Let's Talk About Bladders

Tamara BavendamThe bladder isn't given much thought. Unless it demands our attention, we simply ignore it. And we rarely talk about it… except to make sure our kids use the bathroom before a long car ride. But ignoring the bladder has costs.

Our silence around the bladder has made the subject taboo. Even though 30 million Americans have bladder problems, many are too ashamed to get help. But every woman should know how her bladder works and how to keep it healthy. So from time to time, I'm going to drop in to talk about bladder health, bladder problems, and the treatments that help millions of women have good relationships with their bladders.

But first, let's start with the basics.

Diagram of the urinary systemThe urinary system

Bladder Basics

The bladder is a hollow sac (like a balloon) with muscular walls. It sits behind the pelvic bone.

The bladder is part of the urinary system, which includes two kidneys, two ureters, a bladder, and a urethra. The kidneys take waste and water out of your blood to make urine. The urine travels down your ureters to the bladder. When you're ready to urinate, the urine empties through the urethra.

Your bladder has two main jobs:

  • Holding urine. The kidneys make urine all the time. The bladder holds this urine until you allow it to empty. The bladder should be able to hold about 12 to 16 ounces of urine, about the same amount of liquid in a can of soda. The pelvic floor muscles and your urethra help keep urine in your bladder.
  • Emptying urine. When you are ready to go, the bladder wall muscles squeeze the urine from the bladder into the urethra and out of the body.

Normally, your bladder signals you when it's almost full. This signal gets stronger until you find a bathroom. How often you need to urinate depends on how quickly your kidneys make urine. Most people go every three to four hours while awake. Once asleep, most people wake up to urinate no more than one time during the night.

Diagram of the female bladderThe female bladder

Common Bladder Problems

Because we don't talk about the bladder, many people don't know that bladder problems are very common. Common problems include:

  • Needing to go eight or more times during the day, or frequency.
  • Getting up to go at night, or nocturia.
  • Having a very strong need to go and fearing you might not make it to the bathroom in time, or urgency.
  • Unwanted loss of urine from your bladder, or urinary incontinence. Urgency incontinence is when you can't get to the bathroom in time. Stress incontinence is when you leak urine because of physical stress, such as coughing, sneezing, running, jumping, or lifting. You can have both types.

Many women feel ashamed of their bladder problems. Others believe bladder problems are a normal and unavoidable part of aging. Instead of getting help, women may adapt their life around their bladder by changing their routine to be closer to a bathroom, cutting out physical activities that make them leak, or avoiding social gatherings for fear of an accident.

These changes may seem easier than getting help. But they have health costs. For example, cutting out physical activity may lead to weight gain and muscle weakness.

Don't let bladder problems rule your life. They are not an unavoidable part of being a woman or getting older. If you are experiencing bladder problems, talk to your health care provider about what you can do to treat them.

Let's pay more attention to the bladder and keep it — and us — healthier in the years to come. Learn more about bladder health from this Bladder Health Guide.

About the author

Tamara Bavendam

Tamara Bavendam, M.D., M.S. is senior advisor for Women’s Urologic Health at the NIH. Her career has focused on reducing the impact of lower urinary tract conditions on women. She is a project scientist for the Prevention of Lower Urinary Tract Symptoms (PLUS) Research Consortium.