What Causes Frequent Urination in Women?

Frequent urination can be a source of confusion and anxiety for many women. Many believe they have a small bladder, leading to unnecessary stress.

In reality, the sensation of needing to urinate often may not be about bladder size at all. It is essential to understand the causes of frequent urination in women.

This article will clear up myths about having a “small bladder.” It will also explain what affects how we urinate. Let’s explore the truth behind why you may be asking, “Why do I have a small bladder?”

Your bladder may not be as small as you think. In fact, it’s doubtful that you have an anatomically small bladder. If you frequently experience the need to run to the bathroom to empty your bladder, you may actually have a normal-sized bladder with a diminished capacity to hold urine, also known as an overactive bladder.

Small Bladder?

One usually senses urine in the bladder when the bladder wall starts to stretch at a volume of 150-200 ml, and it becomes uncomfortable at a volume of 400-500 ml. The normal voiding time of a functional bladder is approximately 7 to 8 seconds. The next time you pee, count 1 Mississippi, 2 Mississippi, 3 Mississippi, etc., to see how much urine is released from your bladder. You could also measure it with a 1/2 liter measuring vessel.

Next, record the number of pee breaks in 24 hours. On average, a functional bladder is emptied 5-7 times a day and 0-1 times to wake to pee. Record your pee habits and output for three consecutive days to get a sense of what’s normal for you. Make sure you record on typical days, not while you’re sick, traveling, or drinking diuretic teas.

If you go to the bathroom every hour, you may have an overactive bladder. Waking up two or more times at night can also be a sign. It is not just a small bladder issue.

Retrain a “Small” Bladder

• Avoid frequently going to the bathroom “Just in Case”. Just in case, poor toileting habits can lead to an oversensitive bladder that requires more frequent emptying.
• Hydrate with water (avoid bladder irritants). Many people with overactive bladders avoid drinking water for obvious reasons. The fact is, if you’re dehydrated, your urine becomes concentrated and can be irritating to the bladder, leading to the need to urinate more frequently.
• Try to increase your bathroom trips to every 2-4 hours.
• Talk to your bladder. I used to use the bathroom every hour in between appointments, “just in case.” My bladder had become so accustomed to going every hour that it started sending urgency signals before the end of each appointment. When this started to happen, I told my bladder (silently and calmly, in my head, of course) not to worry, we will get to the bathroom in 30 minutes. This calmed my nervous system and gradually increased my bladder capacity to a normal level. By the way, holding your pee habitually when your bladder is at full capacity comes with its own consequences, so use this technique only when your bladder is overactive and hold off in gradual increments until you reach normal capacity.
• Try a distraction technique. If you feel an urgency to pee as soon as you put the key in the front door, try mixing it up by entering from a side door. Know that the only reason you feel the urgency just as you’re putting the key in the door, seeing a bathroom, or hearing running water is because your bladder has conditioned you.
• Focus on your breath. The breath calms the nervous system, which calms the bladder.
• For more bladder tips, read 12 Tips For A Healthy Bladder
• Mobilize your abdominal adhesions and C-section scar tissue. Adhesions can affect your bladder signaling.
• Take my online Womb Care course to learn self-abdominal massage and pelvic alignment for bladder and/or uterine prolapse. Remember, the uterus and bladder are physically and functionally related.

If you try all these tips and you still experience an overactive bladder, consider manual therapy around your sacrum, tailbone, and pelvic floor. Sacral nerves S2, 3, and 4 keep poo and pee off the floor. A manual therapist trained to work those areas will work with the ligaments connected to the tailbone. Releasing tension and congestion around these areas can help improve innervation to and from the bladder and pelvic floor. A Visceral Manipulation™ practitioner who has completed VM3 can also assist and will address your primary restrictions, support bladder motility, and work on the sacrum and tailbone if necessary.

If you can’t find a practitioner near you, I teach self-abdominal massage in my Womb Care course. When you perform a self-womb massage, you also massage and lift the bladder, as the uterus and bladder are connected. I also teach pelvic alignment exercises for pelvic floor and pelvic organ alignment and health. If you suspect adhesions around the bladder due to inflammation, or c-section, you may also want to consider the Free The Belly, abdominal scars and restrictions course.

Author: Barbara Horsley has more than 26 years of experience as a licensed massage therapist. She specializes in abdominal massage and Visceral Manipulation™ and is an NCBTMB-approved educator. In addition to being certified in abdominal massage, she also studied biomechanics and restorative exercise. She is also a Certified Women’s Herbal Educator and a graduate of the IWHI Perimenopause & Menopause Certificate Program.