Urinary Urge Suppression: Managing the Constant Urge to Pee
Authored by Dr. Maryssa Steffen, PT, DPT, Board-Certified Women’s/Pelvic Health Clinical Specialist
Urinary urgency may be experienced as a sudden, compelling urge to run to the bathroom and can be provoked by the following:
Seeing a bathroom.
Anticipating you are about to pee in the toilet and your bladder feels full.
Taking a shower or hearing running water.
Being cold.
Experiencing fear that you are about to go into a meeting and you will have to go pee during the meeting so you go “just in case.”
During or after dilator exercises for vaginismus.
During exercise, especially higher impact movements like running, jumping, or walking downhill.
Drinking a lot of fluids at once.
Not fully emptying your bladder.
What causes urinary urgency and the frequent need to pee?
Feeling an urge to pee all the time may be caused by the following:
Your bladder squeezes too often (“overactive bladder”).
Your ribs and low back are stiff, thereby limiting the free mobility of the autonomic nervous system nerves that communicate with your bladder.
Irritation and discomfort sensations from myofascial trigger points in the muscles around your bladder, like the rectus abdominis, iliopsoas, obturator internus, levator ani, and superficial pelvic floor muscles. These muscles may be asking you for relief and movement, and your brain is interpreting the sensations as an urge to release urine instead.
Tense pelvic floor muscles that fatigue too quickly during exercise.
Stiff pelvic floor muscles, fascia, and ligaments from poor breathing habits and unsustainable prolonged postures.
“Pushing” or straining to pee. Practice diaphragmatic breathing to release urine. A squatty potty or foot stool may help to relax your pelvic floor muscles.
Peeing in the shower.
“Just in case” peeing.
If you have the feeling of a full bladder all of the time, any pelvic physical therapist may encourage you to practice bladder training.
Bladder training and urinary urge suppression techniques are highly effective! It is never too late to start to train your bladder.
When you have a sudden, strong, compelling urge to urinate, here are some resources to calm your bladder. Start by practicing these urge suppression steps to also prevent leaking and an overactive bladder:
Pause. Avoid urgency. If you run to the bathroom, or move too fast to sit on the toilet, the urinary urge will be overwhelming.
Try slow breaths, diaphragmatic breathing, and coach yourself to relax and stay calm.
If the urgency is not subsiding, try 10 slow heel raises or toe curls. Mindfully moving your feet and ankles can communicate relaxation to your bladder.
If you are standing, sitting down might help. The pressure from the seat on your pelvic floor muscles may help to calm the urgency. Stay still. Breathe. Gently coach yourself that you will go to the bathroom when the urgency is gone.
Distracting yourself may help. Try a mental task like counting backward, singing lyrics, or focusing on another task.
Pelvic floor muscle exercises could help. Can you relax your pelvic floor muscles? Can you squeeze like you are stopping the flow of urine? Can you do this quickly? Can you relax again? Can you squeeze your pelvic floor muscles for 10 seconds while breathing or humming at the same time? Pelvic floor muscle activity can relax your bladder. If you can, isolate your pelvic floor muscles and hold a gentle squeeze, while breathing, until the urge subsides. If you are unable to hold a squeeze for that long, try relaxing and squeezing as many times in a row as you need until the urgency subsides.
If you need more guidance about how to properly practice pelvic floor exercises, internal pelvic floor therapy could help.
If practicing these resources seems insurmountable, start with an easier situation, like during a leisure day at home or times when the bathroom is close by.
If you have a sudden urge to pee while at home, train your bladder with the above resources and practice earnestly for at least two months.
Gradually, your confidence will improve and you can apply these resources to any stressful situations in the community.
Here are other considerations:
Avoid postponing true urges to urinate. Do not ignore your bladder. Discern between a true urge to pee and urinary urgency.
A true urge to urinate is typically experienced as a steady, moderately strong stream of urine for at least 8-10 seconds. Stay relaxed and be patient to fully empty your bladder. Avoid being distracted on your phone.
It is normal to urinate every 2-5 hours or 4-7 times during the day.
Consistency is key. Stay hydrated, but avoid chugging large amounts of fluids too quickly. Do not restrict your water intake.
Limit alcohol consumption.
Avoid constipation.
You may need to include a timed voiding program for bladder training. If you need guidance on how to begin a timed voiding program, if you have questions about how long you should practice timed voids and how to gradually increase time between voids, reach out to your pelvic floor physical therapist for an individualized bladder training program.
