12 things your bladder secretly wants to tell you

You may find you often get up in the middle of the night to wee. Or, perhaps you notice your urine colour is a “strong” yellow or maybe it’s a completely different colour, like green. Or, like some people, you may find it impossible to wee when there are people around. (Hello, public restrooms.)

These bladder problems – which sometimes can be completely normal or sometimes a cause for concern – are very common. However, you might be too shy to ask your doctor about them. So we checked in with several medical experts who answer your most embarrassing bladder questions, from urinary tract infections to urine colour.

Bladders don’t vary much in size; yours might just act small. When it comes to how often you run to the bathroom, there are two things to consider: actual bladder capacity (how much fluid your bladder physically holds) and functional bladder capacity (how long you wait before weeing). “Sometimes patients will sense bladder fullness at an earlier time than others, and that’s when they say, ‘I have a small bladder,’” says Dr Benjamin Brucker, assistant professor of urology, obstetrics, and gynaecology at NYU Langone Medical Center. “You might get that message to wee very soon after it’s empty and starting to fill.”

If you find yourself with bladder problems, like needing to wee often, talk to your doctor. He or she may treat you for overactive bladder by suggesting you minimise bladder irritants (such as coffee, alcohol and artificial sweeteners) or start pelvic floor exercises such as Kegel exercises to strengthen the muscles that help you “hold it.”

Here are 10 clear sign you have an overactive bladder.

It’s not just leaking. There are two different main kinds of incontinence, both of which can be treated by doctors. Stress urinary incontinence occurs when you laugh, sneeze, cough, or do anything else to exert pressure on your pelvic floor. Urge incontinence is when you suddenly and unexpectedly have to urinate, even if you recently emptied your bladder. With both types of incontinence, obesity is a risk factor. In stress incontinence, obesity increases intra-abdominal pressure; meanwhile, metabolic shifts are believed to affect urgency incontinence. While stress incontinence is related to genetics and childbearing, urgency incontinence is commonly seen in diseases such as diabetes or Parkinson’s.

Don’t be embarrassed to talk to your doctor, who may recommend behavioural techniques (such as scheduled toilet trips and diet management), pelvic floor muscle exercises, medications, or even treatments such as injections to help keep the urethra closed.

A man’s urethra, the tube that transfers urine out of the body from the bladder, is about 18-20cm long and passes through the prostate gland and penis before emptying. A woman’s urethra is only 3.81 centimetres long and is embedded in the vaginal wall. “Since women have a shorter urethra, conditions like stress incontinence or accidental leakage with coughing, laughing and sneezing are much more common,” says Dr Brucker. “In men, blockage or having a tough time emptying the bladder is more common because they have a prostate, which can grow and sometimes squeeze or pinch off the urethra.”

Although urinary incontinence in men isn’t as common as it is in women, it’s still an issue.

Sorry, men, but a weaker stream is a natural part of ageing. “The prostatic tissue grows over time, and it can grow into the urethra tube and narrow it,” says Dr Courtenay Moore, a urologist and female pelvic medicine reconstructive surgeon. “That decreases the diameter of the tube – think going from a straw to a pinpoint – and slows the [urine] stream down.” If you notice difficulty starting or maintaining a urine stream, apply heat to your lower abdomen to help relax muscles. If you’re unable to pass urine or pass little urine for one to two days, talk to your doctor about these bladder problems. They may recommend medication to relieve symptoms of an enlarged prostate.

It’s perfectly normal. Most people urinate between six and eight times a day, but if you’re drinking extra fluids, you may be going up to 10 times a day. The average adult bladder can hold 300 to 500 millilitres of urine (enough to fill seven to 11 shot glasses). Certain medications, like diuretics for high blood pressure, also may make you urinate more. Excessive urination, however, may be a sign of an overactive bladder or a symptom of diabetes. When people have diabetes, excess sugar builds up in the blood, forcing the kidneys to filter it and triggering more frequent urination. The excess sugar also may cause the urine to have a sweet smell.

Your urine can say a lot about your overall health and hydration status. You’ve probably heard that dark yellow or amber urine means to guzzle more water, while pale urine means you’re well hydrated. But your urine doesn’t need to be crystal clear – a light straw colour is just fine. “We’re in a water bottle society, but some people don’t need 8 cups of water, especially if they’re not active or living in a warm climate,” says Dr Moore. “Drinking that much just makes you go to the bathroom more. Your brain is pretty smart about telling you when to drink.”

Still, be aware of abnormal colours. Severe dehydration or liver disease may cause brown urine, bacteria infecting the urinary tract or medication can result in green urine, and a liver or bile duct condition may lead to orange urine. Blood in the urine may be a sign of kidney disease, urinary tract infection, cancer, or prostate problems. In any of these cases, see a doctor right away.

Think about your diet if you spot something funky in your urine. Is your urine slightly pink or red? It might not be blood, but perhaps the beet salad you ate for lunch. The pigment that gives beets their colour is only stable at certain levels of stomach acidity and usually too faint to appear in urine; in 10 to 14 per cent of the population, however, the beet pigment, known as “beeturia,” shows up in the toilet.

Carrots can turn urine orange, rhubarb may tint it dark brown, and asparagus can lend it a green hue. Asparagus also can give your urine a pungent smell. When the veggie makes its way through your body, it breaks down into sulphur-like compounds, which causes a rotten-egg stench.

Yes, your bladder can be timid. If you find it difficult or impossible to wee when other people are around, it could be a sign of paruresis, a social anxiety disorder. Don’t feel bashful about it. Between 2.8-16.4 per cent of Australians experience it, according to the Royal Australian College of General Practitioners. Behavioural therapy, support groups, or even drug therapy can helpful. Physical therapy may benefit people who have a hard time relaxing the pelvic floor.

It’s best not to “hold it” if you don’t have to, because there’s a chance it could raise your urinary tract infection risk. Sometimes, though, life gets in the way: You’re at a concert, on a road trip, or in a city lacking public bathrooms. First, avoid anything that might bother the bladder. “Irritants like coffee make your bladder more sensitive, and instead of getting a trigger to urinate at six ounces [177 millilitres], you may have to go after just three ounces [88.7 millilitres],” says Dr Brucker. When you have to go, distract yourself – engage in a conversation or dive into an interesting read. “There’s a big brain component to this, so if you need to go to the bathroom and you distract yourself with some other task, that sensation goes away,” continues Dr Brucker. And, of course, make sure you’re completing your Kegel exercises every day to keep your “hold it” muscles strong. Simply contract your muscles as though you’re stopping urine flow, hold for three seconds, and relax for three seconds; repeat 10 to 12 times daily.

Here are 9 medical reasons you need to wee all the time.