Bladder control problems in women: Lifestyle strategies for relief

Lifestyle changes may improve your bladder control problem or enhance your response to medical treatments. Find out about these strategies for improving bladder control problems. By Mayo Clinic Staff

You've been struggling with the embarrassment and discomfort of a bladder control problem for some time now. Maybe you hoped it would go away on its own, but things aren't getting any better. In fact, your bladder control problem is gradually getting worse.

You're ready to make some changes, but what exactly can you do? There are some simple strategies you can try on your own that may help improve your bladder control problem.

Doctors often call these strategies "behavior therapies." They're safe, easy, effective and inexpensive. These techniques can be used before resorting to other types of treatment, such as medications or surgery, or in combination with them. Sometimes behavior therapies are the only treatment you need. In some cases, they're as effective as — or even more effective than — medication.

Focus on fluids and food

How much fluid you drink and the types of food you eat may influence your bladder habits.

Too much fluid
Drinking too much fluid of any kind makes you urinate more often. If you drink too much over a short time, this can overwhelm your bladder and create a strong sense of urgency. If you exercise a lot or work outdoors regularly, you may need to drink additional fluids. But rather than drink a large amount all at once, try drinking smaller amounts throughout the day. For example, drink about two 8-ounce glasses (237 milliliters) at each meal and one 8-ounce glass between meals. That way, you'll end up at the recommended amount of roughly 60 to 64 ounces (about 1,775 to 1,900 milliliters) of fluid daily.

If you have to get up several times at night to urinate, try drinking more of your fluids in the morning and afternoon, and eliminate alcohol and caffeinated beverages. Although water is best for your bladder, remember that fluids come from any beverage you drink and from foods such as soup.

Too little fluid
Drinking too little fluid can lead to increased concentrations of body waste products in your urine. Highly concentrated urine is dark yellow and has a strong smell. It can irritate your bladder, increasing the urge and frequency with which you need to go.

Bladder irritants
Some foods and beverages can irritate your bladder as well. Caffeine and alcohol both act as diuretics, which means that they increase urine production. This can lead to increased frequency and urgency of urination. Caffeine can also cause bladder spasms.

Certain acidic fruits — oranges, grapefruits, lemons and limes — and fruit juices, spicy foods, tomato-based products, carbonated drinks, artificial sweeteners, corn syrup, sugar, chocolate, coffee and tea may irritate your bladder or contribute to leakage of urine. Why these items sometimes cause irritation isn't exactly understood, and what causes bladder irritation may vary from person to person.

If caffeine or alcohol is a regular part of your diet, try eliminating it for about a week to see if your symptoms improve. Consider also avoiding foods that might be bladder irritants for about a week or so. Then gradually — every one to two days — add one food back into your diet, making note of any changes in urinary urgency, frequency or incontinence.

You might not even have to eliminate your favorite foods entirely. Simply cutting down on the amount might help, too.

Try bladder training

When you have an overactive bladder, you can become accustomed to urinating frequently or at the slightest urge. Sometimes, you may go to the toilet even when you don't have the urge because you want to avoid an accident. After a while, your bladder begins sending "full" messages to your brain even when it's not full, and you feel compelled to urinate.

Bladder training, or retraining, involves adjusting your habits. You go to the toilet on a set schedule — even if you have no urge to urinate — gradually increasing the time between urination. This allows your bladder to fill more fully and gives you more control over the urge to urinate.

A bladder-training program usually follows these basic steps:

  • Find out your pattern. For a few days, keep a diary in which you note every time you urinate. Your doctor can use this diary to help you establish a schedule for your bladder training.
  • Extend your urination intervals. Using your bladder diary, pinpoint the amount of time from one urination to the next. Then extend that interval by 15 minutes. So, if your usual interval is one hour, you work to extend that interval to an hour and 15 minutes.
  • Stick to your schedule. Once you've established a schedule, do your best to stick to it. Start by urinating immediately after you wake up in the morning. Thereafter, if an urge arises, but it's not time for you to go, try as hard as you can to wait it out. If you feel you're going to have an accident, go to the toilet but then return to your present schedule. Strengthening the pelvic floor muscles by rhythmically contracting and relaxing those muscles (Kegel exercises) can significantly improve your ability to extend the time between urination.
  • Practice relaxing. If you feel a sudden need to urinate before your scheduled time, try to stand still or sit down. Then work on relaxing by taking deep breaths, imagining the urge going away and contracting your pelvic muscles. Once you feel relaxed, slowly make your way to the bathroom if you still need to. With time, this practice can help reduce feelings of urgency.
  • Increase your intervals. Gradually lengthen the time between trips to the toilet until you reach intervals of two to four hours. You might do this by extending your intervals an additional 15 minutes each week until you reach the desired goal. Be sure to increase your time limit slowly so that you give yourself the best chance for success.

Don't be discouraged if you don't succeed the first few times. Keep practicing, and your ability to maintain control is very likely to increase.

Jul. 30, 2011 See more In-depth