Peeing patterns – what's normal?
Get up twice as often as your cubicle neighbour, or never feel the call of nature? We decode your peeing patterns and uncover ways to wee better. (Go ahead, laugh, but you’ll thank us later.)
What is urine and where does it come from?
Urine is a waste product. Your kidneys – one on each side of your abdomen – are constantly filtering out waste. They send this waste fluid down two small tubes called ureters to your bladder (you only have one of those). Once your bladder’s ‘full’ – or feels full – you get the urge to wee.
There’s a little valve at the base of the bladder called the urinary sphincter that is usually shut. When you’re ready to pass urine, that sphincter relaxes, allowing your wee to flow through a tube called the urethra out of your body. And voila, it’s all systems go.
How much can your bladder hold?
According to Dr Yik Lim, consultant urogynaecologist at Melbourne’s Mercy Hospital for Women, the amount of urine your bladder can hold depends on how old you are: the older the person, the smaller their bladder capacity.
“For instance, I would expect a young 30-year-old woman to be able to hold 500 to 600 ml with relative ease. But if they get up to age 80, it’s probably around the 300 ml mark,” he says. However, your bladder capacity also depends on how tall you are: “So a five-foot-tall person would have a smaller bladder than a six-foot-tall person.”
What colour should my wee be?
Pee comes in almost as many shades as Pantone swatches, but the colour selection for normal wee is relatively small. In fact, the hue of your urine hints at how healthy your body is and can serve as an SOS. For instance, it shouldn’t be red (although, if you’ve just eaten two beetroot sambos, don’t think you’re bleeding to death, it’s just the natural dye). If you’re not taking any medication or multivitamins, Dr Lim says wee should be a “nice clear yellowish colour”. Multivitamins can turn your pee more fluoro than a Hang Five t-shirt (or neon Top Shop skinnies for the ’90s kids) due to an overload of B vitamin riboflavin, which tends to make a bright exit (good problems; you know your body’s getting rid of what it doesn't need). If it’s dark yellow or deep orange you may be dehydrated, Dr Lim says. If you haven’t eaten beetroot, are not on your period and see red, see your GP. There shouldn’t be blood in there.
How many times?
Dr Lim says that depends on a number of factors, including your age and size. It also depends on how much fluid you’re drinking, and how much urine you pass each time you go. “So if a person goes to the toilet 10 times a day but they drink five litres of fluid a day, then on average you’re looking at 500 ml per [wee], which would be quite normal as far as I was concerned. Whereas if a person only drinks 500ml of water a day and goes to the toilet 10 times a day, you would be a bit more worried.” As a general rule, he says, “You’d probably like to see people going to the toilet when they have anywhere from 200 to 400 ml in the bladder.”
While measuring the amount of urine your produce (you know, by weeing into a measuring jug for instance) would tell you exactly how much urine you’re expelling, we don’t expect you to do that. Instead, Dr Lim says, in general you should probably not need to pass urine more than eight times during the day and more than once overnight.
Does timing matter?
In a word, yes. There’s an ideal wee window. Passing urine ‘just in case’ is a bit like cutting a ton of calories just in case the recommended deficit doesn’t make you lose weight. Soon enough you’ve trained your body that that’s the way it is and once it’s adapted you run into all sorts of problems. Just as metabolism adapts to how much you eat, your bladder can be ‘taught’ how much urine it should hold before feeling full and needing to go, says Dr Lim. So if you’re going ‘just in case’, you’re training your bladder to become smaller, just as you’d train your body to survive on less food.
As a result, your bladder will be able to hold less fluid, meaning lots of extra dashes to the loo. “What I tell my patients is if you don’t stretch the bladder up over time it may not hold as much [urine] as you like,” explains Dr Lim.
But going too late is not a good idea either, says Dr Lim. This is because leaving urine in your bladder for ages makes you more likely to develop a urinary tract infection (UTI). There’s no medal for putting up with it until you think you’re going to burst, so find a bathroom and go. “If a person is holding on to a litre in the bladder, you wouldn’t want them to hold any longer,” Dr Lim says. The solution, he says, is simple: “You should only go when you need to.” Who’d have thought, right?
Why do I leak during pump class?
So much for being an old person’s problem. Little accidents after the gym, during Seinfeld or when you’ve got a cold are more common in 30-somethings than you might think. According to Tena, one in four women over 35 have weak bladders, with pregnancy and childbirth key contributors.
If you’ve got tikes you’ll know what we’re talking about. But there are other factors favouring incontinence in your skinny-jean years.
Incontinence, or leakage, falls into two distinct camps: urge incontinence (sudden and frequent urges to wee even when your bladder’s not full) and stress incontinence (a trickle when you see George confront the Soup Nazi or sneeze). The former owes to involuntary bladder muscle spasms while the latter indicates a weak sphincter muscle in the bladder.
Think of the sphincter like a door that can be opened by exercise, laughing, sneezing and coughing (might want to re-think the comedy festival). Smokers and allergy sufferers are particularly susceptible with all that coughing and sneezing.
What’s your weakness?
Do you wake to wee more than once a night?
Do you go more than eight times a day?
Do you experience frequent UTIs?
Have you got a neurological condition, kidney disease, diabetes, bladder stones or tumours?
It’s probably: urge incontinence.
Have you had an injury to that area?
Do you have chronic bronchitis or asthma?
Have you given birth naturally?
Have you had pelvic surgery?
It’s probably: stress incontinence
Both incontinence incarnations have myriad treatment options, so talk to your GP.
Is there an ideal loo technique?
Even though you’ve been doing it for years, you may be surprised to know there is a ‘best position’ for sitting on the loo. Dr Lim advises having your feet flat on the floor, your bottom on the toilet seat and your body leaning slightly forward. He says it’s super important not to hover over the seat either – even if you’re at a public toilet.
“Research has shown that when you hover and not sit on the toilet seat you may retain up to 30 per cent of the bladder volume inside,” he explains. This is because you need to relax your pelvic muscles in order to empty your bladder properly, and hovering over a seat stops you from fully relaxing.
And don't get too strung out about cooties. “People need to understand they’re very unlikely to catch a sexually transmitted infection [STI] from a public toilet… The reality is the bacteria is unlikely to survive very long on the ceramic toilet seat,” Dr Lim says. When you’re at a public toilet, he recommends cleaning the toilet seat. “And then maybe cover it with toilet paper and just sit comfortably so you can empty the bladder effectively.” Got it?
How can I keep my bladder healthy?
“The important thing is to have a good healthy daily fluid intake,” says Dr Lim. He says this is best achieved by drinking 1.5 to two litres of water a day. He advises steering clear of too many caffeinated drinks (including tea, coffee and caffeine-filled soft drinks), saying that more than three or four cups of coffee a day can ‘irritate’ the bladder and have a diuretic effect (meaning you end up weeing more often).
I think I have a bladder infection. What should I do?
If it burns when you pass urine, you have blood in your wee, you feel like you need to go all the time (even if you’ve just been) or you’re only passing small amounts of fluid really often, you may have a urinary tract infection [UTI]. UTIs are so common that, according to Better Health Channel, an estimated one in two women will experience one in their lifetime.
The reason women are so much more prone to these infections than men is because the tube that leads to the bladder (the urethra) is really short in females – being only about four centimetres long. Consequently, bugs from the outside don’t have far to travel to reach the bladder.
If you think you have a UTI, see your GP pronto, as left untreated it can travel to your kidneys and cause a more severe infection.
Author: Dr Evelyn Lewin