Do Some People Really Have Small Bladders?

You either know that friend or you *are* that friend: the one with the allegedly small bladder, making people pull the car over during road trips and stand up in movie theaters because you have to go—now.  After hearing the bladder size issue raised one too many times, I decided I needed a definitive answer: do people actually have differently sized bladders?! My assumption was absolutely-positively-yes but, when my search results proved inconclusive, I reached out to our resident pelvic health expert, Lindsey Vestal. She quickly set the record straight: bladders do range in size from 16 to 24 ounces, but even if you have a bladder that’s on the smaller side, it’s not the reason you’re running to the toilet every ten minutes.

If it’s not a small bladder… what is it?

Like most bladder and pelvic health conditions, there’s no one-size-fits all explanation for frequent bathroom trips, but if you’re regularly relying on the “small bladder” line, you’re probably experiencing overactive bladder syndrome (OAB), a form of urge incontinence. OAB is often dismissed because of this widespread idea that some bladders are just teeny-tiny, but when the urge to pee is starting to disrupt your daily life it’s time to evaluate what’s really going on. The good news is that a clear diagnosis isn’t too hard to come by, because the symptoms of OAB are easily identifiable:

  • Recurring, emergency urges to pee
  • Frequent trips to the bathroom, triggered by specific, everyday actions (i.e. opening the door to leave your apartment, entering a weekly work meeting, or stepping off the elevator in your building at the end of every day)
  • Waking up regularly in the middle of the night to pee
  • Leaking on your way to the bathroom.

Causes of overactive bladder syndrome (OAB)

Lindsey says that you should typically be peeing six to eight times a day, three to four hours apart. Anything more than that, and it’s likely the cause of your trips is either muscular (meaning there’s an imbalance or weakness in your pelvic floor muscles) or behavioral (meaning you’ve inadvertently trained your bladder to signal your brain to pee prematurely).

Age and body weight can slightly up your chances of having OAB, but Lindsey says behavioral and hereditary causes are a really common culprit. That doesn’t mean an overactive (or small) bladder is in your gene pool, but if you’re someone whose parents always told you to pee before a long car ride, or before leaving the house, it’s more than likely that your bod has been conditioned to feel the urge when you’re on your way out the door or buckling your seatbelt.

In a perfect, pee-pressure free world, your brain *should* be signaling that your bladder needs to be emptied when it starts to reach the halfway point, usually around 8 ounces of liquid. But, if you have OAB, frequent bathroom breaks or learned familial behaviors are probably triggering your brain to send signals when it isn’t really necessary.

Treatment options

  • Bladder training. Because so much of OAB is rooted in associations your brain has made with specific actions or moments in your day, a big part of treatment is retraining your mind to ignore signals that your bladder is full when it really isn’t. You can start bladder training with small steps, like slightly increasing the time between your bathroom trips. So, if you’re someone who goes to the bathroom every hour, start upping the time to every hour and fifteen minutes.
  • Pelvic floor exercises. Never to be underestimated, strengthening and retraining your pelvic floor muscles is an important step in rebuilding bladder endurance. If your urges are being amplified by weak pelvic floor muscles, getting in tune with the function of your pelvic floor can help restore your control over when and where you need to pee.
  • Drink more. Contrary to what most people assume, drinking less won’t stop leaks or the sudden urge to sprint to the bathroom. In fact, drinking less can make your pee more acidic, which in turn makes it irritating for your bladder to hold (which, you guessed it, means your bladder starts spasming and sending you signals to let the liquid out before it does it on its own terms).
  • Drink better. Avoid drinking tons of irritants like alcohol, caffeine, or carbonated beverages that can kickstart your bladder and send signals that it’s time to empty out, even if you’re not holding much liquid yet.

Once you recognize the symptoms of OAB you can start taking back control of your bathroom breaks.

-How do you handle OAB?-