urge or stop it completely. Then, decide if it feels like an appropriate time to go. Does it feel like “yes, this urge makes sense, my bladder is probably pretty full?” Then, once the urge intensity has decreased, go ahead and CALMLY head to the bathroom.
It could also feel like a trigger causing the urge and not actual fullness or irritation. If that’s the case, suppress that urge and trust that when the bladder fills more, you will once again get the urge. You can also reference the clock for a rough time frame of when you might want to go.
8 physical therapy tips to help a small bladder
- Sip fluids throughout the day. Drinking water helps to keep your bladder healthy. Instead of chugging a tall glass of water at once, sip it over the course of an hour or two.
- Avoid/limit alcohol, caffeine and smoking. All these things irritate your bladder and cause more frequent or urgent urges.
- Go when you need to go. It’s important not to ignore the urge when you feel it. Rather, go when you need to go if you feel it’s a “true urge” but also limit “just in case” pees when you don’t have to go.
- Schedule regular bathroom trips. Try scheduling regular times throughout the day for bathroom breaks. This will help you maintain control of your bladder muscles and avoid accidents.
- Practice pelvic floor exercises like kegel exercises. Strengthening your pelvic floor muscles through exercise can help to reduce bladder urgency.
- Gradually increase time between bathroom trips. Try to push your bathroom breaks just 15 minutes longer. Once you achieve that consistently, add 15 more minutes to the interval.
- Wear absorbent clothing. Wear absorbent clothing such as cotton underwear and breathable pants.
- Seek professional help. If at-home remedies are not helping, seek the advice of a medical professional.
Pelvic health therapy for small bladders
You’re definitely going to pee more when you’re pregnant, keep that in mind! Postpartum, you may need to retrain your bladder’s awareness of filling and urges. Remember, it’s a balance between internal cues and thinking.
Sometimes intense or frequent urges may come with pain or leakage. Checking in with a medical provider can help rule out any underlying infections like urinary tract infections.
If your symptoms persist after treatment for infection, you can consult with a pelvic health therapist. The therapist will evaluate if you require strengthening exercises, relaxation techniques, or a combination of both.
The V-Hive membership has courses for both pelvic floor relaxation and strengthening! Take the quiz to determine the right path for you.
