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Pelvic Health
Smarty-Pants Quiz Series 🤓

Question #1: How much liquid does your bladder hold?

The typical bladder holds about 2 cups (~500 ml) of urine. Some of you may be saying "no, I have a small bladder". You might think there is no way your bladder could hold this much.  However, usually what is happening is that your bladder CAN hold that much, but you feel a strong, difficult-to-ignore urge to go much SOONER than when you reach 2 cups. You may have an overactive bladder. If this is true for you, try this simple exercise the next time you feel the urge to use the bathroom: When you feel the urge to go, DO NOT head to the bathroom right away; instead, stand your ground and quiet the urge by: 1. Taking 3 deep and slow breaths 2. Doing 6-8 quick Kegels 3. Counting backwards from 100 by 3’s Once the urge has faded, then delay going to the bathroom by 5 minutes. After 5 minutes, calmly head into the bathroom. Continue to practice this every time you get the urge to go. Over time, increase delaying the trip to the bathroom by 10 minutes, then 15 minutes, etc until you can wait 2-3 hours between bathroom trips.

Question #2: Can eating pizza make you pee more often?

YES! Eating foods with acidic ingredients such as tomatoes on pizza, as well as some other foods and drinks, can make you run to the bathroom more often, especially if you have an overactive bladder. (I know...please don't kill the messenger 😬) Not everyone needs to worry about this. BUT...if you have to pee more often than every 2-3 hours, here is a list of drinks and other foods to watch out for: ​~Carbonated beverages, including sparkling water, sodas, etc ~Coffee—hot, cold, with or without caffeine ~Tea—hot, cold, with or without caffeine ~Caffeinated food and drinks such as energy drinks, chocolate, medicine with caffeine ~Alcoholic drinks ~Acidic foods, such as citrus fruits, tomatoes and tomato-based products, vinegar, even lemon in water or large doses of Vitamin C ​For 3 days, avoid these, as they may be irritating your bladder and causing you to pee more often than normal: After 3 days, add them back into your diet ONE BY ONE to discover which, if any of them, make you go more often than every 2-3 hours. Note: lessen your intake of caffeinated food/drinks slowly to avoid caffeine withdrawal symptoms 🥴 Avoiding the food and drinks which irritate your bladder, along with learning how to control the urge and maximize your pelvic floor strength, is a key step in overcoming Overactive Bladder symptoms.

Question #3: How many times is normal to wake up at night to pee?

0-1 times per night. (The one time becomes more common as we age and is considered normal.) Normally, the amount of urine your body produces decreases at night. This means you should be able to sleep six to eight hours without your bladder waking you up to go. 😴  Why does it matter? Because waking up to pee more than once at night can wreak havoc on your sleep cycle! It can also lead to falls, as well as other health problems. Want to help keep your bladder asleep at night? Try out these 6 simple tips: 1. Avoid drinking anything after dinner. If you need to have a sip or need to take medication, make sure you have only plain old water, and only as much as you absolutely need.  2. Stick to drinking plain water during the entire day. Your goal is to avoid drinking anything that may irritate your bladder, such as coffee, tea, sodas or other beverages with carbonation. Note: If you regularly drink a caffeinated beverage in the morning, you may not want to stop cold-turkey, as this can cause headaches, but try to minimize the amount you drink. 3. If able, adjust your medication time. Some medications, such as diuretics, can cause nighttime urination. If you are taking a medication with a side effect of increased urination, consider discussing the timing of when you take it with your physician or pharmacist; adjusting the time of day when you take it just might help you avoid waking at night. 4. Two hours before bed, elevate your legs and exercise your ankles. (Tip: Set an alarm for 2 hours before your normal bedtime to remember to do this.) Lie down on your bed, floor, or couch and put pillows under your legs, so that your feet are elevated above the level of your heart. In this position, do 20 ankle pumps, 20 ankle circles in each direction, and 10 leg lifts on each leg. After the exercises, continue to rest in this position, with your legs elevated, for another 5 minutes or so. Then you may get up and continue your evening as usual. 5. Empty your bladder right before bed. I know, Captain Obvious, but it has to be said. 6. Keep your bedroom cool, but you keep warm. Being cold can stimulate your bladder, so be sure to have your bed comfy and warm. Sleep experts recommend a cool, yet comfortable room temperature to help you get your zzz's. The ideas behind the above strategies are to keep your bladder calm and empty, as well as to get the fluid that may accumulate in your legs during the day to be processed by your kidneys BEFORE you go to bed, so you can sleep through the night. 😴

Question #4: Is it OK to pee in the shower?

It depends... If you have an overactive bladder (you pee more than every 2-3 hours, have to rush to get to the bathroom, and/or wake at night to pee more than 1 time a night) then the answer is NO. If you do NOT have an overactive bladder, then the answer is YES, it is OK to pee in the shower. The reason that someone with an overactive bladder SHOULD NOT pee in the shower is that running water is a very common trigger for activating the bladder. Think Pavlovian dog: if every time you are in the shower you allow your bladder to empty, then you are reinforcing the connection between running water and peeing. This could be very inconvenient for you when, for instance, you wash your hands or do the dishes!  The best way to deal with triggers is to identify as many of them as you can and come up with a plan for each one. Here are some common ones to help you get started: Key in the door. This is when you have to run to the bathroom the minute you try opening the door when you arrive home. Next time, before you arrive home, plan to do something other than use the bathroom; maybe open your mail, start dinner, greet your family or pets. This teaches your brain a new habit, so that it doesn't trigger your bladder right as you walk in the door. Feeling cold. If feeling cold is a trigger for you, plan ahead. Wear warmer clothes, a scarf, a hat, gloves etc when you leave the house. Use extra blankets or an electric blanket at night, or turn the heat up another degree. Wear warmer pajamas to bed. Running water. Well, for starters, don't pee in the shower! And when you are around running water, try doing a set of Kegels or a few partial squats before you turn the water on, to activate your pelvic floor muscles ahead of time and help keep your bladder calm. Proximity to a bathroom. Start cutting down on your "Just in case" trips to the bathroom, so that your brain learns that you can be near a bathroom and not need to use it. This also helps teach your bladder to hold more urine, since you won't be emptying it as often. If you need help with your bladder triggers, don't hesitate to reach out. (And if you don't have an overactive bladder, then what you do in the shower is up to you :)

Question #5: Should everyone be doing Kegels for good pelvic health?

NO, Kegels are NOT good for everyone. Now I know this is going to come as a shock to many because Kegels have been touted for so long as a magic bullet for pelvic health. But here's the deal: some people have TOO MUCH TENSION in their pelvic floor muscles, and Kegels would be the exact WRONG exercise for them. And it makes sense when you think about it: in what other part of our body do we assume 1 magic exercise will fix everything?? Our back? Nope. Our knees? Negative. Our hips? No way. So really, it makes perfect sense that Kegels are not a perfect exercise for everybody. So that begs the question: who ARE Kegels good for?? Good pelvic floor muscle function is all about balance: If your muscles are too weak, then they may need strengthening, which means Kegels ARE for you. If they’re too tense, they may need relaxation, which means Kegels are NOT for you. If you're in good pelvic health and you want to keep your muscles strong, Kegels MAY be for you, as long as you can feel the muscles relax after doing a Kegel. If you feel you have tense pelvic floor muscles and would like to learn exercises to help you relax them, visit for an in-depth guide. (And yes, it's free!)

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