Interviewer: You're getting older and you're noticing that you're peeing more during the day, during the night. Is this normal? That's coming up next on The Scope.
Today, we're talking with Dr. Kirtly Parker Jones. She's the expert on all things woman. Dr. Jones, the scenario is you're 40, 50, you're getting up there in the numbers and for whatever reason, you're just starting to pee more. You're starting to wake up more in the night, you're starting to take a little more breaks during the day. What's going on? Are you normal?
Dr. Jones: Yeah, this is, well, remember we talked about normal . . .
Interviewer: Is she normal?
Dr. Jones: Is she normal? Welcome to the overactive bladder club. Welcome to the potty club. It turns out that urgency, meaning a bladder that contracts before it's really, really full is quite common. And the range in studies go from five percent to 30 percent of women by midlife have what they consider an overactive bladder and sometimes even leak a little.
Causes for an Overactive Bladder
Dr. Jones: So let's talk about medical or structural problems that might lead to this. We're not talking about stress incontinence, meaning you got to go when you cough or sneeze. This means you're just kind of walking around and then you got to go and then you just went and then it's an hour or two later and you've got to go and it's just going. First of all, the most common that causes urgency, meaning I've got to go is a urinary tract infection. But if this has happened over a long period of time, that's not going to be it. A UTI, a urinary tract infection, is actually an acute event.
Interviewer: And usually hurts, doesn't it?
Dr. Jones: It usually hurts. Now, there are women who have fibroids or something in their pelvis that's growing that's leaning on their bladder. So just as when a woman's pregnant and the baby's head is leaning on the bladder and they have to go all the time, if you have a big fibroid on your bladder or another pelvic mass, that can be a benign mass and it could have been growing slowly over years and you just know that you can't hold as much. So those are some reasons.
There are people with neurologic problems, multiple sclerosis, and other conditions that can make kind of an overactive bladder and that's what you see on the TV, it's called overactive bladder.
The most common reason is we don't know. So I call it idiot-pathic, instead of idiopathic, meaning it's unknown, I call it idiot-pathic. And it has to do with an aging brain. And that is the kind of ability to calm your bladder that you had to learn at two so that you could be continent and not pee in your pants all the time.
As you get older, you lose some of that so your brain can say, "Oh, I think I want to pee and I want to pee now." You can retrain your brain to say, "No, I really don't. I just went two hours ago and I haven't had anything to drink." So mindfulness training actually works very well.
Treating Urgency with Mindfulness
So we have classes here at the University of Utah in mindfulness training specifically to help women with overactive bladder. As I said, it's common. Five to 30 percent of women complain of this. So they have to get up once or twice at night.
Now, another important reason before I get back to the overactive bladder is I see women walking around in their yoga pants with their water bottle. And they have water bottle with them everywhere because it's part of their drinking, drinking, drinking so that certainly can be part of it in women who are trying to watch their weight know that drinking water is good, and then they're drinking buckets of water and they have to go.
And those women, when you ask them are when they keep a diary, actually will let you know if you have them pee in a little thing we called the hat that sits in the potty so you can measure it. They are peeing a lot because they're drinking a lot.
Diabetes and Frequent Urination
There are other conditions like diabetes where you have a lot of sugar in your blood. Those people actually become dehydrated because when you have to get rid of the sugar, you have to get water out with it so those people pee a lot.
So there are a couple of things that are medical that caused frequent urination but those people are peeing in buckets and when you have to get up in the night and you get out of bed and you just pee a little bit, so that's urge incontinence or urgency we call it. There are ways to treat it.
Now, there's medicine to treat it but the medicines make a little difference. So they did some randomized studies where they looked at medicines that are actually, you see them advertised on the TV. They may decrease the number of urge episodes a day by one or two so you're still left with a moderate amount.
Interviewer: You're still pretty much going regularly.
Dr. Jones: You're still going. You are. And they have side effects of dry eyes and dry mouth, and what do you do when you have a dry mouth?
Interviewer: You drink more.
Dr. Jones: You drink more. So I think what we usually try to do is help people retrain their brain.
Interviewer: So mindfulness is the best solution.
Dr. Jones: Mindfulness is one of the best solutions and making sure that you don't have a lump in there, that you don't have diabetes, that you don't have other conditions that will make you go that are medical concerns. The most common is the brain just isn't as good at suppressing that bladder spasm as it was when you were 20, and now you need to retrain your brain.
Interviewer: So if you don't have a medical condition like diabetes, or urinary tract infection, and you're getting up there in the numbers . . .
Dr. Jones: Yeah, in the numbers.
Interviewer: In the numbers, right? We're just going to call them the numbers, and you're peeing a lot more than you used to, this is normal.
Dr. Jones: This is normal and I'm sorry.
updated: August 13, 2020
originally published: May 11, 2017
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