What’s Normal When I Urinate?
Surprise!
Leaking when you cough, sneeze, or jump is not normal. Neither is having to urinate EVERY time you go to the grocery store or dribbling a little when you stand up after urinating. Despite what the people around you are telling you, these things are COMMON, but not normal.
Before we get into what is normal, let’s talk about the elephant in the room - your pelvic floor.
While everyone has a pelvic floor, there are differences between sexes in pelvic floor anatomy and therefore, different urination norms.
For this article, I am referring to the anatomy and urination norms for those who currently possess the same biology that doctors use to determine a baby as a girl.
The pelvic floor is a group of 3 layers of muscles that sit at the bottom (floor) of the pelvis to form a sling or bowl shape. These muscles have the same makeup as the muscles in arms and legs. Around 70% of the muscles that makeup the pelvic floor are built to maintain a contraction for a long period of time, while the other 30% are able to contract quickly for short periods.(1)
When you urinate, this is what happens…
Long story short, the pelvic floor muscles need to be strong to keep you from urinating at undesirable times, but they also need to be able to relax to allow all the urine to escape the body during urination. (2)
Now you’re probably thinking, ok this is great information, but how do I know if my pelvic floor is actually doing all of this correctly?
Well, there are norms we like to use to determine just that:
You have 5-8 voids in a 24-hour period - all 7-8 seconds of urination (3).
Longer, less frequent duration voids can be a sign you’re holding your urine too long while shorter, more frequent voids tell us that you’re urinating before your bladder is actually full. This can be for a variety of reasons from extra tension in your pelvic floor to connections your brain has made with urinating and certain situations, like unlocking your front door.
You have adequate time to get to the bathroom (3).
You can walk to the bathroom easy breezy AND you don’t leak along the way.
Your bladder doesn’t run your life - even at night (3).
It doesn’t dictate your plans of when and where you go (you don’t know where the bathrooms are in every grocery store). You can suppress the urge to urinate if it’s not a convenient time for you.
You don’t get up more than once a night to urinate.
You don’t dribble when you stand up after urinating (3).
This is often a sign you are not fully relaxing your pelvic floor when you urinate so all the urine doesn’t escape.
You don’t leak urine with coughing, sneezing, running, or jumping (3).
Contrary to popular belief, leaking with these things is not normal, despite how common they are. Leaking in these scenarios could be a sign you lack strength or coordination in your pelvic floor OR in the case of running or jumping, your hip, knee, or ankle isn’t strong enough to withstand the forces and your pelvic floor is being asked to do more than it’s capable of doing.
If you notice your habits differ from these, and feel embarrassed or uncomfortable bringing it up to your doctor or physical therapist, please know we are here to help and support you to live a life that is not limited by your bladder. Approximately 60% of women deal with urinary incontinence (4). You are not alone!
Written by Aly Freitag PT, DPT
Sources:
Gilpin, S A, Gosling, J A, Smith, A R B et al (1989). ‘The pathogenesis of genito-urinary prolapse and stress incontinence of urine: A histological and histochemical study’, British Journal of Obstetrics and Gynaecology, 96, 31-38.
Office on Women’s Health in the U.S. Department of Health and Human Service. (2021). A-Z Topics. Urinary Incontinence. Womenshealth.gov.
Al Afraa, T., Mahfouz, W., Campeau, L., & Corcos, J. (2012). Normal lower urinary tract assessment in women: I. Uroflowmetry and post-void residual, pad tests, and bladder diaries. International urogynecology journal, 23(6), 681-685.
Patel, U. J. MD; Godecker, A. L. PhD; Giles, D. L. MD, MS, MBA; Brown, H. W. MD, MAS. (2022). Updated prevalence of urinary incontinence in women: 2015–2018 national population-based survey data. Female Pelvic Medicine & Reconstructive Surgery, 28(4), 181-187.