Frequent urges? Bladder training and pelvic floor basics

Mapping toilets before leaving the house, avoiding the cinema aisle seat, getting up three times in the night: living with frequent urges can wear you down. Please know it is very common, and there is a lot you can do.

This article is about frequent urges and the idea of an overactive bladder in general. It does not diagnose. Urgency can have several causes, including infections, so a conversation with your GP is the first step if it is new for you.

What is an overactive bladder?

An overactive bladder means sudden, hard-to-ignore urges to pass urine, often with frequent visits to the toilet during the day and sometimes at night. The bladder muscle seems to squeeze before it is full.

• Frequent visits, more than you would expect for what you drink.
• A sudden “I must go now” feeling.
• Getting up at night more than once.
• Sometimes leaking before reaching the toilet.

Because infections can also cause urgency and frequency, read what cystitis feels like and speak to your GP if there is burning, fever or blood.

How do I do pelvic floor exercises (Kegels)?

1. Find the musclesImagine you are stopping the flow of urine mid-stream and holding back wind at the same time. The lifting feeling is your pelvic floor. Do not clench your buttocks or hold your breath.
2. Squeeze and holdSqueeze and lift, holding for up to ten seconds if you can, then relax fully for the same time.
3. RepeatBuild up to ten squeezes, three times a day. Quick squeezes can be added at the end.
4. Make them a habitLink them to something daily: brushing your teeth, the kettle boiling, waiting at traffic lights.

Which habits calm a bladder that is always on alert?

• Drink regularly, not heavily: little and often, with more earlier in the day.
• Cut back on triggers such as coffee, fizzy drinks and alcohol, and see if urgency eases (our food and drink guide lists more).
• Keep your weight and bowels in good order, because pressure on the bladder adds to urgency.
• Do not go “just in case” all the time, which can teach the bladder to signal early.
• Stay active: walking, yoga and swimming are all good for pelvic muscles and mood.

It is worth saying that frequent urges are not a sign of weakness or ageing you must put up with. Many women have been through the same, and many find that patient practice, small changes and good advice make days far more predictable.

What does a typical week of bladder training look like?

1. Days 1 to 3: observeWrite down when you go, how big the urge was and what you had been drinking. No changes yet.
2. Week 1: small stretchesTry to wait five or ten minutes longer than usual before each visit, using calm breathing and a pelvic floor squeeze to ride the urge.
3. Weeks 2 to 4: add a little moreWhen one gap feels easy, lengthen it again. Progress is not a straight line, so a bad day is not a failure.
4. Later: keep what worksMany women keep two or three habits for the long term, such as regular drinks and daily pelvic floor sets.

Be patient with yourself. It can take several weeks to feel a change, and a continence nurse or pelvic health physiotherapist can guide you if you would like support.

Where does a urinary routine fit?

Frequent urges and infection-type discomfort are different topics, but women with one often care about the other. If you would like a steady daily routine for general urinary comfort alongside your exercises, Cystobact is our editor’s choice for UK readers: D-mannose, cranberry, strawberry-tree leaf and citrus bioflavonoids in a three-capsule day.

Frequently asked questions