Overactive Bladder

When a patient arrives for an appointment, I always ask if they need to use the bathroom. It’s better to get that taken care of before they are undressed and full of needles! One lady responded “When do I ever NOT need to?” with a laugh. I giggled with her, agreeing wholeheartedly. Then it occurred to me… that’s not normal!

Over the years it snuck up on me, and I hadn’t even noticed… just cracked jokes about having the world’s tiniest bladder, etc. I was getting up to pee at least once a night, and up to three times on a bad one. Frequent urination is a pretty common situation with more mature women, especially those who are heavier or had children, but that doesn’t mean I had to be stuck with it!

There are two issues here – urgency and incontinence. I did some reading, and some thinking, and here’s what I came up with:


There are two warning systems for your bladder. One triggers when it starts to fill: That’s the early notification, “Hey, start thinking about a biobreak?” Then there’s the demanding “NO, REALLY!! FIND A BATHROOM NOW!” when it’s completely full. Apparently if you always relieve yourself when the first alarm goes off, the two start to merge, and the urgency gets ramped up even at the early stages. The best way to combat this is to deliberately delay at the first warning. Distract yourself. Do something engaging so you forget you need to pee. When I first started doing this, I couldn’t put it off for long… maybe 5 minutes. But soon it became an hour, and then two! The trick here is to relax. When you feel that sudden NEED to go, the tendency is to panic, to squeeze your legs and try to hold it in while rushing to the toilet. Unfortunately, that’s just going to push it out! Instead, think about consciously relaxing your abdomen, pelvis, and thighs. Focus on your work or something else (maybe as you make your way to the bathroom, in the early stages). It can be a bit of a roulette at first, but keep with it! Retraining takes some time.

Secondly, I don’t know about you, but I have a tendency to always be in a hurry. I was squeezing and firing off a pressurized firehose out of some misguided attempt to “be efficient.” This led to a buff bladder that was prone to “going hard” when activated. Instead, I made a conscious effort to relax when peeing, and just let it stream.


Pelvic floor health is super important. We’ve all heard of Kegels, and some docs recommend doing them while brushing your teeth, just to make it a frequent habit. Likewise, sexual activity and orgasm (alone or with a partner) can help get those muscles strong and healthy.

Absorbent “period panties” can be useful for containing small leaks. Thinx, TomboyX, and plenty of other brands make use of new fabric technology. These garments are machine washable (hang to dry) and, while the crotch panel may be slightly stiffer than usual undies, they are comfortable. They can be useful in the training period while challenging yourself to hold out. In worst case scenarios, if you are unable to retrain, they are a more dignified option than adult diapers. In the long run, they are cheaper, too.


Obviously, your mileage may vary, but I started seeing changes pretty quickly. A month after I started my experiment, I slept through the night! It’s now been three nights in a row, and one was a 10 hr lazy sleep-in over the weekend. Sleep is sacred, and anything you can do to improve your slumber will have a positive impact on the rest of your day.

Another important benefit to reducing overactive bladder symptoms is the freedom to have a drink of water. I know far too many women who stay perpetually dehydrated because they are nervous about their frequent urination. Take your control back by learning to relax… it may sound counterintuitive, but it’s working for me. Let me know how it works for you!

UPDATE 12/23/22: The retraining held until I rediscovered tea. It turns out caffeine brought back the frequent pit-stops for 24-48 hrs. I do just fine on herbals and still sleep through the night! :)

Postscript 4/6/23: It occurs to me that there’s a connection between general stress / anxiety and overactive bladder issues. If you find yourself in “fight or flight” mode often, it’s worth taking a slow, deep breath… one more… give yourself a moment to relax. We weren’t meant to be on high alert all day. I do a lot of “rest and digest” mode coaching with my patients. Please let me know if I can help you with that!