Health myths: small bladder

“I just have a small bladder”

You probably don’t.

Do you find yourself rushing to the bathroom more often than your friends? Does your key hit your door and are flooded with an instant sensation that you won’t make it to the bathroom?This is likely not because your bladder is smaller than everyone around you. It may actually be symptom of Overactive Bladder (OAB).

What is Overactive Bladder (OAB)?

Often the symptoms of Overactive Bladder have to do with stress, mood, bathroom habits, and even overlapping conditions that cause pelvic pain or symptoms. This urgency is often accompanied by increased frequency, waking in the night to use the bathroom, and even urgency with incontinence. Sometimes symptoms of urgency are related to physical conditions - like a urinary tract infection - so we also want to rule this out!

Why does it occur?

Our nervous system controls our bladder voiding - through both the autonomic side (outside our control) and somatic (within our control). How our brain interprets this info can also be impacted based on how calm or stressed we may be!In the absence of physical reasons for urgency, we often look at re-training your bladder!

Sometimes habits like “just-in-case” peeing impact our bladder reflexes - getting in the way of our natural “fullness” signal. Techniques that involve slowly and calmly pausing and delaying the rush to the bathroom can help.

Urgency symptoms are also often higher in those who experience anxiety and depression - or very high levels of stress. In fact, the relationship seems to be pretty linear - the higher the levels of anxiety, the more severe the symptoms of urinary urgency.

Why are anxiety and stress related?

There are a few theories for why this may be, but it is likely (at least partially) through impacts on the nervous system - especially our stress response system, the hypothalamic-pituitary-adrenal axis. High levels of anxiety can also impact the muscles surrounding our urethra and supporting our bladder - our pelvic floor muscles. These muscles, and the surrounding connective tissue, when they are inappropriately tight or active can impact how our brain senses fullness in the bladder.

What can I do?

Like many things in health, we likely need to approach from a few directions. With a good assessment, we can discuss lifestyle habits, “bladder training”, relaxation techniques, support or refer for mental health concerns, and address any pelvic floor dysfunction if needed. You shouldn’t have to be scanning for a bathroom anytime you go somewhere new - let’s chat!