Holding It In Too Long? What It’s Really Doing to Your Pelvic Floor

Why is it not a good idea to hold it in for too long?

Pelvic floor is a group of muscles which forms a hammock-like structure inside the pelvic area. This muscle works with collaboration with your abdominal muscles and helps you with several functions. For example - Emptying bowel and bladder, Holding urine or feces, Supporting the internal organs, as a core muscle to support you with activities of daily living. Women and Men, as they age, could suffer from pelvic floor dysfunction. In this situation either muscle can get really tight or loose. Holding your urine for too long can cause hyperactive pelvic floor muscle. Holding off or postponing to use the bathroom for too long can cause severe symptoms like urgency, frequency, poor stream, urine retention, constipation and pelvic pain. Repeated urges and repeatedly postponing going to the bathroom can lead to detrusor overactivity ( bladder wall muscle). Overactive pelvic floor would also cause increased pelvic pain in women with pelvic muscle thinning ( atrophy) due to menopause. 

Tips for bladder health and preparing for a road trip, and what women can do longer term as they age (such as pelvic floor exercises). 

Bladder health tips- Drink at least 64 oz of water in a day. Make sure to avoid bladder irritant food and liquids. Some examples of bladder irritants- Coffee, alcohol, citrus fruits and spicy foods. These foods increase the bladder irritation and make you go more. Do your pelvic floor exercises. Gentle vaginal or anal area lifts, hold for 5 sec and relax, let go for 10 sec. During menopause due to the pelvic muscle thinning women could experience increased urgency, frequency and leaking. Talk to your doctor about topical estrogen which would help to reduce the urethral irritation leading to bladder urgency. 

Preparing for a road trip- Make sure you avoid bladder irritants before the trip. You can start prepping for a long trip 2 weeks before. Practice bladder training, everytime you feel the urgency do “ quick lifts “ in the pelvic muscle, when the urgency to urinate reduces then go and empty your bladder. This will train the bladder muscle to relax and will be able to hold better. 

Bonus points if you can recommend solutions for how women can hold pee while stuck in a car with no bathroom in sight.

Bladder can hold roughly around 350cc of urine and should be emptied every 3 hrs. If you are in a situation where you have to hold for 1-2 hrs, you can very well train your bladder. I would recommend training the detrusor to relax when there is urine in the bladder. Remember, following recommendations are only for postponing the urgency in an emergency situation. 

If you are in a situation where you are stuck in the car with no bathroom in site and you have an urge to urinate. Try to distract yourself, try engaging yourself in a conversation which would distract you. Breathe from your chest calm and quiet. More you panic, the more urgency you will feel. Quick lifts to relax your bladder would be very helpful. Remember this strategy will only work for some time. I would not recommend holding for too long which can cause pelvic floor spasm and pain.